Talking about it, part II
So now I need to tell you all something hard about the people you know who are misusing substances.
They can die too soon.
These should be preventable deaths, but instead substance misuse is a leading cause of accidental death, and death from disease, and death in general in the U.S. In part it is because of the breakdown of our mental health and medical care systems, and in part it is due the the escalating rates of substance use and its associated risk.
There are overdoses, now more than ever, with street drugs being laced with fentanyl or animal traquilizers or liquid nitrogen or whatever the latest fad is. As the pace of our world speeds up, so do the cycles of development of the new and trendy drugs - more fads, more new things to try, more often.
Because it is legal and a regular part of social occasions for time immemorial, we forget that alcohol too can be a killer. From 2010 to 2019:
One in eight deaths of U.S. adults 20-64 was attributable to alcohol
One in five deaths of adults 20-49 was attributable to alcohol.
From a 2022 Journal of the American Medical Association (JAMA) study here.
It is not that hard to overdose on alcohol, or reach a percentage of alcohol in the blood that constitutes poisoning, causing an individual to die quickly instead of due to a chronic condition. The high-risk warning level is set at 0.08 percent blood alcohol concentration: for women, four drinks in two hours, for men, five. (https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dangers-of-alcohol-overdose) For chronic heavy drinkers, it is very hard to tell when premature death may come knocking. Bear in mind that each individual's biology may have a very different reaction to a prescribed amount of alcohol, depending on any pre-existing conditions and especially if there are recreational or prescription drugs in their system.
That is how it was for Pete. He was part of a growing national trend in the past two-plus decades. Between 2000 and 2019 (pre-pandemic), in adults over 25, the annual number of alcohol and opioid poisoning deaths increased from 11,385 to 53,783, a 4.7-fold increase overall. Broken down, the data show:
a 6.4-fold increase in opioid poisoning deaths,
a 4.6-fold increase in combined alcohol and opioid poisoning deaths, and,
a 2.1-fold increase in alcohol poisoning deaths.
From a 2022 study published in BMC Medicine here.
While I was aware that Pete was drinking, and saw the havoc it wreaked in his life, I did not know how much or anticipate that it would kill him so soon, at 59. Most of his life he was an athlete and enthusiastically healthy eater, and these habits were readily apparent. His drinking habits were hidden and difficult to know about, for those like me not physically present in his everyday life. As years went on, he made choices that increased his isolation: moving to more and more rural areas, further from long-time friends and family. Phone calls replaced visits. Whether those choices allowed the drinking to accelerate, or the acceleration of his drinking contributed to those choices, it is hard to say what the driving factor may have been but surely both were true. When he lost a job and struggled to find the next one, while living on ten acres of Minnesota's north woods thirty miles from the nearest town, with difficult travel during the nearly six months of winter, the isolation became profound to my eyes.
If you have someone in your life whose substance use is a concern, and a growing concern, or that person is yourself, my strong advice to you is DO NOT WAIT. Do not wait to address addiction. No one knows how much time is available to avoid a death.
Do not be like me and wait too long. Because you will regret it.
