State Health Improvement Plan (SHIP) 2021-2025
ADDICTION MENTAL HEALTH AND SUICIDE
Mental health has a huge impact on how people relate to others, make decisions, and handle stress. A clear relationship exists between mental health issues and substance misuse. Each can lead to the other. In fact, one in four people with a serious mental illness also has a substance use disorder, according to the National Institute on Drug Abuse. In 2020, as part of the mental issue, suicide was among the top 9 leading causes of death for people ages 10-64 in the United States. Many factors can increase the risk for suicide or protect against it. The financial toll of suicide on society is also costly.
The national cost of suicides and suicide attempts is over $70 billion per year in lifetime medical and work-loss costs alone (- Centers for Disease Control and Prevention and School of Public Health and Tropical Medicine, Tulane).
The ADH and its partners will address these issues by implementing interventions to lower suicide rates and the prevalence of tobacco, alcohol, and drug use (e.g., opioid) in Arkansas.
The use of tobacco is the most preventable cause of death in Arkansas. Tobacco use kills close to 5,000 people in Arkansas each year, which makes it one of the biggest causes of short life expectancy in our state. By tobacco use, we mean smoking cigarettes, cigars, pipes, e-cigarettes, or using any form of smokeless tobacco.
Smoking damages nearly every organ of the body and can affect non-smokers as well. Exposure to secondhand smoke is responsible for 41,000 deaths among U.S. adults every year.
While the use of cigarettes, cigars, pipe tobacco and smokeless tobacco has declined among youth in recent years, this decline has been countered with increases in the use of other emerging tobacco products, especially electronic cigarettes. Commonly known as e-cigs or vape pens, electronic cigarettes are now the most commonly used tobacco product among youth, surpassing cigarettes in 2014.
Youth are particularly vulnerable to peer pressure and tobacco companies’ strategies to get tobacco users hooked early, such as flavored tobacco products. Nearly 9 in 10 cigarette smokers have their first cigarette by age 18. Each day in the U.S., about 1,600 youth smoke their first cigarette, and 200 youth become everyday smokers. An estimated 5.6 million youth under age 18 today will die prematurely from diseases caused by long-term tobacco use later in life. Further, smoking is responsible for approximately $170 billion in health care expenditures and an additional $156 billion in lost productivity annually in the U.S.
Excessive drinking comes with short- and long-term risks. Short-term risks include:
Long-term risks include:
Death rates from excessive drinking increased significantly between 2000 and 2019. An estimated 95,000 people die every year from alcohol-attributable causes, making it the third-leading preventable cause of death in the United States, behind tobacco and poor diet/physical inactivity. Excessive drinking is responsible for an average of 261 deaths per day, which is equal to 2.8 million years of potential life lost per year.
Drug misuse and addiction have become serious public health issues for the United States over the past twenty years. The misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a medical complaint such as pain; or taking a medication to get high. Addiction is a brain disease that causes a person to continuously uses drugs even though this may create life problem like keeping relationships, or managing their social and professional responsibilities. A person with the disease of addiction is often described as having a substance use disorder. Both misuse and addiction carry the risk of overdose and death. Over 500,000 people have died as a result of drug overdoses since 1999. In 2016, over 60,000 Americans died from drug overdoses making overdoses cause more deaths than motor vehicle crashes. This is more than any other previous year on record. Multiple types of drugs are creating the overall problem with drug misuse and addiction. Prescription opioids and illicit opioids (like heroin and illicit fentanyl) are the most common and potentially most deadly. In 2016, 66% of all drug overdose deaths in the United States were due to an opioid.
Just like the United States, Arkansas has also seen a rise in drug overdoses in recent years. In 2018, 426 Arkansans died from a drug overdose and opioids were the most widely identified drug. Methamphetamine (“Meth”), benzodiazepines (“Benzos”), and antidepressants are other commonly misused drugs in our state. In 2017, the prescribing rate for opioids in Arkansas was the second highest in the nation. There were more prescriptions for opioids in the state than there were people. High levels of prescription opioids available create more opportunities for misuse and addiction among those at risk.
The biggest danger of drug use is the likelihood of drug overdose or death, but there are also other dangers. Using drugs can spread infections. Infections happen when harmful germs get into your body and make you sick. Infections like Hepatitis C virus (HCV, a liver infection), human immunodeficiency virus (HIV), endocarditis (heart valve infection), osteomyelitis (bone infection), and many others are spread by drug use. There are many known ways to use drugs. Injecting drugs with needles into the vein (“shooting up”) is becoming more frequent. Shooting up drugs and sharing injection equipment (needles, cottons, and/or cookers) is a common way to get these infections. It also can put someone at risk for an overdose or death. These infections can kill and they are on the rise in Arkansas and in the United States.
A healthy mental state is essential to overall positive health and well-being. In some cases, poor mental health may lead to suicide. Frequent mental distress is associated with smoking, physical inactivity, housing insecurity, food insecurity and insufficient sleep.
Mental health disorders and substance use disorders are the most significant risk factors for suicidal behaviors. In addition, environmental factors such as stressful life events and access to lethal means such as firearms or drugs may increase the risk of suicide. Previous suicide attempts and a family history of suicide are also important risk factors.
Suicide is when someone dies by intentionally hurting themselves. Death from suicide is the leading injury-related cause of death in Arkansas. In 2017, more than 600 Arkansans died from suicide. The most common means of suicide are from firearms, suffocation, and poisoning. The chart below shows the rates of suicide in Arkansas are consistently higher when compared to the United States.
Unfortunately, the rates of suicide in Arkansas are increasing. Over the last 10 years, the number of people who died from suicide went from 447 in 2008 to 631 in 2017.