17h36 – Overdoses and suicides further reduce life expectancy in the United States

Life expectancy has continued to decline in the United States in 2017 compared to 2014, a historical deterioration mainly due to the drug overdose crisis, but also to the increase in the number of suicides, according to published health statistics Thursday.

"This is the first time we have seen a downward trend since the great flu epidemic of 1918," says Robert Anderson, head of mortality statistics at the National Center for Health Statistics, who told AFP published the new figures. While stating that the decline was much stronger in 1918.

In 2017, life expectancy at birth was 76.1 years for men and 81.1 years for women. The average for the population was 78.6 years, compared to 78.9 in 2014.

That's three and a half years less than across the border in Canada, which is also affected by overdoses.

"These statistics alert us to the fact that we are losing too many Americans too often for preventable causes," said the director of the Centers for Disease Control and Prevention, Robert Redfield, adding that life expectancy was a indicator of the general state of health of the United States.

The scourge of drug overdoses began in the early 2000s, its intensity accelerating for four years.

In 2017, about 70,000 Americans died of drug overdoses, 10% more than in 2016.

In terms of deaths, Robert Anderson likens this to the peak of the AIDS epidemic, about 50,000 deaths in 1995. "We are a developed country, life expectancy is expected to increase, not decrease," he says.

Among the 35 OECD countries, only Iceland has recently seen life expectancy decline over three years, according to figures up to 2016. Elsewhere, it has increased or stagnated.

Suicides have also continued to increase in 2017 in the United States, reaching 47,000 deaths. Since 1999, the suicide rate has increased by 33%.

"We have a lot of work ahead of us to reverse these trends," said congressional Congressman Bill Foster.

– Opiates –

There are two categories of overdose: non-opioid drugs, such as cocaine, methamphetamine, and other psychostimulants, including MDMA. About 27,000 dead.

The increase is largely due to the second category: opiates.

This includes heroin, morphine, and so-called semi-synthetic opiates such as oxycodone, a prescription painkiller but diverted to the black market, with the help of complicit doctors and labs who claim to ignore the problem, and who is often the gateway to addiction.

Lately, the majority of deaths came from a new generation: synthetic opiates, mainly fentanyl, dozens of times more potent than heroin, where a dosage error can be fatal – 28,000 Americans were killed in 2017 by fentanyl or equivalent drugs.

"The opiate market is now completely dominated by fentanyl," says Joshua Sharfstein, a former Maryland health official at Johns Hopkins University in the Washington Post today.

The singer Prince is dead. The product was used to execute a convict in August in Nebraska. These substances are easy to ship by mail because a small amount, slipped into an envelope, enough.

The rate of deaths from synthetic opiates had doubled from 2015 to 2016. Last year, it increased "only" by 45%.

This is the relative note of hope contained in the figures of 2017: the number of overdoses continues to grow, but at a pace less sustained.

Preliminary data for 2018 even suggests that the crisis peaked earlier in the year. "But it's hard to say, we only have data on the quarter of 2018 for now," said Robert Anderson cautiously.

In Staten Island, New York, the doctor Harshal Kirane, director of the service addiction, is careful of any conclusion. "It's encouraging to see the trajectory bend," he told AFP. "But 70,000 dead, it's still hard to digest."

America is not equally struck by the plague. Rural states in the center of the country, from Texas to South Dakota, are relatively spared.

The crisis is acute in New England, in the northeast corner, where overdose deaths provide more than a quarter of organ donations, rivaling road accidents.

It is also very strong in two states of the former industrial belt (Ohio and Pennsylvania) and, above all, the very poor West Virginia, at the head of the sad clbadification with 58 deaths per 100,000 people, against a national average of 22.