More than one million people have died from drugs, alcohol and suicide over the past decade. If these trends continue, the death rate could grow to claim two million more lives by 2025.
We must expand evidence-based efforts and deploy a full-scale strategy against opioid and alcohol misuse and rising suicide rates.
We need a National Resilience Strategy that takes a comprehensive approach, including prevention, early identification of issues and effective treatment.
In 2017, 151,800 Americans died from drug- or alcohol-induced causes or suicide. That equates to 416 deaths per day, 17 per hour and one person dying every 3.5 minutes. With additional lives hanging in the balance, we must act. There are evidence-based solutions that can help slow the crises.
Accessibility of alcohol
Abuse of prescription opioids
Scarce, outmoded treatment options
Dangerous synthetic opioids
Risky social norms
Limited access to mental health expertise
Easy access to means for suicide
No single program or policy will be a cure-all. United in a comprehensive systems approach, policies and interventions can address the underlying causes of these “deaths of despair” — and make even our most vulnerable resilient.
multi-sector, place-based partnerships that support community efforts.
adverse childhood events with early childhood and family supports.
school-based policies that pay lasting dividends.
supports for families' core needs and household security.
Sobriety Treatment and Recovery Teams is a Kentucky-based program for families with parental substance use disorders, and issues of child abuse and/or neglect, that helps parents achieve sobriety and keep children with parents when it is possible and safe.
Mothers who participated in START achieved sobriety at nearly twice the rate of mothers treated without START (66 percent and 37 percent, respectively). Children in families served by START were half as likely to be placed in state custody as compared with children in a matched control group (21 percent and 42 percent, respectively). For every dollar spent on START, Kentucky avoided spending $2.22 on foster care. In Kentucky, areas have reported that demand for the program is higher than the available services.
The Life Skills Training (LST) Program is focused on middle school students and includes a “booster” program for high school students. LST is designed to address a wide range of risk and protective factors by teaching general, personal and social skills, along with drug resistance skills and normative education. The program has been extensively tested over the past 20 years and has been found to reduce the prevalence of tobacco, alcohol and illicit drug use relative to controls by 50 to 87 percent. When combined with booster sessions, LST was shown to reduce the prevalence of long-term substance misuse by as much as 66 percent, with benefits still in place beyond the high school years.
programs that identify early warning signs.
those in need of assistance.
people to essential services.
Prescription Drug Monitoring Programs (PDMP) are database tools that track dispensed controlled substances in a state. For instance, in Kentucky, mandatory requirements increased use five-fold; multiple prescriptions were reduced by more than half; and opioid prescribing was reduced by around 12 percent. In Tennessee, PDMP use increased by more than 400 percent; opioid prescribing decreased by 7 percent within one year; and patients being able to fill multiple overlapping prescriptions decreased by 31 percent.
The Garrett Lee Smith program uses a “gatekeeper” approach, where adults, tweens and teens interact with community group leaders, coaches and faith leaders to help identify concerns — such as risks and signs of mental illness, substance misuse or suicidal thoughts — and connect individuals to appropriate supports. Communities that implemented this program had significantly fewer suicides (1.3 per 100,000 fewer deaths) among 10- to 24-year-olds, and a review found the program helped prevent more than 79,000 suicide attempts from 2007 to 2010.
Healthcare systems are often in a unique place to bring about clinical change that can impact countless individuals seeking care. We need better integration within healthcare so people can have their needs met in a more seamless and timely fashion. Trying harder is not going to be enough – we need systems-level change.Benjamin F. Miller, PsyD
Chief Strategy Officer, Well Being Trust
on whole health, the interconnections between physical and mental health, and the outside factors that influence well-being.
pain management and treatment.
substance use disorder treatment services.
stigma, a major barrier to mental-health reform.
Crittenton Children’s Center at Saint Luke’s Health System in Kansas City, Missouri, developed Head Start-Trauma Smart (HSTS) to help children, ages 3 to 5, handle complex trauma — violence, arrest/incarceration, substance misuse, homelessness, death and others. HSTS therapists provide training for all of the people (caregivers, Head Start staff, daycare providers, neighbors, grandparents, etc.) who are part of a child’s life to help the child identify and share feelings; and classroom consultation to teachers and children, during which the therapist is able to bring skill-based training into the classroom. The model also includes intensive individual trauma-focused intervention, short therapy sessions and peer-based mentoring for teachers and others to help sustain progress.
Recovery High Schools are designed for students recovering from a substance use disorder as part of the continuum of recovery care. These schools offer programs that uniquely meet the education and therapeutic challenges faced by those in recovery and who were struggling to succeed in traditional school settings. They provide an alternative to the justice system and delinquency, and are a way to reduce school violence while improving education attainment, typically by providing intensive therapeutic and peer-recovery support and an academic curriculum with structured recovery-focused programming. A study found that complete avoidance of alcohol or other drugs increased from 20 percent during the 90 days before entering the school to 56 percent after.
If we can strengthen family and social relationships, improve the social-emotional development of America's young people, and reduce early childhood trauma in our nation, we can reverse many of the dynamics fueling the rise in despair deaths.John Auerbach,
President and CEO of TFAH
silos between health, mental health, social services, and the education and child care sectors.
trauma-informed systems to provide respectful, sensitive and culturally-competent care to people who have experienced trauma.
Recovery-Oriented Systems of Care (ROSC) focus on addressing disorders through a chronic care management model that includes longer-term, outpatient care, recovery housing, and recovery coaching and management checkups. These systems are meant to be “easy to navigate for people seeking help, transparent in their operations and responsive to the cultural diversity of the communities they serve.”
“Navigators,” such as the Accountable Health Communities (AHC) pilot model, focus on bridging the gap between clinical medical care and community services. They do this by systematically identifying and addressing beneficiaries’ health-related social needs, and assessing whether establishing these linkages can reduce healthcare costs and improve quality of care and outcomes. AHCs address housing instability and quality, food insecurity, utility needs, interpersonal violence and transportation needs.
Drugs, alcohol and suicide have wracked our communities for far too long. We must adopt comprehensive, evidence-based solutions that address those who are most at-risk. Read the full report to learn more about the critical need for a National Resilience Strategy.