What is happening to deaths from alcohol, drugs and suicide

The phrase came from the United States, where deaths from drug overdose, alcohol and suicide rose steeply enough among middle-aged white adults from the late 1990s to reverse the country's mortality improvement — a pattern without parallel in other high-income countries. That much is established. What is mixed is nearly everything else. American overdose deaths peaked around 2023 and have since fallen sharply, for reasons that are argued over: fentanyl supply, naloxone, treatment, or the depletion of the population most at risk. Scotland has drug-death rates several times England's and the highest in Europe; alcohol deaths rose across the United Kingdom during and after the pandemic; suicide trends are flat or falling in most countries and rising in a few. The causal story — economic decline, loss of work, social fragmentation — that gave the phenomenon its name has held up less well than the descriptive one: the deaths are real and geographically specific, but their link to despair as such is weaker than the label implies. Policy evidence is stronger here than in most behavioural fields: minimum unit pricing in Scotland reduced alcohol deaths in a measurable way.

Status

established

Direction

mixed

Would change our view

Two more years of American overdose data settling whether the fall is durable; or a natural experiment separating supply-side causes from social ones.

Trackers

Gaps

Drug-death data on a comparable basis across Europe; alcohol-attributable mortality with consistent definitions; suicide data where registration practice varies.