Dead Reckoning

Preliminary data indicates that South Dakota is experiencing a surge in deaths of despair that shows no signs of slowing down.

According to the “Pain in the Nation: Alcohol, Drug and Suicide Epidemics Report” issued by Well Being Trust, drug-induced deaths in South Dakota rose 56% between 2018 and 2019. Also, opioid overdose deaths in South Dakota increased by 29% during that time frame.

Nationally, the rate of drug-induced deaths increased 5% between 2018 and 2019, with 33 states and the District of Columbia specifically showing an increase, the report showed.

Well Being Trust and Trust for America’s Health have issued this annual report on deaths of despair for the last three years, Ben Miller, chief strategy officer for Well Being Trust, told the Press & Dakotan.

The group is a national foundation dedicated to raising awareness about and improving mental, social and spiritual health.

“Unfortunately the 56% increase in drug-induced deaths was the largest in the nation,” he said. “And so while South Dakota has smaller numbers, the percentage of increase based on those numbers was substantially higher than other states.”

In fact, South Dakota has the second-lowest numbers of drug-induced deaths at 11.0 per 100,000, while neighboring Nebraska has the lowest at 9.5 per 100,000.

In 2019, South Dakota lost 453 lives to alcohol, drugs and suicide combined, which is a smaller number of deaths than in other more populous state, Miller noted.

“We run the risk of becoming desensitized to these data because — what is 453 lives? What does that mean?” he said. “But as you’re working with communities, you see that these are friends, these are families who’ve lost loved one, and the ripple effect of one lost life is likely to have an intergenerational impact.”

More data is set to be released by the CDC in the fall, but the upward trend of the data released so far, indicates that 2020 numbers of deaths of despair would again increase, he said.

“If you look at the available data from the Centers for Disease Control and prevention (CDC), we can we can intimate or suggest that the trends that we saw in 2019 are likely to be worse in 2020 because of COVID,” Miller said.

According to the report, other data sources, including ABC News; Household Pulse Survey, National Center for Health Statistics indicated that the U.S. experienced a 27% increase in drug-overdose deaths from October 2019-September 2020.

Until more information is published, that is about the only data point to which Miller said he could conclusively point to say, “It’s worse.”

As far as the manner of death for drug-induced deaths, Miller specifically noted opioids, pointing to the national problem with opioid addiction and death over the last several years.

“Interestingly enough, in a lot of states, we have seen an improvement in opioid overdose deaths,” he said. “In South Dakota, you did see a slight increase, a 9% increase, in opioid overdose. But we also have noticed this really disturbing trend of synthetic opioids that are emerging.”

The data for synthetic opioids (fentanyl and carfentanil) for South Dakota is not yet available, but the general trend nationally is that more people are now dying from synthetic opioids and psychostimulants, including cocaine and methamphetamnine, than they are from opioid overdose, Miller said.

He also pointed to three elements that any plan to address these issues must include: prioritizing prevention; addressing ethnic, racial and cultural disparities and expanding mental-health services.

“We’ve got to figure out some way as a nation to reduce the traumatic experiences that many of our communities are experiencing,” Miller said. “Our American Indian population has experienced trauma repeatedly over and over and over again — that intergenerational piece. There has to be a way that we continue to reduce the trauma.”

Trauma is a risk factor for suicide and substance abuse, he said.

“Teaching children, (through their schools), how to manage or regulate their emotions, as well as how to talk about addiction with their friends and colleagues, is a major strategy that we want to pursue,” he said. “Also, there are substantial disparities that we’re seeing now emerge from drug overdose.”

Nationally, the report showed a 15% increase in drug overdose for blacks and Latinos, an 11% increase for American Indians, a 10% increase of Asian Americans and a 10% increase for whites, Miller said.

“That’s a statistical significance,” he said. “We need some type of plan that addresses those disparities. One size will not fit all and whatever we did around opioid use disorder or addiction for the white community has not worked for the other communities of color.”

Finally, mental health services must be more integrated into our communities, Miller said.

“Mental health services need to be more rapidly available — from your feed store to where you’re getting your haircut to your primary care practice, to wherever people show up,” he said.

But if we look at the trends, we are going in the wrong direction as a country, Miller said.

“We’re losing more lives to preventable causes, more lives to drug alcohol and suicide than we should,” he said. “One life lost is a life lost to many (others), and that we must aggressively began to take on solutions.”

The Press & Dakotan contacted Yankton’s Lewis & Clark Behavioral Health Service regarding Miller’s recommendations, and were told that the organization is working on a grant application to address many of the mental health concerns mentioned in this article.

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