Why are alcohol- and drug-related deaths rising in the U.S. and not elsewhere?

University of Pennsylvania Health & Sciences News|February 3, 2022 ​MD Linx

In the United States, mortality is rising, with more deaths than ever attributable to alcohol and drug poisoning and to suicide, in conjunction with increasing rates of obesity and type 2 diabetes. Yet many other wealthy nations have seen rates of these so-called “deaths of despair” decreasing.
“In Europe, Canada, Japan, Australia, they’re not having a problem or they’re having it to a much smaller degree,” says Penn neuroscientist Peter Sterling. “Here, we’re having a massive problem.” He and colleague Michael Platt wanted to understand the disparity and what the U.S. might learn.
“They have not seen this meteoric rise in people dying from drugs, smoking, eating badly, deaths through dislocation, suicide,” says Platt, the James S. Riepe Penn Integrates Knowledge University Professor. “We wanted to isolate what’s different between those countries and ours.”
In a new JAMA Psychiatry paper, the researchers look at the matter through the lens of neuroscience, anthropology, and primatology, finding that, unlike in the U.S., the countries they analyzed offer communal assistance at every life stage, from universal child care to affordable college. Such support, the researchers conclude, protects individuals and families in the long term.
Countering conclusions
Platt and Sterling have known each other for decades, and since Platt arrived at Penn in 2015 have corresponded frequently. “We seem to share similar concerns,” Platt says. “We’d been looking at the epidemic in deaths of despair the past few years. It hit home personally for me because where I grew up in a gritty part of Cleveland has been pretty devastated.”
Then, in March 2021, the National Academy of Sciences (NAS) published a report on the subject, comparing the U.S. to 16 wealthy nations, including Canada, Australia, Japan, and countries in Western Europe. “It was this 476-page document,” Sterling says. “They don’t ask in the whole 476 pages, what are these other places doing? How come they don’t have this problem?”
The NAS report drew a twofold conclusion, Platt says. “Basically, it acknowledged that this is an epidemic, but the prescription is very mild. ‘We need more research, and we can’t define despair.’ But how do you create an animal model of despair? I was dismayed.”
Platt and Sterling decided to take a closer look themselves. First, they asked, from a neurological perspective, what do humans need to thrive? Second, they wondered whether understanding that could explain why deaths of despair were rising in the U.S. but not in these culturally, politically, and economically equivalent countries. They turned to the neurological question first.

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