The rate of alcohol-related deaths for white women age 35 to 54 has more than doubled since 1999

Six facts about dying young

Over the past year, The Washington Post has explored a historic increase in premature death among white Americans, particularly middle-aged women living in small towns and rural areas. Here are the key findings from The Post’s “Unnatural Causes” series:

1. The nation’s health is deteriorating, with no end in sight. Since the turn of the century, white women have been dying prematurely in a slow-motion crisis driven by decaying health in rural and small-town America, a Washington Post analysis found. While rates of early mortality have continued to fall for women of other races, and have flattened out among white women in big cities, death rates among rural white women in their early 40s, for example, have shot up 47 percent since 1999.

Heavy drinking, suicide and drug overdoses – primarily from opioids – are driving the phenomenon. And though rates of premature death are rising fastest among white women, the effects of ill health are widespread: In 2015, overall life expectancy in the United States dropped for the first time in more than two decades.

2. Prescription drugs play a powerful role in the crisis. And it’s not just opioids. A third of white women who have died of opioid overdose since 1999 also had anti-anxiety drugs known as benzodiazepines in their bloodstreams – a potentially deadly combination, The Post found.

White women who take opioids are particularly likely to be prescribed additional drugs to manage the symptoms of long-term opioid use, The Post found. In addition to anti-anxiety medication, they might get drugs to help them sleep or to ease a condition known as “opioid-induced constipation.” A Post analysis found that nearly 6 in 10 working-age women who take opioids have three or more additional prescriptions.

Meanwhile, The Post found that the suicide rate has risen alongside prescriptions for anti-depressants and other psychiatric drugs, which are often ineffective. “Multiple drugs overload the system in ways we can’t predict,” said Rene Muller, a psychologist at Johns Hopkins.

3. Doctors could be doing more to prevent opioid addiction. A third of Americans who have taken prescription opioids for at least two months say they became hooked on the powerful painkillers, according to a Washington Post-Kaiser Family Foundation survey. But more than 6 in 10 said doctors offered no advice on how or when to stop taking the drugs. And 1 in 5 said doctors provided insufficient information about the risk of side effects, including addiction.

4. The federal government could be doing more, too. The Drug Enforcement Administration initially tried to combat the opioid epidemic by targeting wholesale distributors accused of leaking hundreds of millions of pills a year into the hands of illicit dealers. But in 2012, the drug industry fought back. The DEA virtually abandoned its campaign, shifting to other forms of enforcement. And this year, Congress passed and President Barack Obama signed a measure to take away the DEA’s most potent weapon: The authority to immediately shut down suspicious distribution centers.

Meanwhile, the drug companies have hired some of the best and brightest DEA regulators. At least 42 DEA personnel have taken jobs in the pharmaceutical industry since the campaign against distributors began.

5. But heavy drinking is also a major factor. The rate of alcohol-related deaths for white women age 35 to 54 has more than doubled since 1999, The Post found, accounting for 8 percent of all deaths in this age group. Liver failure has risen alongside dangerous drinking among white women, who report a 40 percent increase in binge drinking since 1997.

Unlike suicides and drug overdoses, alcohol-related liver failure is increasingly striking white women in big cities as well as in rural areas, The Post found.

6. The epidemic of substance abuse is damaging entire communities while destroying individual lives.

In Tecumseh, Okla., where Anna Marrie Jones died at age 54 of cirrhosis, family members buried her alongside friends and relatives who had died in the past decade at ages 46, 52 and 37. Jones had buried her fiance at 55. She had eulogized her best friend, dead at 50 from alcohol-induced cirrhosis.

In Jasper, Ala., opioid painkillers are so enmeshed in the local economy that they’re traded for lawn mowers and school clothes.

In McCreary County, Kentucky, there has been a 75 percent increase in the mortality rate for white women age 35 to 59, one of the highest increases in the nation, The Post found. Separate research at the University of Washington found that McCreary County women are more likely to be obese and to engage in life-shortening behaviors such as binge drinking than in previous generations.

In Farmington Hills, Mich., in the 11th year of her opioid addiction, Amanda Wendler decided to pursue one of the newest treatments for heroin: A monthly shot of a drug called naltrexone, which blocks the effects of opiates on the brain and makes getting high impossible – but also comes with dangerous side effects.

In Chillicothe, Ohio, and surrounding Ross County, 40 people died of overdoses last year, almost all of them opioid related. That number has tripled in the past three years. “It’s the Zombie Apocalypse,” said the local coroner. Read more about Chillicothe.

And in South Charleston, W. Va., officials are starting to focus more resources on “opiate orphans,” who have lost their parents to drugs. Three of the most recent ones live in a small house in South Charleston: Zoie, 10, who believed that her parents had died in their sleep; Arianna, 13, who was just starting to wear her mother’s old makeup; and Zaine, 17, who had been the one to discover his parents dead of a heroin overdose that morning in 2015, and whose grades had been dropping ever since.

5 Responses

  1. I imagine that somehow it’s the fault of prescription opiates that this is happening? If it is its because women are having to self medicate with things like alcohol because they can’t get safer pain medication from their physician!

    • Amen,,,,20 years of wrong diagnose by alll men,,now diabetic ,pancreas destroyed,live expectancy dropped by 10 years,,,,thank u,,,male doctors!!!!MARYW

    • “If it is its because women are having to self medicate with things like alcohol because they can’t get safer pain medication from their physician!”

      Connie, exactly what I was going to say!

  2. Now,,seeing as though i live in the middle of no-where,,,im 52,,,a women,,and I live in wisco,,,I don’t drink,,,don’t ;like the taste of alcohol,,,havent for over 35 years,,but,,,hubby does like his beer,,Sooo occasionally we will go to a small town bar,,,,and sadly this article is kinda right,,,,there are a lot of drinkers in wisco,,,1] its cold here,,,2,,there bored,,3,,its a social thing,,,u know u live in the middle of no-where,,,going to the local tavern u meet up w/people,,,its a way of hanging out w/your friends,,,interaction type thing,,,since u r living in the middle of no-where u don’t see people all that much,,,Also we are a bunch of farmers,,,farming is a seasonal thing,,verses the 9 to 5,,,,u make your own hours,, your only time clock is mother nature,,,,Mother Nature is NOT 9 to 5 thank god,,soo we have more time then your average joe doing the 9 top 5,,, Sooo I can see how this could be true,,,jmo,,mary

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