'Deaths of despair' from drugs, alcohol and suicide hit young adults hardest

Young adults were more likely than any other age group to die from drugs, alcohol and suicide over the past decade, underscoring the despair Millennials face and the pressure on the health care system to respond to a crisis that shows little sign of abating. 

Drug-related deaths among people 18 to 34 soared 108% between 2007 and 2017, while alcohol deaths were up 69% and suicides increased 35%, according to an analysis out Thursday of the latest federal data by the non-profit Trust for America's Health and Well Being Trust.

The analysis of Centers for Disease Control and Prevention data found the increases for these three "deaths of despair" combined were higher than for Baby Boomers and senior citizens. 

The Millennial generation is typically defined as people born between 1981 and 1996 - so are 23 to 38 years old today - although some definitions include young people born through 2000. They make up about a third of the workforce and the military. 

"There is a critical need for targeted programs that address Millennials’ health, well-being and economic opportunity," says John Auerbach, CEO of the Trust for America's Health and Massachusetts' former health secretary.

He cites "burdensome levels of education debt," the cost of housing and the challenge of building careers during the "great recession" and the opioid crisis. Many Millenials are also parents of young children and their alcohol or drug misuse or poor mental health often has serious impacts on multiple generations of their family says Auerbach. 

When Brittany Rose Hallett of Milton, Wisconsin drank herself to death at 26, her $50,000 student loan debt was "weighing heavy on her mind because it was accruing interest and she couldn’t hold a job to pay it," says her mother, Jenny Hallett. She also couldn't afford health insurance after she aged off her father's health insurance.

"She couldn’t see a way out, so she drank more to 'not feel' as she called it," says Jenny Hallett.

Dennis Hobb, executive director of the Washington, D.C. mental health services non-profit agency, McClendon Center, says the disconnect between mental health and addiction services hurts patients who often have dual diagnoses.

"People start doing drugs and alcohol because it's fun and it’s fun until it isn’t anymore and at that point it's usually too late to stop," says Hobb. "When they become adults, they have to have jobs and they have to play roles in their lives and they never really grow into those roles."  

Treating addiction and mental health separately increases the time it takes to get treatment and reduces the chance it will work. 

"When people are ready for treatment you have to get them into treatment right now, you can't wait," says Hobb. 

When she had insurance, Brittany Hallett had to be reevaluated by a counselor every time she sought treatment to see if she qualified for out patient treatment. By the time she would become eligible, Brittany would change her mind, says Jenny Hallett.

The Trust for America's Health and Well Being Trust study comes as another report out this week found post-Affordable Care Act gains in coverage for treatment of addiction and other health problems has stalled and even eroded in some states.

The report from the non-profit Commonwealth Fund also looked at drug, alcohol and suicide deaths and found states that expanded Medicaid to all of the lowest income residents were far better positioned to provide the overdose reversing medication naloxone and to make other policy changes to slow the cycle of addiction. These include West Virginia's use of Medicaid to cover costly treatment for babies born addicted.

Addiction and mental health treatment requires a comprehensive approach that includes public education, treatment of people who are incarcerated and training of emergency medical technicians and doctors, says Commonwealth Fund President Dr. David Blumenthal.

Government or private insurance coverage "facilitates many of those pillars and to not have coverage ties one hand behind your back," says Blumenthal. 

The ACA covers mental health and addiction services, although some of the plans the Trump administration exempted from the health law may not, says Blumenthal. 

Read more on alcohol, drugs and suicide

Alcohol is killing more people, and younger. The biggest increases are among women

Fixes for the US drinking problem are hard to sell

Life after a life of addiction 

Preteen suicides are rare, but numbers are on the rise

Among the possible solutions:   

• Coordinated health care coverage. The Commonwealth Fund says expanding Medicaid to all state residents below the poverty line, enhancing subsidies to help people afford insurance on the ACA exchanges, and improving how providers are paid in private plans will improve access to care. 

•Access to mental health, addiction treatment. Benjamin Miller, chief operating officer at the Well Being Trust, recommends policy changes that reward primary care doctors who add mental health workers to their practices. Schools, he says, also need mental health workers to to identify and help students in need.

•Childhood trauma. The Trust for America's Health and Well Being Trust's report stresses the importance of prevention and treatment of childhood trauma. Adds Miller, "Let’s properly invest in prevention so that the next generation can be the generation that helps turn the tide."

After Brittany Hallett's boyfriend broke up with her, she moved in with her mother and began having "hallucinations of zombies trying to get into our house," caused by her alcohol detox.  

Despite several efforts to quit drinking, Hallett developed pancreatitis and her liver was so scarred, the blood backed up into the veins of her esophagus. They could have burst at anytime and killed her instantly, her mother says. 

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One emergency room doctor told Jenny Hallett that her daughter had the highest blood alcohol concentration he had seen anyone survive at .62. 

Jenny Hallett says Brittany's organs just finally shut down. A few weeks after she died, Hallett received a letter addressed to Brittany saying she had been denied getting for Social Security Administration disability coverage. She thought being on disability would at least freeze her student loan interest.

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