Our Need for a National Resilience Strategy

Americans are in pain.

From the more than one million that have died from drug overdoses, alcohol, and suicides in the past decade, to the first decrease in life expectancy in more than 20 years. The new report from Trust for America’s Health and Well Being Trust, “Pain in the Nation: The Drug, Alcohol and Suicide Crises and the Need for a National Resilience Strategy,” calls for the need to develop a national strategy to improve resilience in the United States. The report examines current trends and evidence- based and expert-recommended policies, practices, and programs to take a more comprehensive approach to counter these crises.

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The rapid rise of these epidemics over the past 15 years constitute three of the most serious public health crises of this century. The life-and-death consequences of drug and alcohol misuse and suicide have reached urgent levels in many communities. In addition, wide-scale substance misuse and insufficient attention to mental health disorders have broad impact. The added recent dramatic increase of illicit opioids — heroin and its blending with the more potent fentanyl and even more potent carfentanil — have made the immediate situation even more dire and complicated.

While the crises have received much attention — this report finds the actions that have been taken to date are severely inadequate.

The Current Crisis

Drug-related deaths have tripled since 2000 — and were responsible for more than 52,400 deaths in 2015. More than 33,000 of these were from opioids, mainly prescription opioids (pain reducers), heroin and fentanyl.

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Alcohol-induced deaths have reached a 35-year high — growing by 37 percent from 2000 to 2014 — with more than 30,000 Americans dying from liver diseases, alcohol poisoning, and other diseases. The rate for all alcohol-attributable deaths — including alcohol-related motor vehicle, violence and other fatalities — total 88,000 a year.

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Suicides increased by 28 percent from 2000 to 2015, accounting for more than 44,000 deaths a year. Although suicide rates are higher among men, the highest increases have been among middle-aged women (63 percent increase) and girls ages 10 to 14 (200 percent increase).

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A National Resilience Strategy

The report calls for the creation of a National Resilience Strategy — a comprehensive approach to improve the lives of Americans — and addressing the factors that contribute to substance misuse, suicide and other related harms.

The country has long struggled with effective approaches to promoting positive mental and behavioral health — and to effectively manage all forms of pain. The confluence of “despair deaths” are directly related to pervasive issues with how the country views and manages mental health, pain and despair — and without better strategies that focus on preventing problems and providing effective support, services and treatment, the trends are likely to be perpetuated and get worse.

Summary Of Policies And Programs To Reduce Substance Misuse And Improve Well-being

Reducing Drug and Alcohol Misuse and Suicide

1. Opioid Response
– Surveillance
– Evidence-based community prevention programs
– Improving pain treatment and management practices, including responsible
prescribing of prescription opioids
– Increased education and training for providers
– Responsible prescribing of prescription opioids and Prescription Drug
Monitoring Programs
– Public education, safe storage, disposal, and Take Back programs
– Strengthen the “public benefit” considerations of FDA approval practices
– Reducing the harms caused by overdoses and misuse
– Expanding naloxone availability and good Samaritan laws
– Sterile syringe access
– Diversion strategies
– Treatment as prevention

2. Preventing Excessive Drinking
– Pricing, access, and availability
– Reducing under age drinking
– Reducing drinking and driving

3. Preventing Suicides
– National Violent Death Report System
– Statewide suicide prevention plans
– Suicide risk identification training for medical professionals – and improving access to
mental health services
– Limiting access to “hotspots” and lethal means for suicide

Improving Behavioral Health Services to Address Whole Health
  1. Expanding and modernizing behavioral health services
  2. Bolstering the behavioral workforce and expanding access to services in underserved communities
  3. Medication-Assisted Treatment
  4. Maximize Medicare and Medicaid
  5. Align and integrate behavioral health with health care
  6. Focusing on early identification of issues and connections to care
  7. Coordination across health care, behavioral health, and social services
Prioritize Prevention

1. Supporting healthier community and raising a mentally and physically healthier generation of kids
– Multi-sector collaborative partnerships
– Expert networks
– Early childhood strategies
– Modernizing child welfare system
– School-aged tween/teen strategies
– Family opportunity programs
– Economic opportunity initiatives

According to the report, the nation needs much stronger action to counter the rising opioid, alcohol and suicide death trends — and to address the underlying pain, prolonged stress, hopelessness, financial insecurity and other factors that contribute to these crises. Without a more concerted effort, the problems will continue to get worse — and that limited attention on preventing problems in the first place perpetuates a negative cycle.

Now is the time to turn to one another, to put a face to the statistics, to hear and acknowledge one another. Urban, rural, red, blue, rich, poor, coastal, heartland – deaths of despair make no distinctions. In the face of so much suffering and pain in our nation, undercutting all we value as a people, we can and must do something to change the trajectory. Pain in the Nation issues a clarion call to action and highlights the policies and practice changes that are showing promise in communities across the country. The report underscores the need for a National Resilience Strategy – a comprehensive multi-sector approach to promoting positive mental health and well-being for all Americans. A commitment to life that can address the complex conditions and underlying factors that lead to death by alcohol, drugs, and suicide.

Visit paininthenation.org to learn more. 

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