The global COVID-19 pandemic dramatically changed the daily lives of most people in high-income countries. The early months of the pandemic saw the closure of schools, bars and restaurants, and severe restrictions on social interactions. The resulting social isolation raised concerns about possible increases in depression and suicide . Similar concerns were expressed about increases in excessive alcohol and other substance use to cope with the stress of the pandemic. Subsequent data showed significant deteriorations in mental health during the pandemic, particularly among women, young people and low-income people. Before the pandemic, rising levels of mortality from alcohol, drugs and suicide, the so-called ’deaths of despair’ , had been well documented in the US.
Some have identified this as a uniquely American phenomenon, however, disaggregating the constituent nations of the United Kingdom highlights some dramatic trends. In recent years, Scotland has seen drug-related deaths and male suicide rates rise in line with increases seen in the US, while alcohol-related deaths have fallen. At the same time, deaths attributable to alcohol have risen steadily in England and Northern Ireland. While tax data suggested there was no notable change in overall UK alcohol consumption during the first two years of the pandemic, individual-level surveys showed an increase in heavier drinking, suggesting greater polarization of drinking behavior in England, although not necessarily in Scotland. Survey data in the US showed more drinking days per month and heavier drinking, particularly for women.
It is not clear whether the dire predictions about increased mortality from alcohol, drugs and suicide, the so-called "deaths of despair" , developed during the pandemic. Some studies suggest little impact on suicide rates, but notable increases in alcohol deaths in the UK in 2020, as well as substantial increases in alcohol and drug-related mortality in the US in 2021 for comparison mortality rates from these three causes across nations to better understand the broader public health impacts of the pandemic.
Goals
The COVID-19 pandemic significantly affected mental health, health-related behaviors such as alcohol and illicit drug use, and the accessibility of health and social care services. How these pandemic shocks affected “despair” -related mortality in different countries is less clear.
This study uses public data to compare alcohol, drug, and suicide deaths in the US and UK to identify similarities or differences in the pandemic’s impact on important non-COVID causes of death across countries. and to consider the public health implications of these trends. .
Study design and methods
Data were taken from publicly available mortality figures for England and Wales, Northern Ireland, Scotland and the United States of America 2001-2021 and analyzed descriptively across age-standardised and age-specific mortality rates for suicide. , alcohol and drug use.
Results
- Alcohol -specific deaths increased in all countries between 2019 and 2021, most notably in the US and, to a lesser extent, in England and Wales.
- Suicide rates did not increase noticeably during the pandemic in any of the nations included.
- Drug- related death rates increased dramatically during the same period in the U.S., but not in other nations.
The shaded gray area represents the pandemic period.
Suicide deaths
Deaths from alcohol and drugs
Conclusions Mortality from ’deaths of despair’ during the pandemic has shown divergent trends between causes and countries. Concerns about rising suicide deaths appear to have been unfounded , while alcohol deaths have increased in the UK and the US and in almost all age groups. Scotland and the US had similarly high levels of drug-related deaths before the pandemic, but different trends during the pandemic highlight the different underlying causes of these drug death epidemics and the importance of adapting policy responses to these. specific contexts. |
Discussion
The COVID-19 pandemic disrupted daily life on an unprecedented scale, closing schools and businesses and restricting social interactions for many months. Concerns about the mental health impacts of social isolation and other disruptions emerged early on, but it is unclear how much this translated into increased non-COVID mortality. We summarize mortality from three causes related to “despair” (alcohol, drugs, suicide) in the US and UK countries during the pandemic and compare them to pre-pandemic trends. Despite these concerns, we found little apparent association between the pandemic and suicide deaths .
The most consistent increase across countries was in alcohol -specific deaths . The US was the only country to see a dramatic increase in drug-related deaths , compounding already very high levels. England and Wales and Northern Ireland experienced slight increases in drug-related deaths in line with previous upward trends, while changes in drug deaths in Scotland remained stable despite a strong upward trend in recent years. These patterns were largely consistent across age groups, with no evidence that younger age groups suffered more.
