• Christopher J Ruhm.
• Frank Batten School of Leadership and Public Policy, University of Virginia, Charlottesville, Virginia. Electronic address: ruhm@virginia.edu.
• Am J Prev Med. 2018 Jul 1; 55 (1): 111811-18.

IntroductionIncreasing mortality rates among midlife non-Hispanic whites have been identified but are not well understood.MethodsVital statistics data were used in 2017 to examine to what extent increases in mortality rates and years of potential life lost among midlife non-Hispanic whites from 1999 to 2015 are correlated with increases in fatal overdoses and specific drug categories.ResultsThe mortality rate rose by 21.2 per 100,000 people and years of potential life lost by 712,000 years from 1999 to 2015 for non-Hispanic whites aged 22-56 years; 63% of the mortality rate and 76% of the years of potential life lost increase occurred among individuals aged 22-39 years. For males, 92% of the mortality rate and 98% of the years of potential life lost growth was among individuals aged 22-39 years. The increases attributed to drug poisonings were: 26.4 per 100,000 people and 854,000 years, 51% and 64% of which occurred among individuals aged 22-39 years. Illicit opioids without involvement of prescription opioids were involved in mortality rate and years of potential life lost increases of 13.9 (95% CI=13.2, 14.7) per 100,000 people and 489,000 (95% CI=463,000, 515,000) years. For prescription opioids without illicit opioid involvement, the growth was 7.8 (95% CI=7.3, 8.3) per 100,000 people and 230,000 (95% CI=214,000, 246,000) years. Illicit opioids played a key role for individuals aged 22-39 years, especially males. Mortality rate and years of potential life lost declined dramatically for nonwhites or Hispanics aged 22-56 years, with only small increases because of drug deaths.ConclusionsGrowth in fatal overdoses was strongly correlated with increased mortality rate and years of potential life lost for midlife non-Hispanic whites from 1999 to 2015, with a particularly large rise for young adults, especially males, and illicit opioids contributing most to this association.Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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