Pain in the Nation 2023: The Epidemics of Alcohol, Drug, and Suicide Deaths

Pain in the Nation is an annual report on the on the alcohol, drug, and suicide deaths crisis in America with proposed solutions. This edition uses data from 2021 and shows that the rate of U.S. deaths due to alcohol, drugs, and suicide climbed 11 percent in 2021. The 2021 data showed such deaths were up across the U.S. population, with the largest increases occurring among certain populations of color as well as people living in the South, West, and rural regions of the country. Deaths due to alcohol, drugs, and suicide have been on the rise for over two decades, doubling over the period from 104,379 deaths in 2011 to 209,225 in 2021. Between 2016 and 2021, the escalation in the rate of drug overdose deaths was more than 60 percent. These increases disproportionately impacted Black and Latino populations. Most of the upturn in deaths due to drug overdose involved opioid overdose, with additional deaths due to cocaine and psychostimulants. In addition, a new and growing threat is xylazine, a tranquilizer approved for veterinary use but mixed with fentanyl to create a highly toxic illicit drug combination. During the last two decades alcohol and suicide deaths have also increased, but not as sharply as drug deaths. This year's report includes a special feature on Youth Mental Health and Well-Being.