Drugs and Despair in America: Does Anyone Notice?

“The greatest hazard of all, losing one’s self, can occur very quietly in the world, as if it were nothing at all. No other loss can occur so quietly; any other loss - an arm, a leg, five dollars, a wife, etc. - is sure to be noticed.”    --Søren Kierkegaard

Death by despair—can a person actually die from despair?  Brought so low by hurt and heartache, by economic struggles and mental illness, by addiction and unemployment that the cause of one’s death is finally despair. Believing no one cares for you, about you, that your one life does not matter anymore.  Convinced you are just not worth it. Spiraling down into alcoholism, drug abuse, and depression. “When I am gone, no one will notice.”

Death by despair--the term used by some social scientists to describe an alarming state and nationwide increase in the number of deaths by suicide, liver disease, alcohol poisoning and drug overdose among one specific group of Americans: white, non-Hispanic men, middle aged, with a high school education or less.

So, for example, last year in Massachusetts, almost 2,000 people died from opioid-related drug overdoses; 1,200 from the above described demographic. That 2,000 figure is up 26 percent from 2014, a six fold increase since 2000. The hot spots for drug deaths are ground zero for poverty and joblessness in the Bay State: 141 deaths in Boston, 56 in Lowell, 25 in Lawrence, 45 in Lynn, 48 in New Bedford, 41 in Quincy, 41 in Springfield, and 76 in Worcester.         

This trend is happening nationwide too. In a groundbreaking but largely under-reported 2015 study about life expectancy rates among Americans, Princeton University economists Angus Deaton and Anne Case made a startling discovery. Since 1999, while every other age, racial and ethnic group in the United States has seen a rise in life expectancy, white middle aged men, ages 45 to 54, are dying at increasing rates. Deaths by alcohol and drug poisoning in this group are up by nearly 30 percent; chronic liver diseases and cirrhosis, 20 percent; suicides, up by 24 percent.  In trying to find a historic precedent, Deaton said, “Only H.I.V./AIDS in contemporary times has done anything like this.”

Deaton and Case name two trends that might explain the phenomena: financial distress and social isolation. Real wages for the group have dropped by 19 percent since 1999 and the number of manufacturing jobs, once a dependable bulwark for this demographic, has dropped precipitously since 2000. 

And so the notion that you’d work in the same factory your father and grandfather did, provide for your family with a decent union job and middle class wages: that hope slowly fades and then dies.  And so you get sick but have little or no health insurance; the bills mount, you lose your job and turn to drugs or alcohol to numb the pain.  And so cheap drugs like heroin are easily available, sometimes cheaper than booze, and you use that substance to escape, if only for a few hours on the couch. And so businesses in town begin to close one by one; the social groups which once tied neighbor to neighbor—churches, clubs, bowling leagues, the Rotary, the Lions Club—these close too.  And so you live in a city where the young and well educated are moving in and housing costs skyrocket and you can no longer afford the rent, not on a minimum wage job.

And so…you despair.

The worst part of despair? Invisibility, the fear that no one sees you anymore. You’ve slipped through the cracks, unmoored from community, forgotten.  I imagine such despair can lead to great anger directed outward, maybe even seeking a messiah like figure who can rescue you and the memory of who you once were.  I imagine enclaves of despair in city neighborhoods and once proud mill towns, now lost in the hustle and the bustle and the pace of this brave new world we now call home.

As a nation, in these perilous times, we’ve got a lot to do to repair our social fabric across all demographic groups. We’ve got lots of folks who feel left out and who therefore despair. Faith teaches this: one of our main jobs as children of God and neighbors is to seek out the lost and lonely, the overlooked and powerless, folks left behind.

The antidote to despair is always hope and hope happens when someone takes an interest in our well being, takes the time to reach out. In church basements where addicts help other addicts.  In houses of worship where the hungry are fed. In the halls of government where the brave and the compassionate actually speak up on behalf of people other than the well connected and the powerful.

The despairing are out there, waiting for some one, any one, for you, me, to care.  Will we notice those who despair? I hope our answer is, “Yes”