Journal Article

The contemporary American drug overdose epidemic in international perspective

Drug overdose mortality has reached unprecedented levels in the United States, more than tripling over the past two decades. This study situates the contemporary American drug overdose epidemic in broader perspective by comparing the US to 17 other high-income countries. Vital statistics data covering 1994–2015 are drawn from various sources including the Human Mortality Database and the WHO Mortality Database. The US now has the highest drug overdose death rates—3.5 times higher on average—among high-income countries. This is a fairly recent phenomenon; in the late 1990s and early 2000s, Nordic countries had the highest drug overdose death rates. Drug overdose is increasingly important for the US life expectancy shortfall. In 2013, drug overdose accounted for 12 percent and 8 percent of the average life expectancy gap for men and women, respectively, between the US and comparator countries. The increase in this gap between 2003 and 2013 would have been one-fifth (men) and one-third (women) smaller on average in the absence of drug overdose. Potential drivers of the US’s strikingly elevated drug overdose mortality levels include a variety of factors such as health care provision and financing, institutional structures, and cultural attitudes toward pain and the medical establishment.

Published in a peer-reviewed journal of the Population Council.