Deaths from drug misuse, alcohol use and suicide, often referred to as deaths of despair, are on the rise.  New research, by the Strategy Unit and the Health Foundation, show how deaths rates vary by sex and socio-economic deprivation, and how these rates changed during and after the COVID-19 pandemic.

Each year, about 3% of all deaths in England are attributed to the direct or indirect effects of alcohol consumption, to drug misuse or to suicide. Rates are on the rise. And, because these deaths often occur in young adulthood and middle age, they now account for 1 in every 6 of all years of life lost.  
Men and those living in more deprived areas are at greater risk.  During the COVID-19 pandemic, rates rose for everyone, but increases were more notable amongst women.  By 2022 rates had returned to pre-pandemic trends.

Similar patterns have been described in many other countries.  The phenomenon was first noted in the US in 2015. The term ‘deaths of despair’ was coined to describe it, recognising the suffering that underlay such deaths.  Although there is fierce debate about the underlying drivers, the raw statistics are difficult to argue with.  

Solutions will probably require coordinated policy intervention on the economy, public health, and the health service. Social and economic interventions can reduce the prevalence of despair; appropriately targeted legislation can reduce access to drugs and minimise alcohol consumption; and well-designed health services can step in to minimise the consequences and alter a patient’s trajectory when harms occur.  The Neighbourhood NHS concept and relational public services seem particularly well suited to this last task.  

The Strategy Unit hopes to publish further work on this topic shortly, exploring the health service’s evolving response to this growing challenge. 

Research paper: https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609841/full