'Deaths of despair' are on the rise

By Cathy Dyson
The Free Lance-Start

FREDERICKSBURG, Va. (AP) — In the months since her baby sister overdosed on heroin laced with fentanyl, Rene Myers has been sickened by the reaction from so-called friends.

They want to write off Dorothy Nicole Ries as nothing more than a druggie who died at her own hands. They suggest the 25-year-old Nicole, known as “Coley” to her brother and three sisters, was a drain on society and, really, what did it matter if one more junkie overdosed?

That kind of thinking made Myers reach out to The Free Lance-Star. She wanted to put a face on the opioid crisis, an epidemic that claims 115 Americans every day, according to the Centers for Disease Control.

“It was not who she was, it was just a part of her,” said Myers, a 31-year-old Spotsylvania County resident and wife, waitress and mother of two daughters. “She was this bubbly, happy person who would do anything to make you feel better if you were having a bad day. She was a normal girl. She just had her demons.”

So do many others of the same age and racial background, according to a study from Virginia Commonwealth University’s Center on Society and Health.

The report notes an alarming rise in specific deaths among Virginia’s white population, ages 25-54.

While overall death rates for all whites decreased between 1995 and 2014, deaths by drug overdoses, suicides and health problems caused by alcohol and drug poisoning have jumped 83 percent in the same time frame for those aged 25-54, according to the study.

The report looked at the mortality rate for “stress-related conditions,” which have been described in other studies as “deaths of despair.”

Call them what you want, they’re creating a public health crisis that hasn’t been seen in the state before — at least among this population.

“Middle-class white households were largely protected from the social disadvantage and economic insecurity that are common today, and that people of color have experienced for generations,” the report noted.

Denis Nissim-Sabat, a retired clinical psychologist and University of Mary Washington professor, says these types of deaths long have been prevalent in communities of color.

“My concern is, and others have said this, is we’re now paying attention when it hits whites,” he said.

The suicide rate for American Indians and Alaska Natives is 16.93 per 100,000 people, compared to the overall U.S. rate of 12.08 per 100,000, according to the Suicide Prevention Resource Center. Likewise, when African-Americans used drugs, “it wasn’t seen as a health issue, it was seen as a criminal issue,” Nissim-Sabat.

The report acknowledges those factors and states that, between 2010 and 2014, the death rate among blacks in Virginia still was 1.2 times higher than of whites.

The study aimed to look at what is causing these stress-related conditions, or SRC deaths, among whites. It offers a sobering statement about the impact of opioid drugs, substances primarily used for pain relief.
“The opioid crisis is the tip of an iceberg,” according to the report. “Many people are dying from the use of other drugs, alcohol abuse, the injuries and diseases they cause, and suicides. The root causes that are driving people to their deaths must be addressed.”

While the SRC mortality rates among young whites climbed in every region of Virginia, they were higher in more rural and less populated areas, where people had lower incomes and more child poverty, less health insurance and more older housing.

The highest rates were found in regions that border Kentucky and West Virginia, along with rural areas of the Shenandoah Valley and in the Eastern Shore.

But even the most populated and affluent region of the state — the Northern Virginia area, which includes Fredericksburg and the counties of Spotsylvania and Stafford — were affected. SRC death rates in Northern Virginia were the lowest in the state, but still increased by 57 percent after 1995, the report stated.

A chart for Fredericksburg showed 30,985 whites ages 25-64 years, and for statistical reasons, “it is hard for a population that small to produce statistically significant increases,” said Steven Woolf, a VCU professor and senior adviser with the Center on Society and Health.

The SRC death rate among Fredericksburg whites increased 39 percent after 1995.

“You shouldn’t jump to the conclusion that the increase in Fredericksburg wasn’t as great as elsewhere,” Woolf said.

Besides, rates in one of its neighboring localities were off the charts.

In Spotsylvania County, there was a 273-percent increase in the rate of drug overdoses after 2000, “and this was statistically significant,” Woolf said.

Sharon Killian, a clinical services director at the Rappahannock Area Community Services Board, said the report mirrors what she sees among her clients.

She recently had a group meeting with eight adults. Seven of the eight were males, and all were white.

Except for one participant, every person in the group was the first in his or her family to use drugs. Most were raised in the church and came from two-parent households.

As they talked about “how this happened to me,” Killian saw a pattern emerge.

“Families are busy, schedules are packed, both parents are working, kids are in activities, there’s not a lot of family time that’s not structured,” she said. “When they are together, they’re on their phones.”

There’s not one single cause that leads to people using drugs or contemplating suicide. But when people have a trauma or don’t have time to bond with others — or have a “conglomerate of stress” in the family — Killian says it creates a perfect storm.

“At the end of the day, bonding is the cornerstone for all of us,” she said. “When you have the bond and something interrupts it, or you don’t have that bond at all, you essentially have a hole in your heart. And you’re going to fill it with something.”

Drugs and alcohol are easy targets, Killian said, because they don’t talk back.

A society that seemingly has everything at its fingertips also has more stress-related problems than prior generations.

“We are the most in debt, overweight, addicted group of adults walking the planet. Why? Because we are numbing something,” said Allison Sampson-Jackson, an expert in Adverse Childhood Experiences, or ACEs. “We offload hurt instead of lean into pain and cope with it.”

She recently spoke at a Fredericksburg town hall meeting of more than 200 people about the impact childhood trauma can have on physical and mental health for the rest of a person’s life.

In her travels, she meets people who never learned how to connect with others, to share their feelings or even be aware of different emotions a person has.

“We are pushed more today to move faster, get more done, have things, yet we have lost the art of connection, breathing, rest and play,” she said. “The average person today gets more information on their smartphone in one day than our grandparents and great-grandparents got in a year.”

“We need a culture change,” she added.

The VCU report doesn’t cite constant access to the worldwide web as a potential cause of higher deaths of despair.

But it does suggest that life conditions for whites ages 25-54 are drastically different from what their parents and grandparents faced — and that this subset doesn’t have the resilience to deal with the cumulative stress.

After World War II, loyal workers could count on a job for life with health insurance, a pension and other benefits. These ideal setups no longer exist, and frustration and hopelessness increase anxiety and depression, the report stressed. They produce harmful coping behaviors, whether it’s overeating or smoking, drug use or suicide.

Myers watched her little sister struggle with pills, then street drugs, from her teen years on, after an episode that Myers doesn’t want to discuss. She and her family tried, through repeat rehab and treatments, to loosen the grip of addiction, but the disease won.

“It hurts because you do all this for somebody who is an amazing person,” Myers said, “but just can’t look in the mirror and see it for herself.”

There’s little comfort in knowing that many others face the same anguish over the loss of a loved one.

“Growing up, death was an old-person thing; it was your grandmother or grandfather,” Myers said. “Now we’re burying our friends and our siblings. Our children will probably see more deaths in 10 years than we did our whole lives.”