Trifecta of opioids, alcohol and suicide are blamed for the drop in U.S. life expectancy

An epidemic of despair is disproportionately claiming the lives of rural white Americans in the prime of adulthood. And for a second year in a row, their deaths by drugs, drink and self-destruction have caused life expectancy in the United States to fall.

That milestone, suggests an editorial in a respected medical journal, marks a sustained reversal of close to a century of improving health for Americans. And it raises a puzzling mystery: What is causing the despair, and what will restore hope and health to these battered Americans?

The opioid epidemic, which claimed the lives of 64,000 Americans in 2015 alone, “is the tip of an iceberg,” a pair of public health scholars wrote in the journal BMJ.

In an even larger public health crisis unfolding in the United States, death rates from alcohol abuse and suicides have also seen sharp increases in recent years, wrote Steven H. Woolf of Virginia Commonweath University and Laudan Aron of the Washington-based Urban Institute.