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March 21, 2019
by Elizabeth Pratt

US Loses High Amount of Health Life Years to Substance Abuse and Mental Health Disorders

March 21, 2019 08:00 by Elizabeth Pratt  [About the Author]

Researchers have found the US had the highest number of healthy life years lost due to mental health disorders between 1990 and 2017. 

A recent study found the US lost 2,221 healthy life years per 100 thousand residents to mental health disorders, for a total of over 181 million healthy life years lost to conditions of this kind.

Researchers from the Delphi Behavioural Health Group analysed data from the World Health Organization between 1990 and 2017. They wanted to see how mental health disorders and substance abuse impacted countries around the world.

The US was found to be particularly impacted by mental health disorders.

“With over 181 million healthy life years claimed by mental health disorders, we were alarmed to find the US lost more healthy life years than Canada, the U.K., Germany, Japan, Australia, Sweden, and Switzerland combined. Comparatively, Japan experienced the second largest loss at over 59 million healthy life years lost,” a spokesperson for Delphi Health Group told Theravive.

Countries analysed in the research included the US, Australia, Netherlands, France, Sweden, Portugal, Germany, Switzerland, United Kingdom, Canada and Japan.

Switzerland had the lowest rate of healthy life years lost to mental health disorders with 4,318,799 healthy life years lost. Japan has the second highest after the US with over 59 million healthy life years lost, and Germany was ranked third with over 46 million healthy life years lost.

In the United States, mental health disorders came at an economic cost of 7.6 trillions dollars between 1990 and 2017. The researchers note that with that amount of money, the United States could pay for 60 years of cancer treatment for every person in the world.

In every country studied, the researchers found that women lost more health life years to mental health disorders than men. Experts acknowledge that disorders like anxiety and depression are more common in women, but the researchers argue the reasoning behind the disparity could have cultural rather than biological explanations.

“Across each nation studied, more female healthy life years were lost to mental health disorders than male. While we’re aware of national cultural factors that may contribute to high stress levels such as industry pay and traditional roles within households, we were surprised to see this trend prominently echoed by each nation studied. As mentioned by the World Health Organization-- the data source we analyzed for this project-- more research is needed to conclusively determine whether the higher stress levels associated with females are rooted in biological differences, cultural differences, or some combination of factors,” they said.

As well as mental health disorders, the past few decades has seen a notable increase in substance abuse challenges in the United States. According to the CDC, an average of 130 Americans die every day from an opioid overdose.

The researchers found that between 1990 and 2017, the United States lost over 80 million healthy life years to substance abuse disorders, a figure 10 times higher than any of the other countries studied.

The United States is an outlier in terms of drug related abuse and deaths, say the researchers, seeing a significant increase in opioid related deaths since the late 1990s. Other countries by comparison have seen an improvement in healthy life years lost to drug use disorders. Portugal had the lowest number of healthy life years lost to drug use both in total and per capita. Portugal legalized drugs in 2001 and experts suggest the policy which focuses on free treatments rather than criminal penalties is working.  In 2017, 198 per cent fewer healthy life years were lost to drug use disorders in Portugal when compared to the United States. 

Unlike the data on mental health disorders, men lost more healthy life years to drug use disorders than women in every country studied. In the US, men are more likely to use illegal drugs and die from an overdose.

Since 1990, the US saw a 259 per cent increase in drug use disorders. The researchers say this is likely attributed to addictive prescription opioids from the 1990s and surges in methamphetamine use twice in the period studied.  

The cost of drug addiction in the US is significant, with the researchers finding the US lost 3.4 trillion dollars to drug use disorders between 1990 and 2017. That could fund the Centers for Disease Control and Prevention (CDC) for 600 years, or fund a free public education program in the US for 72 years.

Dr. Neeraj Gandotra, a Chief Medical Officer at Delphi Behavioral Health Group, says the impact of drug use disorders has far reaching consequences.

“Addiction does not just damage one’s own mind and body, it sacrifices dreams. A person with a substance use disorder will lose productivity in several key areas, but most affected is their trajectory to contribute. Instead of the adult being productive for his or her family, community, and nation, the disorder erodes their social capital. They cannot contribute as well to their family responsibilities. They are less likely to contribute to their communities. Their behaviors are influenced by both psychological and physiological forces that seemingly trap their choices between only unfavorable decisions of self betrayal,” he said.

The researchers argue the significant rise of drug use disorders in recent times calls for a new approach, starting with eliminating stigma.

“Primary prevention is our greatest opportunity to reverse the course, but unfortunately by the time the disorder has taken hold, treatment must be the focus.  If our findings prove anything, it is that these widespread disorders are a matter of medical need and not a moral failure,” they said.

About the Author

Elizabeth Pratt

Elizabeth Pratt is a medical journalist and producer. Her work has appeared on Healthline, The Huffington Post, Fox News, The Australian Broadcasting Corporation, The Sydney Morning Herald,, Escape, The Cusp and Skyscanner. You can read more of her articles here. Or learn more about Elizabeth and contact her via her LinkedIn and Twitter profiles.

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