American Life Expectancy Drops Again

The failing drug war is largely to blame.



The Centers for Disease Control and Prevention reports that for the third consecutive year, average life expectancy has declined: After peaking at 78.9 years in 2014, it has dropping to 78.6 years in 2017. This follows decades of increases.

While a fiercer than usual outbreak of influenza contributed to the decline last year, the main causes are rising suicides rates and the increasing number of deaths from drug overdoses associated with opioids.

Overdose deaths in 2017 rose to 70,237, up from 63,632 the year before. But overdose deaths associated with legal opioids did not significantly change from 2016. The increase came almost entirely from street drugs.

And why was there a rise in the use of black market fentanyl and heroin? The biggest reason is most likely the drug war.

In 2010, the manufacturers of legal opioids agreed to reformulate their products so that they could no longer be easily crushed and inhaled. A 2012 study in the New England Journal of Medicine found that this reformulation was the primary reason that many painkiller addicts switched to heroin. "The most unexpected, and probably detrimental, effect of the abuse-deterrent formulation was that it contributed to a huge surge in the use of heroin, which is like OxyContin in that it also is inhaled or injected," said the study's principal investigator.

A fascinating 2018 National Bureau of Economic Research paper, "How the Reformulation of OxyContin Ignited the Heroin Epidemic," finds that the rise in the use of heroin began the very month after legal opioids were reformulated. From the abstract:

We attribute the recent quadrupling of heroin death rates to the August, 2010 reformulation of an oft-abused prescription opioid, OxyContin. The new abuse-deterrent formulation led many consumers to substitute to an inexpensive alternative, heroin. Using structural break techniques and variation in substitution risk, we find that opioid consumption stops rising in August, 2010, heroin deaths begin climbing the following month, and growth in heroin deaths was greater in areas with greater pre-reformulation access to heroin and opioids. The reformulation did not generate a reduction in combined heroin and opioid mortality—each prevented opioid death was replaced with a heroin death.

Now cheaper and more deadly black market fentanyl is making the situation worse. As my Reason colleague Jacob Sullum writes, we can all "thank drug warriors for the escalating death toll from superpotent synthetic opioids." And for a fall in average life expectancy too.