Deaths of Despair

Princeton researchers Anne Case and Angus Deaton have dubbed suicide, drug overdoses and alcohol-related liver diseases ‘Deaths of Despair.’ Drug overdoses and suicides are the biggest factors behind the drop in life expectancy in the United States. This trend has persisted over the last three years, a pattern that last occurred over a century ago at the time of WWI and the Spanish Flu pandemic.

Whilst life expectancy continues to rise in Australia the incidence of death by suicide, drug overdoses and alcohol-related liver diseases is cause for concern.

The statistical data available provides insight into the scope of the problem. For some, statistics are clinical and impersonal. The numbers and percentages seemingly cause a numbing of the brain. However, statistics play an important part in various aspects of our life. Their usefulness is dependent on our ability to think critically about the information being presented; to understand the context; and to be able to tell the story in the data.

What follows is a statistical snapshot of death by suicide, drug overdoses and alcohol-related liver disease in Australia.


In 2018, there were 3,046 deaths by suicide. There were 2,320 male deaths and 726 female deaths. On average, six men and two women end their own lives in Australia every day.

On the basis that approximately 135 people are affected by each suicide death, more than 400,000 Australians have been impacted in 2018: as a family member, friend, work colleague, teammate, first responder, neighbour or treating professional.

Suicide was the leading cause of death among people aged between 15-44 years, and the second leading cause of death among those 45-54 years of age.

40% of all deaths among young people (15-24 years) were attributed to suicide.

Substance use was present in over one-quarter of suicide deaths in 2018.

Drug Overdoses

There were 1,740 registered drug-induced deaths in 2018 according to the Australian Bureau of Statistics. Opioid drugs were found to contribute to two thirds of drug-induced deaths.

Opioids contribute to two thirds of drug-induced deaths

Director of Health and Vital Statistics at the ABS, James Eynstone-Hinkins, said there were more than three deaths a day in 2018 where opioid drugs were a factor.

Most of these opioid-induced fatalities were unintentional overdoses in middle aged males involving the use of pharmaceutical opioids, often in the presence of other substances.

This suggests the profile of Australians dying from drug related deaths today has changed.

We now know, middle aged men mixing cocktails of prescription drugs are more likely to die in an accidental drug related death than illegal drug users.

DRUG related deaths have reached alarming rates in Australia

Alcohol-Induced Deaths

There were 1,366 registered alcohol-induced deaths in 2017: the highest in 2 decades (1,156 deaths in 1997), with an additional 2,820 (alcohol-related) deaths where alcohol was mentioned as a contributing factor to mortality.

Alcohol can contribute to mortality in many ways and deaths can be directly attributable or partially attributable to harmful levels of alcohol consumption. The most common cause of alcohol-induced death was alcoholic liver disease; while mental and behavioural conditions due to alcohol use, including alcohol addiction, is the most common contributor to alcohol-related deaths.

Alcohol and illicit drugs have a significant impact on the health of Australians, together responsible for nearly 1 in every 20 deaths, according to new analysis from the Australian Institute of Health and Welfare (AIHW).

Researchers argue that despair is a common factor in suicide, drug overdoses and alcohol-induced deaths. What then is despair?

According to the Cambridge Dictionary, despair is defined as, ‘The feeling that there is no hope and that you can do nothing to improve a difficult or worrying situation.’

Despair is a very intense feeling of hopelessness. The feeling can be described as a mix of misery, discouragement, anguish, agony, and distress. For those with depression, this feeling is often associated with suicidal thoughts.

Joann Farkas, Kinesiologist and Counsellor at the Karrinyup Wellness Centre says,

‘When an individual is in despair, they are feeling a complete loss of hope, usually accompanied by desperation, anguish and sadness. People is despair may get up every day and go about their business, but there is no joy in life.’

We often feel despair after tragic events in our lives, especially when we experience a significant loss. It tends to be the main emotion people feel after a sudden traumatic event, which is normal, but can lead to irrational decision-making and impulsive acts.

When we feel that there is no hope for a happier future, life itself can seem meaningless. This hopeless feeling affects different people in different ways.

Jonathan Foiles is a therapist who works with patients experiencing profound injustice and pervasive trauma. He says,

“Hope can seem like a radical, even foolish, act. In times of despair, it can seem naive or dangerous to think that things may get better.”

Jonathan Foiles

But to be hopeful is to acknowledge that the future remains unwritten and we have a part to play in its making. We don’t have to be able to see the future to know that there is one.

What then are the indicators of despair that we need to be mindful of? They are anything ‘that manifests itself in feelings of sadness, thoughts of defeat, and self-destructive behaviours.’

Researchers Case and Denton trace the causes of ‘deaths of despair’, particularly among white middle-aged men, to various social problems—especially the economic problems of unemployment. They found that deaths of despair have been accompanied by falling labor force participation, reduced marriage rates, increases in reports of poor health and poor mental health. Deteriorating labour market conditions erode confidence, undermine the possibility of stable marriages, and threaten social connections. In this environment people are denied the kind of economic and social supports they need in order to thrive. 

Magazine author, Mike Woodard says,

‘Dealing with despair takes two forms, prevention and long-term cure. Prevention is the strategy of dealing with conditions that lead to despair which can include simple things like enough rest or talking out discouragement with a trusted friend.’

It is also looking for other ways to make life meaningful. Get out into nature, practice meditation, read a novel. What works for you may not work for me but disconnect and give yourself some time to breathe.

Woodward stresses the importance of identifying what underlies our hope. He says,

‘Prevention involves finding a foundation that gives hope, especially amid circumstances that produce despair. Many people find such a foundation through re-examining their spiritual roots in order to discover meaning and purpose beyond themselves.’

The challenge facing anyone overcome by despair is to re-discover a genuine reason to live and to know where your hope is placed.  

Author: Bruce Rickard

Reflections on Suicide and Staying Alive: My son's suicide changed everything. I felt an obligation to understand why anyone would want to end their life. My regular blog posts explore the causes and prevalence of suicide and what is needed to sustain a healthy mind and a hope-filled future.

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