New international research reinforces the link between public policy and life expectancy

PUBLIC RELEASE: 21-MAR-2016
New international research reinforces the link between public policy and life expectancy
Changes in substance use policies associated with abrupt and significant impacts on life expectancy
CENTRE FOR ADDICTION AND MENTAL HEALTH

While average life expectancy has been rising steadily in most countries over the past century, new research led by the Centre for Addiction and Mental Health (CAMH) shows that life expectancy declined significantly and rapidly in three countries where policy changes increased access to prescription opioids, alcohol or illicit drugs. Published in BMC Medicine, the study underscores the need for effective substance use policies and public health interventions, and provides key principles to guide policy decisions.

"Our study shows that failed substance use policies can reverse life expectancy trends for large population groups or even countries," says Dr. Jürgen Rehm, Director of Social and Epidemiological Research at CAMH and first author of the study. "On the other hand, we also observed that effective policy changes are associated with substantial gains in life expectancy."

The researchers investigated marked changes in life expectancy linked to substance use and related policies in three countries: the U.S., the former Union of Soviet Socialist Republics (USSR) and Mexico.

In the U.S., prescription opioids are used in larger quantities than in any other country. Usage started increasing rapidly in the mid-1990s, partly as a result of allowing family doctors to prescribe short-acting opioids such as oxycodone for chronic pain and other relatively common diseases. Non-medical use of these substances and associated harms, including overdose deaths, increased alongside prescription use. From 1999 to 2013, mortality increased by nine per cent in middle-aged white non-Hispanic Americans, despite life expectancy continuing to rise among other U.S. populations, including Hispanic and black non-Hispanic populations.

"Canada is second in the world only to the U.S. in our rates of prescription opioid use, and the rise of prescription opioids in our provinces has also shown to be strongly linked to overdose deaths,"

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The study also found that, in the USSR, after years of declines, life expectancy increased by 3.2 years for men and 1.3 years for women from 1984 to 1987 as policy reduced the supply of alcohol. But, between 1987 and 1994, as restrictive alcohol policy was abandoned and alcohol became widely available, life expectancy fell by 7.3 years for men and 3.3 years for women.

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tags: drug use, drug abuse