Mortality from deaths of despair far surpasses anything seen in America since the
dawn of the 20th century. (The trend for middle-aged whites reveals a more dramatic
rise but only goes back continuously to 1959.) The recent increase has primarily been
driven by an unprecedented epidemic of drug overdoses, but even excluding those
deaths, the combined mortality rate from suicides and alcohol-related deaths is
higher than at any point in more than 100 years. Suicides have not been so common
since 1938, and one has to go back to the 1910s to find mortality from alcohol-related
deaths as high as today’s.
At the same time, a long-term perspective reveals that while drug-related deaths
have been rising since the late 1950s, the current increase in suicide and alcoholrelated deaths began only around 2000, as the opioid crisis ramped up. Suicide and
alcohol-related mortality trends track each other well over the past 45 years, and after
accounting for the changing age distribution of the US, combined deaths from the
two causes were as common in the mid-1970s as today.
Self-reported unhappiness probably has been on the rise since around 1990 (though
not all sources agree). That predates the increase in deaths of “despair” by a decade.
Moreover, unhappiness likely fell over the 25 years preceding 1990, while deaths
of despair rose and then plateaued. And one data source suggests stable levels of
unhappiness over the long run.
Rising unhappiness may have increased the demand for ways to numb or end
despair, such that the cumulative effects show up years later in the form of higher
death rates. But the proliferation of a uniquely addictive and deadly class of drugs
has meant that the supply of despair relief has become more prevalent and more
lethal, which would have increased mortality even absent an increase in despair.
https://www.jec.senate.gov/public/_cache/files/0f2d3dba-9fdc-41e5-9bd1-9c13f4204e35/jec-report-deaths-of-despair.pdf 
