Called to Lead

Addressing Diseases of Despair

Minnesota, we have a problem.  

In 2017, 637 parents, children, siblings, neighbors, co-workers and friends died from overdoses in our state – part of 70,000 nationally. The availability of synthetic opioids is largely driving this increase, but alcohol still kills more people each year than drugs, about 88,000 in the United States last year. And the rate of women dying from alcohol-related causes is up a staggering 85 percent.

Suicide, often linked with substance abuse disorders, is also on the rise, particularly among veterans, rural white males, young American Indians, LGBTQ individuals and physicians.

The 2016 Minnesota Student Survey found that 1 in 5 students showed signs of depression. The links between Adverse Childhood Experiences and prevalence of substance abuse disorders is strong. We also know that a primary prevention approach focused on community well-being can reduce the likelihood of ACEs and contribute to enhanced health.

There is a financial as well as a human cost to all this. Healthcare spending for individuals with a diagnosis related to drugs, alcohol and/or at risk for suicide is 2.5 times higher than the average American. The emergency room is the most expensive place to treat these problems, but between 2008 and 2014 the rate of ER visits involving acute alcohol consumption rose nearly 40 percent.

It should come as no surprise that alcohol, drug misuse and suicide are being termed “diseases of despair,” due to the strong link with trauma and toxic stress. When people lose hope and feel isolated, they seek ways to numb their pain, whether the source of that pain is physical, mental, spiritual or psychological. The impact is not only felt among families and communities, but in the health care system, loss of workplace productivity and increased violence. Substance misuse is now the leading cause of children being removed from the home in Hennepin County.

Fortunately there are solutions at hand.

Current efforts to increase access to treatment, mental health care and supportive housing are necessary and encouraging. First responders have saved countless lives, often using Narcan. But, as former Surgeon General Vivek Murthy, M.D. said, “We can set up countless substance use disorder treatment centers, but if we aren’t addressing the fundamental emotional well-being of our communities, we won’t prevent diseases of despair from cropping up.”

A 2017 report, “Pain in the Nation” from the Well Being Trust, calls for a national resilience strategy to “create a more comprehensive, focused and effective approach that prioritizes putting primary prevention first…and develops systems of support to identify issues early and ensures Americans receive the support and care they need to thrive.”

The report cites evidence that investments in prevention have “shown results in reducing the risk for substance misuse and suicidal thoughts and attempts,” in addition to reducing behavioral problems in school, the need for child welfare services, depression and anxiety, chronic illnesses and more.

Two additional action steps are needed to supplement our current response to diseases of despair: building resiliency in community and workplace settings; and increasing education regarding and access to effective non-narcotic pain management therapies for both physicians and patients.

Minnesota can and should take the lead on this.

In September of 2018, the Catalyst Initiative at The Minneapolis Foundation hosted a gathering of over 120 diverse stakeholders, including representatives from healthcare, community corrections, nonprofits and human services, for “Building Resilience: Preventing Diseases of Despair.” Key recommendations from this meeting included investing in community resilience training and providing increased access to holistic, whole person medical care.

The time is right for Minnesota to once again demonstrate our unique ability to craft forward-thinking solutions. This means investing in primary prevention and access to non-narcotic pain management therapies as components of our response to this crisis. We have evidence that increasing social connectedness and teaching healthy coping skills can be easily reinforced in family, community and organizational settings.

We have much to gain and little to lose by adopting a comprehensive resilience strategy that will save lives, taxpayer dollars and human suffering.

Our parents, children, siblings, neighbors, co-workers and friends are counting on us.


Suzanne Koepplinger is the Director of Catalyst Initiative at the Minneapolis Foundation. Visit Catalyst’s webpage to learn more.