The US is in the throes of a deep and pervasive social crisis -- and it's killing people at an alarming rate.
That's the takeaway from the announcement in December that, for a second year in a row, average life expectancy in the US has declined.
According to the National Center for Health Statistics at the Centers for Disease Control and Prevention, Americans can now expect to live 78.6 years on average -- a decline of 0.1 years for 2016 over the figures from 2015, which also represented a drop.
That might not sound like a lot, but any decrease in life expectancy is a rare occurrence in a developed nation. In this case, it's the direct result of the opioid crisis that continues to ravage large swathes of the country.
To put it in perspective, the last time there was a decline in life expectancy in the US was in 1993 at the height of the AIDS crisis -- and the last time there were two years of decline was 1962-63 as a result of a major flu epidemic.
Worse, 2017 is on track to produce yet another decline in life expectancy, according to the National Center for Health Statistics' Bob Anderson. "We have data for almost half of 2017 at this point. It's still quite provisional, but it suggests that we're in for another increase" in drug-related deaths, Anderson told CNN. "If we're not careful, we could end up with declining life expectancy for three years in a row, which we haven't seen since the Spanish flu 100 years ago."
Actually, seven of the top 10 leading causes of death in the US -- including heart disease, cancer, diabetes and influenza -- declined in 2016. But that was more than offset by a rise in deaths from Alzheimer's disease, suicide and "unintentional injuries" -- a category that includes drug overdose deaths.
According to the Washington Post, "More than 42,000 Americans died of opioid overdoses alone in 2016, a 28 percent increase over 2015. When deaths from drugs such as cocaine, methamphetamine and benzodiazepines are included, the overall increase was 21 percent."
Overall, noted the Post, "Deaths from fentanyl and other synthetic opioids more than doubled from the previous year. Heroin and prescription opioid overdose deaths also rose, but more modestly."
The picture is especially bleak among Millenials. The statistics show that from 2014 to 2016, the death rate for 25-34 year olds jumped by 19 percent, from 108 per 100,000 to 129 per 100,000.
The crisis is hitting particularly hard in Rust Belt areas, where a decades-long decline in manufacturing has decimated formerly solid working-class communities, leaving Virginia, New Hampshire and Ohio with highest rates of overdose deaths in the country. Morgues in many of the hardest-hit counties continue to run short on space to hold the bodies of the dead. From mid-2016 to mid-2017 in West Virginia, the state spent $1 million just to transport bodies to and from morgues.
In the town of Petersburg (population: 2,500) one pharmacy allegedly sold more than 1.8 million doses of opioids that had no medical purpose.
"It was like passing out candy on Halloween," Breanne McUlty, a recovering addict from Petersburg, told the Washington Examiner. "I can't say there isn't one person I know who hasn't been strung out...I'm the only person in my family right now who hasn't had an active addiction."
It's important to note, however, that it isn't only white Rust Belt communities that are suffering. Taking a closer look at the 2016 figures, the New York Times reported in late December that deaths related to opioids spiked by a whopping 41 percent in Black urban communities, especially among older Black men who are dying from heroin laced with fentanyl.
This, the Times wrote, "suggests that the common perception of the epidemic as an almost entirely white problem rooted in overprescription of painkillers is no longer accurate, as fentanyl, often stealthily, invades broader swaths of the country and its population."
In Washington, DC, for example, drug deaths doubled in a single year -- and are now "on par with those in Ohio and New Hampshire."
There is an urgent need for a drastic response from the government including addiction and treatment services, jobs programs, medication and other resources.
For months, public health officials have been begging the Trump administration to declare the opioid crisis a national emergency, which could have made a large amount of funding available. Instead, in October, Trump declared it a "public health emergency" and devoted few additional resources.
As if to underline the administration's lack of seriousness in approaching the opioid crisis, Trump appointed not an expert or a scientist, but his former campaign manager and current White House Counselor Kellyanne Conway to lead White House efforts to combat the crisis.
Conway, who has zero experience with anything related to addiction or addiction policy, once told ABC News' George Stephanopoulos that the White House failed to increase funding for the opioid crisis because what addicts really need is "a four-letter word called 'will.'"
Such comments, said Massachusetts Sen. Ed Markey, are a "death sentence for addicts."
Hoping to score cheap political points, Trump announced in late November that he would be donating his $100,000 third-quarter presidential salary to the Department of Health and Human Services. But the paltry amount will do next to nothing to stem the crisis -- especially when his administration is cutting funding in other ways.
After all, $100,000 is a drop in the bucket compared to the $190 billion over 10 years that public health advocates like Harvard University health economics professor Dr. Richard Frank say will be needed to help stem the crisis. And given that Medicaid currently covers some 34 percent of the estimated 2.66 million Americans with an opiate-use disorder, the crisis will deepen if Republican plans to further gut government health-care programs come to fruition.
In fact, as the Huffington Post reported in late October, Trump's budget calls for cutting funding for the opioid crisis by $97 million -- including a massive cut to the budget of the National Institutes of Health:
The president could have tied other actions to his public health emergency declaration but did not, said Regina LaBelle, former chief of staff at the Office of National Drug Control Policy in the Obama administration.
"Such actions could have included building a naloxone stockpile, addressing regulatory barriers to mobile methadone vans, not to mention including more funding to address the epidemic," LaBelle said in a statement. "At a time when only 20 percent of people with opioid use disorders get needed treatment, we need to act with urgency."
Instead of "urgency," America was treated to Trump lecturing the media about "an idea that I had" for kids to say no drugs -- a nod to the totally ineffective "just say no" campaign of the 1980s, which never showed a direct connection to reducing drug use.
"If we can teach young people -- and people, generally -- not to start," Trump said. "it's really, really easy not to take them."
Truly, words of wisdom from a "stable genius."
The decline in US life expectancy is a kind of "canary in a coal mine" -- a troubling indication of the degree to which whole sections of US workers are in living in despair under a system that is designed not to meet their needs.
Princeton University economist Anne Case recently told NPR that opioid deaths, along with the uptick in suicides and deaths from alcohol, are all "signs that something is really wrong, and whatever it is that's really wrong is happening nationwide."
But while much of the media attention has focused on the spike in opioid addiction among whites, researchers are pointing out that working class and poor Blacks -- who already suffer higher rates of disease and mortality as a result of preventable causes often related to poverty and institutional racism -- are also suffering.
"Rates of mortality for African Americans have risen after a fairly long period of decline, and that is concerning and disturbing and it may reflect a wider array of harms arising from drug issues," Jonathan Skinner, a Dartmouth College economic professor, told NPR.
In general, there has been a systematic failure of the government at the local, state and federal levels in all communities to provide the resources that people deserve.
While the Trump administration is spending its time policing scientists at the Centers for Disease Control over their use of words and phrases like "evidence-based" and "vunerable," millions of Americans are needlessly suffering and communities are being ripped apart by a crisis with no end in sight -- and no solutions on offer.