This report uses an enhanced conceptualisation of self-injury mortality (SIM), which comprised registered or known suicides by any method and estimated non-suicide deaths from opioid and other drug self-intoxication. SIM surpassed diabetes as a cause of death in the USA in 2015. The gap expanded in 2016 with respective rates of 29.1 and 24.8 per 100 000 population. Facing similar social and psychologically complex health problems to SIM, the USA has initiated and sustained successful broad-based prevention efforts that have reduced deaths from cardiovascular diseases, smoking-related lung cancer, HIV and motor vehicular injury—given both necessary epidemiological understanding to define the problem and sufficient political will to address it. Development of strategies to prevent SIM will be facilitated by focusing on factors that are common risks for diverse outcomes. Like premature mortality frequently associated with diabetes, deaths from self-injurious behaviours are preventable.
What is already known on this subject?
There is a burgeoning epidemic of mortality from opioid and other drug intoxication in the USA.
The suicide rate is also rising.
What this study adds?
Collectively representing self-injury mortality, suicides and estimated non-suicide drug self-intoxication deaths have surpassed diabetes mortality.
Turning the tide will require coalescence and coordination of upstream efforts through both governmental policies and community prevention initiatives, with a focus on common risks for diverse outcomes.