In a recent paper (2017) University of New Hampshire researcher S.M Monnat reported that suicide rates in the U.S. are increasing at staggering levels, as are deaths from drug and alcohol poisoning. These three combined, suicide + drug poisoning + alcohol poisoning, have increased by an unprecedented 52% between 2000 and 2014, which totals an additional 133,000 deaths.

Why Does This Matter?

We have known for sometime that drug and alcohol misuse and abuse and suicide are the leading cause of death among young white males in the U.S. This comprises nearly 50% of all mortality in this cohort. But why?

Both drugs and alcohol target the brain’s pleasure and reinforcement systems, primarily through neuronal dopamine signaling. The possibility of neurotoxicity has been discussed by experts for many years, as well as disruption of dopamine signals. Neuroadaptation resulting from substance abuse often results in once pleasurable activities becoming no longer pleasurable. Consequently anhedonia, boredom and prolonged depression is not uncommon among abstinent former users. In addition to the social, familial and legal consequences and stressors, young men (>25 years old), have an undeveloped prefrontal cortex (PFC). The PFC is home to many of our learned and higher human functions. When fully developed, the PFC inhibits impulsiveness, risk taking and solely hedonic driven behavior via dopamine signaling. More emphasis should be placed on the neuroadaptive changes associated with substance use and abuse, and their causal role for addiction, depression and suicidality. Understanding the mechanisms underlying addiction, depression and suicide requires a renewed commitment to more basic science research.