Provider Spotlight: Dr. Mandel, ER Maverick & Locum Tenens Physician

Dr. Ken’s Corner: U.S. Life Expectancy Takes Another Alarming Drop

For the second straight year, U.S. life expectancy has fallen, according to a CDC report on 2016 data released in December 2017.  An American born today can expect to live to 78.6 years, a decrease of about a month when compared to 2015. “It may not sound like much, but the alarming story is not the amount of the decrease but that the increase has ended,” according to Steven Woolf at Virginia Commonwealth University.  “In 1960, the U.S. had the highest life expectancy in the world.  It’s lost ground to other industrialized nations ever since” (USA TODAY, Feb. 8, 2018).

When first confronted with a decrease in U.S. life expectancy two years ago, the CDC placed the biggest blame on the opioid crisis.  “It’s a larger issue,” says Woolf, “involving addiction to opioids but also fatal overdoses from other drugs.  More importantly,” he said, “it’s accompanied by a dramatic surge in deaths from alcohol abuse and an increase in the suicide rate.”

When compared to older Americans, a disproportionate number of drug-related deaths occur in teens and younger adults.  From a statistical perspective, deaths in a younger segment of the population have a larger negative impact on overall U.S. life expectancy data.  In fact, the CDC report points out that despite two years of falling life expectancy, death rates from most causes not related to the opioid crisis have actually decreased for the U.S. population at large.  For example, not only are older people healthier now than ever before, they are dying at a slower rate.  A man who reaches 65 can expect to live to 83.  A woman who reaches 65 can expect to live to 85.6.

Although part of a much bigger problem, the use of the term opioid epidemic is not an exaggeration. The CDC reports that the rate of fatal opioid overdoses in the U.S. has quadrupled since 2000.  “When asked what they think is the reason behind the country’s opioid epidemic, physicians in a recent survey cited two leading causes: easy access to illegal opioids and overprescribing by physicians” (fiercehealthcare).

Of the 1,450 physicians surveyed, many commented that “patient expectations are too high when it comes to pain management and many expect never to experience pain, even after surgery.”  Other doctors commented that grading physicians based on patient satisfaction surveys has contributed to overprescribing opioids.  Many also said that physician education on when and how to prescribe opioids has been inadequate.  Fifty-six percent of surveyed physicians said doctors who prescribe narcotics should be given additional training, but that this training should be voluntary, not mandated by any government of licensing agency.

In an effort to curtail the overprescribing of opioids, the Center for Medicare and Medicaid Services (CMS) has recently proposed that initial prescriptions for opioids be limited to no more than seven days. (As of this writing, the CMS has requested that comments on this proposal be submitted by March 5th. The proposal, with any changes, will be published by April 2nd, with an anticipated “take effect” date of 2019.)  Many doctors are concerned that this proposal will harm patients who stand to benefit from opioid therapy.