ArticleFrontiers in public health2026
National trends, disparities and forecasts in substance use disorder-related suicide mortality in the United States: a CDC WONDER analysis.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Suicide remains a leading cause of mortality in the United States, and substance use disorders (SUD) are strong predictors of suicide risk. Long-term trends and disparities in SUD-related suicide mortality remain insufficiently characterized. Methods: We analyzed 2001-2023 mortality data from the CDC WONDER Multiple Cause of Death database, using the most recent complete 23-year national time series. SUD-related suicide deaths were defined as deaths with suicide as the underlying cause (ICD-10 U03, X60-X84, Y87.0) and SUD listed among multiple-cause or contributing conditions (ICD-10 F10-F19). Each death was counted once. AAMRs were calculated by sex, race/ethnicity, census region, and urban-rural status, while age-specific rates were calculated by age group. Joinpoint regression estimated APC and AAPC. ARIMA and ETS models forecasted AAMRs through 2035. Results: The overall AAMR increased from 0.45 in 2001 to 0.74 in 2023, representing a 64% rise (AAPC, 1.70, 95% CI, 1.16-2.24). Men consistently had higher mortality than women, whereas women showed steeper proportional increases. Mortality was highest among adults aged 45-54 years and lowest among those aged 15-24 years. Non-Hispanic White individuals, the Midwest, and nonmetropolitan areas had the highest burdens. ARIMA projected largely stable rates with widening prediction intervals, whereas ETS suggested a modest increase through 2035, mainly driven by the male series. Conclusions: SUD-related suicide mortality increased substantially and remained unevenly distributed across demographic and geographic groups. Divergent forecasts highlight uncertainty and the need for targeted prevention.
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