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Comment by phamilton4 | Hacker News Reader

I wonder how much of this has to do with COVID and how much has to do with fentanyl.

I am shocked that no one is even talking about the excess fentanyl deaths. Also how much of this is attributed to our fading health system?

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No one is talking about fentanyl? The opioid epidemic is a constant and ongoing topic of conversation and debate. It's one of the defining political issues of our time with Gavin Newsom just weeks ago vetoed a supervised administration bill which took up a news cycle. The opiod epidemic is one of the most talked about things out there. Pharma companies and others are being sued to hell and back for their role in the epidemic. Just this February there was a 26 billion dollar settlement[1]. Honestly, I'm not sure how you'd manage to avoid hearing news about one of the defining public health issues of the past two decades.

[1] https://www.npr.org/2022/02/25/1082901958/opioid-settlement-...

Fentanyl has had a ton of coverage so I’m not sure why you think nobody is talking about it but I suspect that our limited response mostly has to do with the degree to which drug problems are often symptoms of social problems we’ve chosen not to do with.

The article specifically details the different factors in the overall decline in expected longevity. COVID is the largest but definitely not the only one:

https://static.scientificamerican.com/sciam/assets/Image/202...

Fentanyl and suicide tend to kill young people, while COVID tends to kill people who are very old (at one point, the average age of a COVID death was greater than the life expectancy number).

It's the increasing mortality of young people that really drops life expectancy.

While true, the obesity issue was always going to force this down eventually anyways. Boomers are probably the oldest generation that will die younger than their parent due to it (statistically speaking). And probably just get worse from there for a good while. Innovative breakthroughs in health science can not keep pace with the wave of obesity related health issues.

But did the lockdown cause more overdose deaths?

The number I could find for all cause drug overdose death (including everything in addition to fentanyl) for the last twelve months was 110k.

Cardiovascular disease 870k.

Cancer 610k.

Usual caveats apply to cause of death reporting, but fentanyl alone is not terribly relevant to this topic.

If a typical fentanyl overdose is destroying 30-40 years of life expectancy and a typical covid death is destroying 5, then 40k fentanyl overdoses would be similar to 280k covid deaths in terms of life expectancy.

I don't know if my numbers are right, but your numbers don't lead me to dismiss fentanyl from the current conversation.

Yeah, I don’t think excess COVID deaths are driving life expectancy either. It’s the two things I listed in my comment, both of which are getting worse with time and are affecting people earlier and earlier.

Although I’ve heard anecdotal evidence that COVID infection does damage cardiovascular health.

The CDC has that information.

https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/...

Everyone is talking about fentanyl. The problem is that overdoses aren't "excess deaths", those show up in hospitals as real data. And they aren't enough to explain the kind of numbers we saw with covid. Surely fentanyl overdoses are a problem, and they get a bunch of coverage. But they absolutely aren't "the real story" behind the covid excess death numbers; that's just your priors arguing in your head.

Fentanyl overdoses and suicides are excess deaths in that they contribute to excess death numbers when they are higher than expected. They just don't account for the full number of excess deaths over the last few years - the lion's share is almost certainly from the virus.

This article about life expectancy specifically lists overdose deaths as a major contributor to decreased life expectancy

The comment I was responding to was positing that the covid "excess deaths" statistics (not the same thing as life expectancy measurements) were confounded by fentanyl overdoses. They are not.

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