Between 25 and 45 percent of deaths by overdose may be suicides, according to the immediate past president of the American Psychiatric Association. Dr. Maria Oquendo told NBC News the opioid epidemic is occurring at the same time suicides have risen to a 30-year high. One study of overdoses from prescription opioids found almost 54 percent were unintentional. The rest were either suicide attempts or undetermined, the article notes. Few doctors are looking for a connection between opioid addiction and suicides, Dr. Oquendo said. “They are not monitoring it,” she said. “They are probably not assessing it in the kinds of depths they would need to prevent some of the deaths.”

The incresing rate of deaths due to opioids, alcohol and suicides are part of a public health crisis described as “deaths of despair” in a new report published recently. Life expectancy in the United States has decreased for the second year in a row because of these factors, researchers wrote in BMJ. The drop was particularly steep among middle-age white Americans and people living in rural areas, USA Today reports. “Why white Americans are dying at higher rates from drugs, alcohol, and suicides is unclear, complex, and not explained by opioids alone,” the researchers wrote. They note that possibilities include the collapse of industries and the local economies they supported, the erosion of social cohesion and greater social isolation, economic hardship, and distress among white workers over losing the security their parents once enjoyed.

More than 1.6 million Americans could die from drugs, alcohol and suicide over the next decade, a new report concludes. USA Today reports the findings come from the Trust for America’s Health and the Well Being Trust. The nonprofit group found in 2015, there were 39.7 deaths per 100,000 U.S. residents due to drugs, alcohol and suicide, compared with 23.1 deaths per 100,000 in 1999—a 72 percent increase. That number could rise to 56 deaths per 100,000 by 2025, the group said. “We see a connection among the three epidemics,” said John Auerbach, President and CEO of the Trust for America’s Health. “They are all behavioral health-related — that is, they have a substance abuse or mental health diagnosis associated with them.”

A new study finds an increased risk of suicide attempts in teens is associated with prescription drug abuse, Reuters reports. Teens who said they used prescription drugs for non-medical purposes at the start of the study were almost three times as likely to report a suicide attempt a year later. The study of 3,300 Chinese teens is published in JAMA Pediatrics. The researchers found teens’ suicide risk was more than tripled if they abused opiates. Overall, fewer than 3 percent of teens in the study reported misusing any prescription drugs, including 1.8 percent who said they misused opiates or stimulants, and 1 percent who said they abused sedatives.