Trends in Mental and Behavioral Disorders due to Psychoactive Drugs and Stroke-Related Mortality in Adults Aged 25 and Older in the United States

Document Type

Conference Proceeding

Publication Date

1-29-2026

Publication Title

Stroke

Keywords

Behavioral aspects, Stroke

Abstract

Background: Mental and behavioral disorders are a major global health burden, causing ~14% of annual deaths (~8 million). Affected individuals face 3–4 times higher mortality and lose 10–20 years of life expectancy. Using two decades of CDC WONDER data, we examined national trends and disparities in mortality from psychoactive drug-related disorders and stroke. Methods: From 1999–2023, deaths from psychoactive drug-related disorders (F10–F19) and stroke (I64) were extracted from CDC WONDER. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percentage changes (APCs) with 95% confidence intervals (CIs) were calculated. Trends were analyzed using Joinpoint regression. Results: Between 1999 and 2023, a total of 157,717 mental and behavioral disorders due to psychoactive drugs and stroke–related deaths were reported in the U.S. The overall AAMR increased from 1.46 in 1999 to 6.42 in 2023. Overall mortality declined from 1999 to 2015 (APC: 30.87, 95% Cl: 21.39 to 41.08), till 2023 (APC: -1.25, 95% Cl: -3.21 to 0.75). With the highest AAMR in males (8.37) of (APC: 30.87 95% Cl: 21.39 to 41.08), as compared to females (4.23) with (APC: 30.87 95% Cl: 21.39 to 41.08). The Midwest region had the highest AAMR (7.60), followed by the South (6.20) and the Northwest (4.97), with the lowest in the West (4.94). In urbanization, metropolitan areas showed a gradual increase in AAMR from 1999 (1.29) to 2020 (6.87) (APC: 1.23; 95% CI: 0.24 to 2.23). In the non-metropolitan areas, there was a sharp increase in AAMR from 1999 (2.23) to 2020 (12.73) (APC: 0.66; 95% CI: -1.94 to 3.33). The American Indian or Alaska Native showed the highest AAMR (7.69), followed by Black or African American (7.18), Hispanic or Latino (2.68), and White (6.06), with the lowest AAMR in the Asian or Pacific Islander population (8.98). The highest mortality burden was recorded in individuals aged 85+ among all other age groups, with the highest CMR of (25.18), while the lowest was in patients aged 45-54 years (0.95). States in the top 90th percentile, including Oregon and Idaho, had higher AAMR than states in the lower 10th percentile, including California. Conclusion: Mortality from psychoactive drug-related disorders and stroke has risen since 1999, disproportionately affecting males, nonmetropolitan areas, the Midwest, and American Indian/Alaska Native populations. These disparities call for targeted, equity-focused interventions to reduce mortality in vulnerable groups.

Volume

57

Issue

SUPPL_1

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