According to the latest-available set of comparable data, North Carolina ranks 33rd in the nation in “deaths of despair” — that is, in the combined rates of suicides, fatal drug overdoses, and alcohol-induced deaths. In 2020 our age-adjusted rate was 55.5 deaths of despair per 100,000 residents, slightly higher than the national average of 54.8. From 2018 to 2020, our rate rose by 26%.