Many have called the War on Terror the “War of Terror” because it has taken the lives of over half a million civilians in Iraq, Afghanistan and Pakistan. It is also having alarming health effects on U.S. troops. Veterans and troops who have seen combat in these wars are at a significant risk for becoming addicted to opioids — even more so than other members of the military who have not seen combat, according to a study by the National Bureau of Economic Research (NBER).
The NBER study, titled, “Did the War on Terror Ignite the Opioid Epidemic?” found rates of opioid abuse are 7% higher in soldiers exposed to combat than those who were not.
The authors, Resul Cesur, Joseph J. Sabia and W. David Bradford conducted their study based on two others: the National Longitudinal Study of Adolescent and Adult Health and the 2008 Department of Defense Health and Related Behaviors Survey. From the first study, they found that out of 482 male service members, 13% reported abusing prescription drugs. From the second study, they found that out of 11,542 service members who saw combat, 9% reported using pain relievers for non-medicinal use and .6% reported using heroin.
The NBER study also found that those who were involved in combat were one percentage point more likely to use heroin than those who were deployed but not fighting.
The study is the first to link opioid abuse with the War on Terror, although it is well-known that opioid abuse is prominent within the military community. The Department of Defense (DoD) and the Department of Veteran Affairs (VA) have both launched campaigns to try to curb opioid abuse within the military.
The difference in abuse rates, the study said, is likely attributable to the fact that those who were wounded in combat were likely prescribed opioids for pain management. About a third of opioid medication abuse could be linked to injuries, the study said. When it comes to heroin use, that percentage rises to 58%.
The study found the use of heroin is rare in the U.S. military, but most common within the Army and Marine Corps, followed by the Navy and the Airforce having the lowest rates.
Approximately 2.8 million people have been deployed in Iraq and Afghanistan 5.8 million times since the start of the conflict, the MilitaryTimes reports.
In 2015, VA officials reported they saw a 55% increase in opioid abuse disorders since the start of the War on Terror. In 2016, VA treated approximately 68,000 veterans for opioid addiction, and between 2010 and 2016, 6,485 veterans in the VA healthcare system died of opioid-related causes.
The study notes the enlisted population suffers the most because they are more prone to mental illness and substance use. It also estimated the cost of opioid addiction cost the U.S. $1 billion per year. For heroin use, it cost about $470 million per year. The authors say their estimates are likely modest because these issues often go under-reported.
In addition, veterans and troops also reported using sedatives — like benzodiazepines — for non-medical purposes and along with opioids.
The study found evidence that in areas where medical marijuana use is legal, pain medication prescriptions, opioid-related hospitalization and age-adjusted opioid death rates are lower, suggesting medical marijuana is a safer alternative.