Combat 'substantially' increases troops' risk of painkiller and heroin abuse, study shows

Abbie Bennett
October 17, 2019 - 11:00 am

U.S. Air Force photo by Mark Herlihy

United States combat veterans who deployed in service to the Global War on Terror, are at "ground zero" of the national opioid epidemic, a recent study says. 

Service members who deployed since Sept. 11, 2001 and saw combat have a much higher rate of opioid abuse than troops who didn't deploy to combat zones and have more than twice the overdose rate of civilians, according to the study titled "Did the War on Terror Ignite an Opioid Epidemic?" published recently by the National Bureau of Economic Research. 

Resul Cesur, a researcher at the University of Connecticut who has published work on the effects of combat on veterans, led what the university calls the first study of its kind. A service member's risk of prescription painkiller abuse and heroin use is much higher if he or she served in combat than service members who didn't deploy to combat zones, the study found. And those substance abuse problems have far-reaching effects. 

Post-9/11 veterans and service members who have deployed to Iraq and Afghanistan can experience chronic pain, psychological trauma and Post-Traumatic Stress Disorder and have access to "cheap opium supplies," the study says, all of which can fuel a potential addiction. 

Overall, combat service can increase a service member's likelihood to abuse such drugs by as much as 7 percent, according to the study. 

U.S. Air National Guard photo by Senior Airman Amber Mullen

“Combat deployments have a severe effect on the likelihood of injury, which is obvious, and also it has a severe effect on mental health. So, we are not that surprised” that combat service would cause higher rates of opioid abuse, Cesur said in a university statement. "But we also try to understand the mechanisms. Our work suggests that combat injuries and also psychological stress like PTSD (post-traumatic stress syndrome) due to combat are the reasons behind it. The biggest conclusion from our work is that it’s not simply because these people would abuse opioids even if they didn’t enlist; quite the contrary. The opioid epidemic in the U.S. military has a lot to do with what servicemembers went through in combat zones.” 

Nearly $1.04 billion per year is spent on caring for combat veterans' prescription painkiller abuse issues and another $470 million for their heroin use, according to the university.

But improvements are being made. Since 2012, the rate of opioid prescriptions by the Department of Veterans Affairs has dropped by more than 40 percent, the study says. 

Cesur believes marijuana could help those veterans. Though medical marijuana was not part of his study, Cesur says it could be an alternative to opioids, which are more likely to be addictive and lethal. 

“We are not saying that this is going to solve all the problems, but it seems like it’s a viable alternative among the policy options,” Cesur said. “This is a sensitive issue. On the one hand, people die from opioid abuse; on the other hand, people have severe pain. So, I don’t have a quick fix and I don’t have a magic solution.” 

The study was based on surveys of thousands of male service members by the University of North Carolina and the Defense Department. 

Service members in some areas earlier this year began learning how to administer Naloxene nasal sprays as part of the Defense Department's Project DAWN (Deaths Avoided with Nalaxone) in an effort to help reduce opioid deaths. 

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Reach Abbie Bennett: or @AbbieRBennett.

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