Did the War on Terror Ignite an Opioid Epidemic?

60 Pages Posted: 18 Sep 2019

See all articles by Resul Cesur

Resul Cesur

University of Connecticut, School of Business - Dept. of Healthcare Economics

Joseph Sabia

University of New Hampshire; San Diego State University - Department of Economics

W. David Bradford

University of Georgia - Department of Public Administration and Policy; University of Georgia - Department of Economics

Date Written: September 2019

Abstract

Grim national statistics about the U.S. opioid crisis are increasingly well known to the American public. Far less well known is that U.S. war veterans are at ground zero of the epidemic, facing an overdose rate twice that of civilians. Post-9/11 deployments to Afghanistan and Iraq have exposed servicemembers to injury-related chronic pain, psychological trauma, and cheap opium supplies, each of which may fuel opioid addiction. This study is the first to estimate the causal impact of combat deployments in the Global War on Terrorism on opioid abuse. We exploit a natural experiment in overseas deployment assignments and find that combat service substantially increased the risk of prescription painkiller abuse and illicit heroin use among active duty servicemen. War-related physical injuries, death-related battlefield trauma, and Post-Traumatic Stress Disorder emerge as primary mechanisms. The magnitudes of our estimates imply lower-bound combat exposure-induced health care costs of $1.04 billion per year for prescription painkiller abuse and $470 million per year for heroin use.

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Suggested Citation

Cesur, Resul and Sabia, Joseph and Bradford, W. David, Did the War on Terror Ignite an Opioid Epidemic? (September 2019). NBER Working Paper No. w26264. Available at SSRN: https://ssrn.com/abstract=3454365

Resul Cesur (Contact Author)

University of Connecticut, School of Business - Dept. of Healthcare Economics ( email )

School of Business
2100 Hillside Road
Storrs, CT 06269
United States

Joseph Sabia

University of New Hampshire

15 College Road
Durham, NH 03824
United States

San Diego State University - Department of Economics ( email )

5500 Campanile Drive
San Diego, CA 92182
United States

W. David Bradford

University of Georgia - Department of Public Administration and Policy ( email )

Athens, GA 30602-6254
United States

University of Georgia - Department of Economics ( email )

Athens, GA 30602-6254
United States

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