Haley is correct that fentanyl deaths top those from 3 wars combined

Nikki Haley

Statement: “We’ve had more Americans die of fentanyl than (in) the Iraq, Afghanistan and Vietnam wars combined.”

ATKINSON, N.H. — Addressing a conference room full of New Hampshire voters, Republican presidential candidate Nikki Haley shared a grave statistic about the synthetic opioid fentanyl.

"We’ve had more Americans die of fentanyl than (in) the Iraq, Afghanistan and Vietnam wars combined," the former South Carolina governor said Dec. 14 at the Atkinson Resort and Country Club.

Fentanyl is a potent synthetic opioid. It is used legally in pharmaceuticals, but most deaths are connected to its illegal manufacture and distribution. Small amounts can be lethal. The opioid factored in nearly 400 New Hampshire deaths in 2022, numbers from New Hampshire’s chief medical examiner show. The state’s high rate of opioid-related deaths has been a leading public health concern for several years, just as national overdose deaths have also climbed.

Federal data shows Haley’s math is accurate when measuring national fentanyl deaths against U.S. military deaths. About 127,000 Americans died of drug overdoses involving a synthetic opioid other than methadone (primarily fentanyl) in 2020 and 2021 alone, compared with 65,278 U.S. military deaths in Iraq, Afghanistan and Vietnam.

Although public officials have long compared drug deaths with war fatalities, U.S. health officials approach addiction issues as public health matters and typically compare opioid deaths with deaths from other public health causes.

Military and drug overdose deaths

Military data from the Defense Department’s Defense Casualty Analysis System shows that 65,278 people died during the three conflicts when counting hostile battles and other nonhostile, in-theater situations. These figures include deaths from accidents, illness, injury and self-inflicted causes.

In 2021 alone, the National Center for Health Statistics reported more than 106,000 drug overdose deaths. Of those, 70,601 involved synthetic opioids other than methadone. Fentanyl overdoses are not specifically separated, but the agency’s reports say that the deaths in this category are primarily because of fentanyl.That was up from 2020, when 56,516 people died from drug overdoses involving synthetic opioids other than methadone.

With just a few years' worth of data, it is clear that the fentanyl death toll surpasses the wartime death toll Haley specified.

We have seen this war death comparison before

This is not the first time we have seen war deaths used to illustrate a public health issue’s direness. Politicians and TV commentators have used military conflicts to illustrate the toll of gun violence, and more recently President Joe Biden used them to quantify deaths from COVID-19.

Drugs-and-war parallels have been hard to avoid since 1971, when President Richard Nixon declared a "war" on illegal drugs.

"Comparing deaths linked to public health crises to war deaths, and especially the Vietnam War, is a pretty common thing," said David Herzberg, a drug historian and professor at the University at Buffalo. "And on its face it is a reasonable strategy for conveying gravity," or seriousness of a crisis.

Fentanyl has taken a deadly toll , especially on younger adults. A Washington Post analysis found that fentanyl overdoses are the leading cause of death for American adults ages 18 to 49.

Drug overdose deaths are counted among the entire U.S. population of more than 330 million people; casualties of soldiers occur within a smaller population, so deaths will never surpass the number of people who serve in a given conflict. For Vietnam, that was about 2.7 million, according to the Department of Veterans Affairs.But experts such as David Luckey, a senior international and defense researcher at the Rand Corp., a global policy think tank, said this sort of comparison can "show the scope of this problem" and put the scale of the illicit fentanyl crisis in a perspective that people can understand.

Comparing the fentanyl death toll to other public health crises such as heart attacks or car accidents, "would technically be more accurate," said Herzberg, "but might not get the idea across because the public may not know whether those other things are really big problems or not — so they aren’t as useful as a benchmark."

The CDC counts drug overdose deaths in the category of "accidents (unintentional injuries)." In 2021, heart disease, cancer and COVID-19 claimed more lives than those who died in accidents. The CDC reported that 695,547 died of heart disease, 605,213 of cancer and 416,893 of COVID-19. The overall death count for accidents was 224,935, of which opioid deaths made up a major portion.

Fentanyl as a Chinese threat

Haley’s other comments hint at why she’s invoking war numbers. She said fentanyl deaths are among many reasons she believes China is the United States’ leading national security threat.

"China has been preparing for war with us for years," Haley said.

China was the primary source of illicit fentanyl early in the U.S. opioid epidemic, we found. But when the Chinese government banned fentanyl production in 2019, producers switched tactics.

A 2022 Congressional Research Service report found that Chinese traffickers no longer send fentanyl directly to the U.S. Instead, chemists send the materials to Mexican criminal organizations, which produce the fentanyl. Data shows that the vast majority of people sentenced for fentanyl trafficking are U.S. citizens.

Our ruling

Haley said, "We’ve had more Americans die of fentanyl than (in) the Iraq, Afghanistan and Vietnam wars combined."

Her numbers are right. About 127,000 Americans died of drug overdoses involving a synthetic opioid other than methadone (primarily fentanyl) in 2020 and 2021 compared with 65,278 U.S. military deaths in Iraq, Afghanistan and Vietnam.

We rate this claim True.

This article originally appeared on Austin American-Statesman: PolitiFact: Fentanyl deaths top those from 3 wars combined