In the last couple of weeks, watching the end of the American war in Afghanistan and the Taliban takeover, I realized that Afghanistan is at the intersection of the war on terror and the war on drugs. I have been engaged for nearly 20 years now in work to update global estimates of conflict deaths and global estimates of deaths attributable to drug use.
Alfred McCoy has documented the role of opium production in the Afghanistan wars in his 2015 book In the Shadows of the American Century (see also how-the-heroin-trade-explains-the-us-uk-failure-in-afghanistan). After 20 years, the fighting (mostly) has ended, but western intervention has resulted in Afghanistan becoming the world’s first true narco-state. Opium harvesting along with US support sustained the Afghan resistance to the Soviet occupation in the 1980s, and the rise to power of the Taliban in the 1990s. In July 2000, the Taliban ordered a ban on all opium cultivation, and opium production fell by 94%. When the US invaded Afghanistan in 1991, they allied with the Northern warlords who had been active in the drug trade and smuggling. Opium production resumed and grew over the following two decades.
The UN Office on Drugs and Crime reported in its World Drug Report 2021 that Afghanistan reported a 37 per cent increase in the amount of land used for illicit cultivation of opium poppy during 2020 compared with the previous year. It was the third highest figure ever recorded in the coun- try and accounted for 85 per cent of the global total of opium production in 2020. The increase follows a trend that has seen the global area under opium poppy cultivation rise over the past two decades, particularly after 2009. In 2020, 43% of arable land in Afghanistan was under poppy cultivation. This was somewhat lower than the 60% peak in 2017. An estimated 95% of heroin in Europe comes from Afghanistan. Only a small proportion of heroin in the USA comes from Afghanistan, the majority comes from Mexico.
However, the US-led war on drugs with its attendant prohibition and criminalization keeps heroin prices and profits high, so that poppy cultivation remains far more profitable than other crops, and has played a significant role in funding both sides of the Afghan conflict. Narcotics are likely to have provided the Taliban with over half its revenues through organising cultivation, protecting harvests, and securing criminal supply routes into central Asia. Its military victory may now see a further expansion of the opiate economy. But what of the impact on the USA, where pharmaceutical and other synthetic opioids, particularly fentanyl have fueled an exponential increase in drug overdose deaths.
The CDC has recently released provisional estimates of US drug overdose deaths in 2020, and I have done a quick update of previous time series estimates for US opioid and other drug overdose deaths. The results are shown in the following plot. Dug overdose deaths (grey curve) have been rising exponentially for over three decades at an average annual growth rate of 10.4% (dotted grey curve) with a 29% jump in the pandemic year 2020 to 96,000 overdose deaths, of which 70,470 were due to opioids. Fentanyl and other synthetic opioids were responsible for most of these, heroin in 2020 was responsible for only around 15,400 deaths.
I have also done an approximate projection of total deaths attributable to drug use (yellow curve), which include overdose deaths, road injuries and suicide, as well as HIV and hepatitis B and C deaths associated with transmission through injecting drug use. The total attributable deaths in 2020 were estimated at around 140,000.
How does the mortality toll from the war on drugs compare with the deaths due to the Afghan conflict? Conflict death estimates for Afghanistan are hugely uncertain. Wikipedia has a review of various estimates for the Soviet war period of the 1980s, with 1.2 million deaths being a mid-range estimate. The post-Soviet period of civil war in the 1990s probably results in around another half million deaths. For the period from 2001, when the US commenced action against the Taliban and Al-Quaeda, to the end of US involvement in August 2021, I have updated earlier conflict death estimates prepared for WHO and UNICEF (see here for details) to include new data from ACLED, the Armed Conflict Location and Event Data Project. I have again drawn on the latest data from ACLED up to end of July 2021 to update estimates of total conflict deaths in Afghanistan from 1985 to 2021. For the years 2001 to 2021 inclusive, there were an estimated total of 483,800 conflict deaths.
A very approximate apportioning of this almost half a million deaths suggests that there were around 116,000 Afghan soldiers and police deaths, 51,000 Taliban fighter deaths and around 300,000 civilian deaths. Almost 2,500 US soldiers died, along with 1209 deaths among US allies (UK, Australia, Canada and EU forces), and almost 4,000 US civilian contractors.
These figures for deaths due to the Afghan war and for US drug-related deaths dwarf the current US total of just over 640,000 Covid-19 deaths to date, though of course these are concentrated into a much shorter period of one and a half years.
The table and figure below compares these death tolls by decade (and include 2021 for Covid-19 only):