The Role of Drugs in AIDS

1/10/93 Ms. No. T1867

an anti-HIV drug (3). Thus, in the U.S. the drug epidemic is new, while the
HIV epidemic is old (2, 3).
Another striking coincidence is that over 72% of all American AIDS
patients (4) and over 80% of all Americans who consume hard psychoactive
drugs (28, 36) or get arrested for possession of drugs (29) are 20-45 year-old
males.
In addition, drugs and AIDS appear to claim the same casualties from
this group. For instance, the annual mortality of 25-44 year-old American
males increased from 0.21% in 1983 to 0.23% in 1987, corresponding to about
10,000 deaths among about 50 million in this group (37). Since the annual
AIDS deaths had also reached 10,000 by 1987 (4-6) HIV was assumed to be the
cause. However, mortality in 25-44 year-old males from septicemia,
considered an indicator of intravenous drug use, rose almost fourfold from
0.46 per 100,000 in 1980 to 1.65 in 1987 and direct mortality from drug use
doubled (37, 38)-suggesting that drugs played a significant role in the
increased mortality of this group (37). Moreover, deaths from AIDS diseases
and non-AIDS pneumonia and speticemia per 1000 intravenous drug users in
New York increased at exactly the same rates, from 3.6 in 1984 to 14.7 and 13.6
respectively in 1987 (39). In view of this, the Centers for Disease Control
(CDC) acknowledges "We cannot discern, however, to what extent the
upward trend in death rates for drug abuse reflects trends in illicit drug use
independent of the HIV epidemic" (37). Further, maternal drug consumption
was blamed by some (40) and HIV infection by others (4, 6) for a new epidemic
in American children of physiological and neurological deficiencies,
including mental retardation. Here I investigate the overlap between the
"The twin epidemics of substance use and HIV" (7, 27).