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The Drug-AIDS
Hypothesis Note: The information on this website is presented for
educational purposes and This document was provided by 3. THE AMERICAN/EUROPEAN DRUG EPIDEMIC 3.1. Chronology of the drug epidemic in America. During and after the Vietnam war, in the 1970s, the number of illicit recreational drug users in America soared from a negligible background to currently about 20 million who use drugs chronically, or about 8% of the total US population of 250 million. In addition, 75 million Americans (30%) use such drugs occasionally 50-52 . This sudden epidemic of drug addiction followed a 40 year period (from World War II until the upsurge in the 1970s) during which there was very little illicit recreational drug use. Prior to World War I, heroin, cocaine, and nitrite inhalants were legal, and widely prescribed as medicines and sold as recreational drugs 53-55 . Those who became addicted generated an early drug epidemic that lasted about 35 years, "from around the mid-1880s until the 1920s"51 . The concurrent diseases and social consequences soon led to anti-drug legislation, which together with the political situation of the wars ended "the first cocaine epidemic"51, 54, 56 . According to the Bureau of Justice Statistics: "Cocaine abuse decreased substantially by the 1920’s, and then virtually disappeared from the American scene until the 1970’s. During the 1930’s drug interest dwindled due to concern with the events in Europe. During WW II international trafficking was eliminated. As the 1950s ended, efforts to treat, rehabilitate and care for drug addicts were made for the first time since the turn of the century."51 . As of 1964 the Bureau chronicles the appearance of the new American drug epidemic: "rapid rise in marijuana use; amphetamines and barbiturates move from homes to the streets; rise in heroin addicts leads to methadone maintenance pilot programs (1964). By the late 1960s increases in cocaine, heroin and marijuana use prompted concern about drugs..." In the 1970s the "Vietnam war produces drug testing and dependence among returning veterans." And by 1980 "crack appears in American cities" and "AIDS first described in medical literature. Athletes die from overdoses, showing the lethal implications of crack/cocaine (1986)"51 . The director of NIDA wrote in 1985, "Over the past 10 years, cocaine ... has evolved from a relatively minor problem into a major public health threat."57 . In 1986 scientists from the National Institute on Drug Abuse (NIDA) published an epidemiological overview of drug use in the US in Science. According to the NIDA scientists cocaine addiction spiraled in the US from "negligible" numbers in 1973 to 9,946 non-fatal and 580 fatal medical cases in 1985 58 . The new cocaine epidemic has since increased more than 10-fold, raising the numbers of cocaine patients to 80,355 cases in 1990, and 123,423 in 1993 and 142,878 in 1994 25, 50, 58- 61 (see Fig. 2 and Table 2). Cocaine emergencies hit a new record of 13,496 cases in California in 1994, up from 3,688 in 1985 62 . Even popularwriters have accurately chronicled the rise of the new American drug epidemic, as for example Jill Jonnes in Hep-cats, narcs, and pipe dreams 54 . In step with its medical consequences cocaine consumption escalated to unprecedented records. By 1996 the number of regular cocaine users had reached 3.6 million, with 28 million who had at least tried the drug once in their lifetime 51, 61 . To keep up with their demand cocaine imports had to be increased 200-fold, from 2 tons in 1980 to 400 tons in 1990, and have since been kept at this level 25, 52, 61 (Fig. 2). These data are based on cocaine seizures that increased from 500 kg in 1980 to 100 tons in 1990 and have since remained at this level 61, 63, 64 (see Fig 2). The Bureau of Justice Statistics estimates that only 10-20% of the imported cocaine is confiscated, and that American consumption is currently at least 400 tons per year 52, 65 . This corresponds to about 110 g for each of the 3.6 million regular users per year, which is rather close to the estimated daily consumption of 1g per day per addict 66 . Heroin-related hospital emergencies doubled, from over 30,000 in 1990 to 63,232 in 1993 50 (Table 2 and Fig. 2). Heroin deaths climbed from 2,260 in 1991 to 3,522 in 1994 according to the Drug Abuse Warning Network (DAWN)60 (Table 2). About 1,500 kg of heroin were confiscated annually between 1992 and 1995 61 . In view of these alarming statistics the popular press 50, 59, 67, 68 including the San Francisco Chronicle warned that "a growing segment of the population [is] attracted by its [hero-in] deadly mystique and encouraged by its low prices ..."69 . According to a 1994-survey of the NIDA "more than 5 percent (221,000) of the 4 million women who give birth each year use illicit drugs during their pregnancy" 50 . Many of these mothers are among the AIDS patients listed as intravenous drug users, and many of their babies are listed as pediatric AIDS cases by the Centers for Disease Control (CDC)3 (see 6.8. and 6.9). Based on the amounts confiscated, 2 million doses in 1981 and 97 million doses in 1989, amphetamine consumption has spiraled 50-fold in the 1980s 64 . Non-scientific reports describe new upsurges of amphetamine consumption in the US and Europe among male homosexuals 70, 71 and others 72 . According to the US Department of HHS, "amphetamine-related emergency room episodes... [presenting with] violent paranoid behavior as well as stroke, seizure and death..."73 increased from 8,800 in 1990 to 17,665 in 1993 50, 60 (see Table 2). In California amphetamine or ‘speed’ hospitalizations rose even faster from 1,466 in 1984 to 10,167 in 1994 72, 74 . And the Drug Abuse Warning Network reports a three-fold increase in amphetamine deaths from 252 in 1991 to 751 in 1994 60 (Table 2). There are no American statistics from the Bureau of Justice on the consumption of nitrite inhalants, even though nitrites have been banned for recreational use in the US since 1988. Despite this ban they are sold legally as room deodorizers 76-78 . Before the ban about five million doses of amylnitrites were consumed in the US in 1980, mainly by male homosexuals 55, 79, 80 . After the ban, in 1993, 4.2 million Americans, including 2.8 million men and 1.4 million women, had used nitrites based on a survey from the National Institute on Drug Abuse 39. 3.2. Chronology of the drugepidemic in Europe. Europe was hit by a drug explosion ("Drogen-Explosion") at the same time as America. Based on the amounts confiscated by the Bundeskriminalamt (BKA), the German consumption of cocaine, heroin, amphetamines, LSD and cannabis increased 1000 to 10,000 fold from the 1960s to the 1990s (Table 2a) 350 . According to the Deutsche Hauptstelle gegen die Suchtgefahren (Center for drug addictions) in 1997, 19.3% or 3.9 million of the 18 to 59 year old former West German males, and 9.9% or 1.9 million of the females have used illicit drugs at some time 351 . The majority of these had used haschisch (cannabis) but 7.5%, or 1.5 million, males and 4%, or 0.75 million, females had used hard drugs such as cocaine, heroin and amphetamines. Altogether 19.3%, or 7.5 million, of the for-mer West Germans have used illicit drugs in their lifetime, and 5%, or almost 2 million, are monthly users 353 . About 200,000 are lifetime users, and 80,000 are regular users of inhalants ("Schnüffelstoffe"), probably including nitrite inhalants 353 . Among the 80 million current Germans, four million are addicted to alcohol and 120,000 to heroin 350 . The German Rauschgiftbilanz reported an 11.2% increase in the consumption of illicit recreational drugs in 1994 compared to 1993 75 . And the number of first time users reached 15,000 in 1995, up 5% from 1994 350 . Most of these, 83%, were over 21 years old. In 1993, 122,240 Germans were reported for drug offenses and 29,086 were convicted. There were 2,125 deaths officially blamed on drug use in Germany in 1991, 1,565 in 1995 and 1,712 in 1996 350, 353 . This represents a 10-fold increase since the decade that started in 1975 with 195 drug deaths (Fig. 2a). As can be seen in Fig. 2a the rise in German drug deaths paralleled the rise in AIDS cases. Like in America, German males outnumbered females about 3 to 1 in the consumption of hard recreational drugs (cocaine, heroin and amphetamines, use of nitrite inhalants is not recorded in Germany)351 , and 9 to 1 in AIDS cases 352 . Drug consumption by the combined European Union almost matches, and in the case of heroin, even exceeds the American epidemic based on the amounts confiscated (Table 3a). For example, 5.9 tons of heroin were confiscated in Europe in 1994 compared to 1.5 tons in the US (see above). At the same time, 29 tons of cocaine, 1.9 tons of amphetamines, 733 tons of cannabis and 61,000 doses of LSD and 1.25 million doses of ecstasy were seized in the European Union in 1994 350 . A review of the European recreational drug explosion by the popular Springer Verlag (press) mentions just two health consequences: "heart arrest" from cocaine, "itching" and "collapse of the immune system" from ecstasy 350 . 3.3. Epidemiology and age distribution of recreational drugs. In contrast to infectious diseases, the epidemiological distribution of recreational drug use is far from random. Instead it is highly differentiated in the American and European populations (Table 3). About 70- 80% of the American consumers of hard recreational drugs such as cocaine, heroin and amphetamines are males over 18 years of age based on information from the Bureau of Justice Statistics, the NIDA, The White House and Public Health Services other than the CDC (Table 3). The National Drug Control Strategy: 1996 from the White House reports that 78% of the drug users are males, and that 74% are 21-44 years old 52 . Patients and deaths from drug diseases (see 3.3.) show essentially the same sex and age distribution (Table 3). Almost all drug decedents are over 18 years of age, and most are over 25 60, 61, 84 (see Table 3). According to a German study the median age of death of European intravenous users of cocaine and heroin is 30 years 38 . Their American counterparts die between 25 and 44 years 40, 85 . The drug epidemiology is further differentiated based on sexual persuasion. While cocaine and heroin are used independent of sexual preferences in all major American and European cities, including New York 86-89 , Baltimore 90, 91 and Milan 92 , nitrite inhalants are almost entirely, and amphetamines are partially, monopolized by male homosexuals (see 3.3.). However, in contrast to the hard illegal drugs used for psychoactive effects only (Table 3), those used specifically as sexual stimulants by male homosexuals like nitrite inhalants are not recorded nationally, neither by the Department of Justice nor by any of the many divisions of the Department of HHS. Therefore, we have put together the pattern of drug use by homosexuals from non-scientific reports and from sporadic reports in the scientific literature. Numerous non-scientific reports confirm the popularity of the "gay drug"91 (nitrite inhalants) among male homosexuals in America and Europe 7, 76-78, 91-95 (see Table 4). The Swiss gay interest journal, aK, just surveyed the availability of poppers which "seit Jahren von vielen Leuten – vor allem Schwulen – beim Sex zwecks Verstärkung der Lust verwendet wird" [used as a gay drug for years]340 . The journal points out the fierce competition among sex shops for the gay market, particularly in view of the enormous profit margins of over 1000%. Bottles containing poppers that cost less than 1Sfr to produce sell for up to 58 Sfr in Zurich, Lucerne, Bern, and Basel. According to the journal the popper market has recently been upset because sales have been banned in some Swiss states because amyl nitrites, but not other nitrites, are listed as poisons by the Federal Public Health Office, BGA. In agreement with the non-scientific literature, the AIDS epidemiologist David Ostrow reported that nitrite inhalant use in a study of over 5000 male homosexuals from Chicago, Baltimore, Los Angeles and Pittsburgh, the MAC cohort, showed a "consistent and strong cross-sectional association with ... anal sex"95 . The San Francisco Department of Health and the NIAID sponsored San Francisco Men’s Health Study also report that 98% of nitrite inhalant users are homosexuals 79, 80 (Table 3). Like male homosexuals from San Francisco 80, 99, 100 and Chicago/Baltimore/Los Angeles/Pittsburgh 101, 102 , those from Vancouver 100, 103 , Sydney 100 , Amsterdam 100 and London 104, 105 also show a specific affinity for nitrite inhalants, because of "their ability to briefly relax the smooth muscles of the anal sphincter and thereby facilitate penetration"102 (see Table 4). The current American use can be estimated from British sales statistics because nitrites were legal in the UK until 1996, and because the drug use habits of the homosexual communities in the US and UK are comparable. For example, in 1984, 86% of British male homosexual AIDS patients from St Mary’s Hospital in London had inhaled nitrites compared to 86.4% from clinics in New York, San Francisco and Atlanta 341 . Since in 1995 at least 1.5 million bottles (15 ml each) were sold for a profit of £8.5 million in the United Kingdom 76 , it is likely that the current American use is proportional to its British counterpart. This assumption is confirmed by numerous epidemiological studies of cohorts of American male homosexuals (see 3.2, Table 4). Even the NIDA and the CDC announced informally at a nitrite-AIDS conference in 1994 342 , that "nitrite use by gay men in Chicago and San Francisco" has increased in the 1990s after a decline in the late 1980s 343 . Recently amphetamines have gained popularity, compared to nitrites, as sexual stimulants among America male homosexuals 70 . Says the director of an outpatient treatment center in Los Angeles, "Look at the demographics. It’s such a nasty drug, the way it destroys the body and the mind. Crystal (amphetamine) is a gay person’s drug and a gay community problem."70 . According to the CDC from before 1984 106-108 , and according to independent observers to this date 25, 76, 77, 80, 93, 103, 105, 108-111 , American and European male homosexuals at risk for AIDS or with AIDS stand out not only for the amounts, but also for the bewildering combinations of recreational drugs used (see Table 4). For example, the biggest American survey of about 5000 male homosexual men, the MAC study, reports various combinations of 13 recreational drugs 101, 102 (see Table 4). The median age of these 5000 American homosexual men at risk for AIDS and with AIDS is 32 years 112 . In an interview with the gay magazine The Advocate about a "Morning party" to benefit the Gay Men’s Health Crisis (GMHC) on Fire Island in New York in August 1992 Larry Kramer, founder of GMHC and author of the novel Faggots, commented:
Among the 685 respondents to "the biggest ever survey of gay men’s drug use" conducted in England in the summer of 1996 by Gay Times, 80% had used poppers (nitrite inhalants), 48% ecstasy (amphetamines), 57% speed (amphetamines), 40% coke (cocaine), 48% acid (LSD), 25% heroin, 76% cannabis, 58% cigarettes, 95% alcohol 105 (Table 4). A tricontinental epidemiological study confirms and extends the bewildering pattern of recreational drugs consumed by male homosexuals with AIDS or at risk for AIDS in the US and Europe and finds the same pattern repeated in Australia 100 . Remarkably not one of the many studies recording drug use by homosexual men with AIDS or at risk for AIDS has ever identified even one AIDS patient who was drug-free (see Table 4)! 3.4. Drug diseases. The ultimate costs of the American/European drug epidemic are the staggering numbers of drug diseases and drug deaths: in 1994, 8,541 Americans died from illicit recreational drugs, and 518,521 were delivered to emergency rooms for drug diseases 51 (see Table 2). In Germany there were 2,125 deaths officially blamed on drug use in 1991, 1,565 in 1995 and 1,712 in 1996. 350, 353 . Because of the high morbidity and mortality associated with long-term intravenous and oral drug use, addicts typically die at an average age of only 30 years 25, 38, 40, 85, 113 . The first scientific paper on drug diseases describes immunodeficiency caused by morphine addiction in Paris, France, in 1909 114 . An early American study by the pathologist Willis Butler first drew attention in 1921 "to the fact that most addicts suffered from a serious illness, such as syphilis or tuberculosis"53 . Since then numerous scientific studies, listed in Table 5, have documented the drug diseases of long-term drug addicts and their babies. These diseases include immunodeficiency, pneumonia, tuberculosis, dementia, candidiasis, weight loss, diarrhea, fever, night sweats, congenital abnormalities, mouth infections, impotence, epileptic seizures, paranoia, lymphadenopathy, hemorrhages, hypertension and many others 25, 39, 70, 115-122 . Table 5 also records the many overlaps between the well established drug diseases and the diseases embraced by the CDC’s AIDS definition of 1993 (see 2.). These overlaps were unintentionally confirmed in August 1996 by a drug treatment specialist of the Federal Bureau of Prisons from Greenville, IL, at a seminar in Kona, Hawaii. The specialist reported that every one of the over 300 AIDS patients he treated over the past 10 years had been a drug user outside and often even inside the prison 123 . The pathogenicity of recreational drugs is the product of 1) direct drug biochemistry, and 2) indirect factors affecting the lifestyle of those addicted to illicit drugs. 1) Biochemistry of drug diseases. Cocaine, heroin and amphetamines each function as a catalyst of neurotropic reactions. Cocaine and heroin are natural compounds and amphetamines are synthetic adrenalins, used in Germany during World War II to suppress fatigue and anxiety in pilots and tank commanders 124 . A typical daily dose of 1-2 g of cocaine 66, 350 , or heroin 121 or amphetamine 113 consists of about 10 21 molecules, or 10 7 molecules for every one of the 10 14 cells of the human body. At that concentration these catalysts are so active that recipients forget to eat, to drink, to sleep and lose many of the inhibitions that control undrugged life – the reason for their popularity and eventual pathogenicity. The pathogenicity of cocaine and heroin is exhaustively documented in numerous pre-AIDS publications and in rare AIDS publications that acknowledge HIV-free AIDS (see Table 5). However, little is in the professional literature about the pathogenicity of amphetamines 113 . The toxicity of amphetamines, like that of many other new drugs, has been credited to HIV because amphetamines became popular only during the AIDS epidemic. Nevertheless, drug treatment specialists have informally described amphetamine diseases. Says one specialist from St. Vincent’s Hospital in New York: "We are just starting to see heavy usage types in our emergency rooms in New York City. What’s troubling about this drug isn’t just the way it destroys the body – life expectancy for those intravenously injecting crystal is two years – but the bizarre psychotic symptoms that develop."70 . Even an orthodox AIDS specialist from AIDS project Los Angeles, now director of an AIDS foundation in France, acknowledges the pathogenicity of amphetamines, although coded in HIV-jargon, "there is ample evidence to suggest that crystal accelerates premature progression to full-blown AIDS in people dealing with HIV infection. Studies have shown that crystal eats T-cells for breakfast, lunch and dinner."70 . The pathogenicity of nitrite inhalants is the result of non-physiological chemical reactions. Nitrite inhalants react with all biological macromolecules, mutating and inactivating DNA and RNA, diazotizing proteins, killing vitamins and oxydizing hemoglobin to inactive methemoglobin 25 . At the recreational dose of 1 ml per day 25, 125, 126 the user introduces about 10 21 molecules into the lungs, or 10 7 molecules for every cell in the human body – enough for abundant toxicity. Under these conditions nitrites are cytotoxic and immunotoxic in animals and humans 125, 127 . The cytotoxicity of nitrites on the epithelial tissues of the lung are enhanced by the toxins of cigarette smoke, which also suppresses the immune system 128 . In addition to their cytotoxic potential, nitrites are among the best established mutagens and carcinogens 129-132 . The pathogenicity of nitrites has been recognized long before the AIDS epidemic, and continues to be acknowledged even by orthodox HIV/AIDS researchers if only as a co-factor of HIV, the hypothetical source of all evil. For example, in view of the toxicity of nitrite inhalants, a prescription requirement was instated by the US Food and Drug Administration (FDA) in 1969 133 . The FDA also limits nitrites as food preservatives to less than 200 ppm (parts per million), because of direct toxicity and because "they have been implicated in an increased incidence of cancer"129 and because they are listed as carcinogens by the National Research Council since 1982 132 . In 1988 the NIDA published a monograph entitled "Health Hazards of Nitrite Inhalants" that warns about the AIDS risks, particularly Kaposi’s sarcoma risks of nitrite inhalants 55, 125 . As a result of the NIDA monograph, the US Congress banned the sale of nitrites in 1988 citing an "AIDS link"134, a decision which was followed by the "Crime Control Act" in 1990 with a Public Law (100-690) 7, 25, 135 . Based on the results of the NIAID-sponsored MAC study, AIDS epidemiologists David Ostrow et al. in 1993 expressed concern about the nitrite-AIDS connection: "From the earliest case control studies conducted by the Centers for Disease Control’s (CDC) Task Force on Kaposi’s Sarcoma and Opportunistic Infections (Jaffe et al., 1983) to recent studies of predictors of human immunodeficiency virus-type 1 (HIV) infection (Penkower et al., 1991), recreational psychoactive drug use has been associated with HIV-related illness or infection among homosexual men."102 . In 1995, the National Institutes of Environmental Health Sciences reconfirmed the nitrite-AIDS hypothesis. Based on exposure of mice to isobutylnitrites (IBN) (poppers) for 15 weeks the Institute published in 1995, "The results suggest that, in the absence of impaired pulmonary host defenses, IBN produces significant and partially reversible suppression of systemic humoral immunity"136 . And in the summer of 1996 the Royal Pharmaceutical Society first banned the sale of nitrites in the UK citing: "Our primary concerns were the health risks associated with the drug, including the suggestive links between poppers and Kaposi’s sarcoma"137 . Also in 1996 a Swiss court convicted a sex offender for popper use because poppers cause "headache, arrhythmia, vertigo, fainting, paralysis, and unconsciousness". During the same year an official of the Swiss Public Health Office, BGA, stated to the gay interest journal aK that it was not possible yet to predict the health effects of popper use ("noch keine Risikoabschätzung des Poppers-Gebrauchs möglich"), although he acknowledged that a man had just died after inhaling two grams of amyl nitrite 340 . 2) Lifestyle factors contributing to drug pathogenicity. Many drug diseases are consequences not only of direct drug toxicity, but also of frequent drug-induced suppression of appetite causing malnutrition and sleep depravation,121 both of which are the world’s leading causes of immune suppression 138 . These health risks are compounded by poverty due to the enormous costs of illicit drugs. For example, an average cocaine habit of 1g per day costs $800 per week 66 . One of the first to ring the alarm about drug diseases among male homosexual drug users was the American writer John Lauritsen, author of Death rush, poppers and AIDS 139 and The AIDS War 96 . In The AIDS War Lauritsen described in 1993 the explosion of drug use in the gay scene in London:
But recently even the established gay press appears to show some concern that recreational drugs may do more than facilitate HIV infection. For example, the British magazine Gay Times cited in its survey of the bewildering drug use of male homosexuals in 1996 (Table 4) the concerns of a first aid officer from a London gay club:
And an article in 1996 in the American gay magazine The Advocate with the title "A deal with the devil" asked philosophically:
3.5. Conclusion. The chronology and epidemiology of the American and European drug epidemics, which affects primarily 25-54 year old males, coincide exactly with the AIDS epidemic. Moreover, a comparison of the long-established list of drug diseases with the CDC’s long catalog of AIDS-defining diseases proves that drugs alone could be responsible for the AIDS epidemic (see Table 5). It is for this reason that throughout the epidemic drug-aware AIDS researchers found it difficult to distinguish between the drug and AIDS epidemics as the following titles of their articles indicate: 1) 1987: AIDS and intravenous drug use: the real heterosexual epidemic 140 . 2) 1989: Cocaine abuse and acquired immunodeficiency syndrome: tale of two epidemics 116. 3) 1991: The Twin Epidemics of Substance Use and HIV 20 . 4) 1991: AIDS, drugs of abuse and the immune system: a complex immunotoxicological network 119 . 5) 1993: Entangled epidemics: cocaine use and HIV disease 118 . 6) 1995: New picture of who will get AIDS is dominated by addicts 141 . 7) 1996: Clinical features of drug use and drug use related to HIV 39 . |