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Health Report: Drug Abuse Poses Biggest Health Problem

This week's RFE/RL Health Report highlights a new study which concludes that drug abuse is, as one expert puts it, America's number-one health problem, while a senior U.S. medical official says there are also improved tools available to combat the problem. The Health Report also looks at what experts think is a promising new vaccination treatment for HIV, the infection that leads to AIDS. Our Correspondent K.P. Foley reports.

Experts View Substance Abuse As Nation's Worst Public Health Problem

Washington, 16 March 2001 (RFE/RL) -- Public and private experts agree that drug and alcohol abuse and tobacco addiction continues to place the heaviest burden on the U.S. public health system.

A new report commissioned by the private Robert Wood Johnson Foundation concludes that, "substance abuse causes more deaths, illnesses, and disabilities than any other preventable health problem today."

The foundation is a philanthropic organization that seeks to improve the health of and health care for all Americans. It released the report earlier this week. At a press conference, Brandeis University researcher Constance Horgan, who helped draft the report, said substance abuse wreaks havoc on the nation.

"The impact of substance abuse on American society is truly devastating."

Horgan says drug and alcohol abuse remains the nation's number-one health problem, responsible for thousands of millions of dollars in annual losses.

"Combined, alcohol, smoking, and drug abuse cost our economy more than $400 billion annually."

The report said that of the two million deaths each year in the United States, one in four can be blamed on alcohol, tobacco, and illicit drug use. The cost to the health care system alone was estimated at $114 billion.

Horgan says the country continues to pay a heavy price for a problem that has solutions.

"Substance abuse is preventable and treatable through options that work."

According to the director of the U.S. government's National Institute on Drug Abuse, there are science-based treatments for drug addicts that have been proven to be highly effective.

Alan Leshner told a U.S. Senate hearing on drug abuse this week that, "the good news in this grim and costly scenario is that scientific advances both in the laboratory and in the clinical setting are providing us with tools to slow the drain of drugs on society."

He said that research by the institute, "shows that comprehensive treatments that focus on the whole individual, and not just on drug use, have the highest success rates." Leshner described comprehensive treatment as an approach that provides a combination of behavioral therapy, medications, and other services such as referral to medical, psychological, and social services. Leshner added that it is important to tailor the treatments to the needs of the individual patient.

Leshner also told the hearing that scientific findings are "steadily improving our ability to prevent the initiation of drug use." He said researchers who have been studying what makes some people more susceptible or vulnerable to abuse have concluded that, "no single, unique factor determines which individuals will use drugs." He said abuse appears to develop because of a variety of genetic, biological, emotional, cognitive, and social risk factors."


Researchers Encouraged By HIV Vaccine Tests

U.S. researchers say they are encouraged by animal test results of a new vaccination strategy to control the virus that causes the fatal condition known as Acquired Immune Deficiency Syndrome (AIDS).

Scientists at Emory University in the southern state of Georgia and at the U.S. National Institutes of Health's (NIH) allergy and infectious diseases division reported their results for the 9 March issue of "Science." They tested a vaccine combination on 24 monkeys. Four monkeys were not vaccinated. The researchers waited seven months and then exposed all of the animals to a virus that is similar to the Human Immune Deficiency Virus (HIV).

The NIH says the new vaccination strategy, called a protocol, kept the virus similar to HIV under control. The researchers used two vaccines, one developed at Emory and one at the NIH. They wanted to test a protocol the researchers call "prime boost."

The idea is that the first injection will trigger, or "prime," an immune response against the virus. The second injection is supposed to strengthen, or "boost," the immune system's response. NIH physician Peggy Johnston told reporters that the vaccination scheme worked very well on 23 of 24 animals that were exposed to an animal variant of HIV.

"What they observed was -- in the animals that had received the vaccine -- the animals got infected, but they were able to control the virus down to undetectable levels -- compared to the animals that did not receive the vaccine, where the virus went on and caused disease and eventually death in almost all of those animals."

The four monkeys that were not vaccinated developed AIDS and were euthanized.

Johnston says the researchers are not sure if the results of the tests on the monkeys can be duplicated in humans. However, she says the research teams have developed test vaccines that are designed to be used on men and women. The NIH is seeking to have the vaccination protocol entered into human trials by the end of this year.


In a related story, a Harvard University expert says those vaccination trials underway in the West are of little help to the millions of Africans at risk for HIV/AIDS.

Seyou Ayehunie, a Harvard University physician, told a United Nations-sponsored session on AIDS in New York last week that there are several subtypes of HIV in Africa. The worst, he said, is a strain called subtype C. The doctor says this strain causes 90 percent of all infections in Africa and 75 percent worldwide.

Ayehunie told the conference that more than 90 percent of current vaccine designs are based on viruses that are prevalent in the West. However, he said testing of a vaccine for subtype C represents only five percent of vaccine trials.