New York City News • April 4, 1984 • Page 4



To The Editor:

    It was enlightening to read in Gary Spokes' column (NYCNews, Feb. 24, 1984) that the CDC's "hierarchical" presentation of the AIDS "patient characteristics" has effectively concealed the fact that more than one-third (36%) of the AIDS cases have been intravenous drug users. Knowing this gives a quite different perspective on the possible etiology of AIDS. Now drugs are very likely the key to the AIDS mystery.
    Usually it is assumed that IV drug users get AIDS because, by using a shared or dirty needle, they have been infected with some kind of microbe. However, this is still an unproven hypothesis. Alternatively, one might hypothesize that IV drug use — as drug use — either causes AIDS directly or powerfully increases the drug user's susceptibility to whatever else does cause AIDS.
    Along this line of reasoning, it may be noted that many, perhaps most, drug abusers do not use IV drugs. All of the so-called recreational drugs — including quaaludes, coke. poppers, ethyl chloride, uppers. downers, etc. — very much count as drugs.
    From the published studies of homosexual men with AIDS, it appears that the lifestyle of these men included heavy use of many different recreational drugs. In these studies, from 96% to 100% of the cases were reported as being users of the nitrite inhalants (poppers). (It is unfortunate that these studies were done over two years ago, and were inadequate even at the time. The CDC has failed miserably to do the necessary epidemiological research that would give us a comprehensive profile of the AIDS cases.)
    If it is in fact true, as the early studies indicated, that virtually all of the homosexual men with AIDS were also heavy users of drugs, then we might add together the CDC's "patient characteristics" as of Feb. 3, 1984, to show that at least 91% of the AIDS patients may be drug users (Homosexual/Bisexual, 76%, plus Intravenous Drug Users, 15%, equalling a total of 91%). Furthermore, it is likely that some of those listed as Haitians (4%), Hemophiliacs (1%), or "None Apparent/Unknown" (4%) are also drug users. Indeed, from the information we have now, it is conceivable that all of the AIDS cases are drug users of one kind or another.
    In the last two years, several of the leading medical journals published lead editorials which reviewed the current status of AIDS research and theories (New England Journal of Medicine, Yale Journal of Biology and Medicine, British Medical Journal). In all three editorials, drugs were stressed as a likely causative factor, possibly in conjunction with an infectious agent ("drugs plus bugs").
    For example, David T. Durack (New England Journal of Medicine) poses the crucial question of why the AID syndrome is apparently new, since both viruses and homosexual behavior are at least as old as history. He reasons as follows:

Some new factor may have distorted the host-parasite relation. So-called "recreational" drugs are one possibility. They are widely used in the large cities where most of these cases have occurred, and the only patients in the series reported in this issue who were not homosexual were drug users.... Perhaps one of more of the recreational drugs is an immunosuppressive agent. The leading candidates are the nitrites, which are now commonly inhaled to intensify orgasm.... Let us postulate that the combined effects of persistent viral infection plus an adjuvant drug cause immunosuppression in some genetically predisposed men.

    At this point, the evidence seems to be contradictory as to whether or not there is a new, as-yet-unidentified etiologic agent for AIDS. It does, however, seem highly probable that drugs play a role — and perhaps a very major role — in causing AIDS.
    At the rate the CDC is proceeding, it will be doomsday before we understand how AIDS is caused. In the meantime, common sense dictates that gay men should avoid use of any and all drugs — especially including poppers — as well as restrict their sexual activities in an intelligent manner.

John Lauritsen

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