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By Peter H. Duesberg
Department of Molecular and Cell Biology, 229 Stanley Hall, University of California, Berkeley, CA 94720, USA (Received 28 November 1991; accepted 10 December 1991)

Original Publication
Biomed & Pharmacother
Vol.46, pp. 3-15, 1992
Dossier

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Summary

It is proposed that the new American and European AIDS epidemics are caused by recreational and anti-HIV drugs rather than by human immunodeficiency virus (HIV). Chronologically, the AIDS epidemic in the 1980s followed a massive escalation in the consumption of recreational drugs that started in the 1960s and 70s. Epidemiologically, both epidemics derive about 80 % of their victims from the same groups of 20-44 year-olds, of which 90 % are males. In America 32% of these are intravenous drug users and an unknown percentage are prescribed the cytotoxic DNA chain terminator AZT, as inhibitor of HIV. Direct evidence indicates that these drugs are necessary for HIV-positives and sufficient for HIV-negatives to develop AIDS diseases. The drug-AIDS hypothesis predicts correctly that: (i) AIDS is new in the US, because the drug epidemic is new, while the HIV epidemic is old -- fixed at a constant 1 million Americans since 1985; (ii) despite an increase in venereal diseases, AIDS remains restricted to long-term drug users and small groups with clinical deficiencies; (iii) over 72 % of AIDS occurs in 20-44 year old males, because they make up over 80% of hard psychoactive drug use; (iv) distinct AIDS diseases correlate with the use of distinct drugs, eg Kaposi's sarcoma with nitrite inhalants, tuberculosis with intravenous drugs, and leukopenia, anemia, and nausea with AZT; (v) AIDS diseases are only acquired after long-term drug consumption, rather than after single contacts as the virus-hypothesis predicts. The drug hypothesis can be tested epidemiologically and experimentally in animals. It predicts that most AIDS can be prevented by stopping the consumption of drugs, and provides a rational basis for therapy.

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what is in front of your eyes.

(Xenien, Goethe)

Introduction

AIDS is a new syndrome of 25 previously known diseases (19,62,63), In American 63% are microbial diseases such as pneumonia, candidiasis, tuberculosis, cytomegalovirus, and herpes virus disease (18,19) that result from immunodeficiency due to a severe depletion of T-cells (62, 63). The remaining 37% of AIDS diseases are dementia, wasting disease, Kaposi's sarcoma, and lymphoma which are not caused by, and not consistently associated with immunodeficiency and microbes (18, 33, 36, 115) In the US 32% of AIDS patients are intravenous drug users (18, 86), about 60% are male homosexuals [18], and most of the remainder have sever clinical or congenital deficiencies, including hemophilia [18,33 100]. Over 80% of the American AIDS patients are 20-44 year olds, of which about 90% are males [18]. Different AIDS risk groups have different AIDS diseases. For example, homosexuals have 20 times more Kaposi's sarcoma than other AIDS patients [7], intravenous drug users have a proclivity for tuberculosis [12,114], crack (cocaine) smokers exhibit pneumonia [41], and users of the cytotoxic DNA chain terminator AZT, prescribed to inhibit human immunodeficiency virus (HIV) develop anemia, leukopenia and nausea [94, 99, 113].

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In view of these inconsistencies between AIDS and infectious disease and the total lack of a common, active microbe in AIDS, several investigators have concluded that AIDS may not be infectious [3, 17, 33, 34, 56, 59, 61, 70, 77, 92, 96, 100]. Here the hypothesis is investigated that American and European AIDS diseases, above their normal background, are the result of the long-term consumption of recreational and anti-HIV drugs.

Chronological coincidences between the AIDS and the drug epidemics

The appearance of AIDS in America in 1981 [62, 63], coincided with a massive escalation in the consumption of psychoactive drugs [16, 44, 57, 73, 87, 89, 111]. The Bureau of Justice Statistics reports that the number of drug arrests in the US has increased from about 450,000 in 1980 to 1.4 million in 1989 [16, 111]. About 500 kg of cocaine were confiscated by the Drug Enforcement Administration in 1980, about 9,000 kg in 1983, 80,000 kg in 1989, and 100,000 in 1990 [16, 44, 131]. The agency estimates that at most 20% of the cocaine smuggled into the US is confiscated [4]. Cocaine-related hospital emergencies increased 5-fold from 1984 to 1988 [89]. The number of dosage units of domestic stimulants, such as amphetamines, confiscated increased from 2 million in 1981 to 97 million in 1989 [44].

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Since 1987 the cytocidal DNA chain terminator AZT is prescribed as an anti-HIV durg [67, 130]. Currently about 80,000 HIV antibody-positive Americans and 120,000 world-wide, with and without AIDS, take this drug [33].

Epidemiological overlaps among drug-and AIDS-related health statistics

Drugs and AIDS appear to claim their victims from the same risk groups. For instance the CDC reports that 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 [15]. Since the annual AIDS deaths had also reached 10,000 by 1987, HIV was assumed to be the cause [18, 19, 62]. However, mortality in 25-44-year-old males from septicemia, considered an indicator of intravenous drug use, rose almost four- fold from 0.46 per 100,000 in 1980 to 1.65 in 1987 and direct mortailty from drug use doubled [15, 85], suggesting that drugs played a significant role in the increased mortality of this group [15]. Moreover, deaths from AIDS diseases and non-AIDS pneumonia and septicemia per 1,000 intravenous drug users in New York increased at exactly the same rates, from 3.6 in 1984 to 14.7 and 13.6 respecitvely in 1987 [110]. In view of this, the 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" [15]. Further, maternal drug consumption was blamed by some [119] and HIV infection by others [18, 63] for a new epidemic of physiological and neurological deficiencies, including mental retardation, in American children.

Another striking coincidence is that over 72% of all American AIDS patients [18] and over 80% of all Americans who consume hard psychoactive drugs [51, 87] or get arrested for possession of drugs [16] are 20-44-year-old males. Thus there is substantial epidemiological overlap between the two epidemics [73] reported as "The twin epidemics of substance use and HIV" by the National Aids Commission [86].

Drug use in AIDS risk groups

Intravenous drug users generate a third of all AIDS patients

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About 80,000 Americans and 120,000 persons world-wide, with and without AIDS, currently take the cytocidal DNA chain terminator AZT [33] and an unknown number take other DNA chain terminators like ddI and ddC [113]. AZT has been prescribed since 1987 to symptomatic [43, 63, 67, 99], and since 1990 to asymptomatic carriers of HIV including babies and hemophiliacs [38, 123], in an effort to inhibit HIV DNA synthesis [130]. Thus an unknown, but possibly a high percentage of the 30,000 Americans that currently develop AIDS per year [18] have used AZT prior to or after the onset of AIDS. For instance, 249 out of 462 HIV-Positive, AIDS-free homosexual men from Los Angeles, included in the above survey [91], are on AZT or ddI [84].

Drug use necessary in HIV-positives and sufficient in HIV-negatives for AIDS diseases

To distinguish between HIV and drugs as causes of AIDS, it is necessary to identify either HIV carriers that develop AIDS only when they use drugs or to identify HIV-free drug users that develop AIDS indicator diseases.

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Thus, the long term use of recreational and anti-HIV drugs appears necessary in HIV-positives and sufficient in HIV-negatives to induce AIDS indicator and other diseases.

Toxic effects of drugs used by AIDS patients

Toxicity of recreational drugs

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Surprisingly, long-term studies of AZT in animals compatible with human applications have not been published [113, 130]. In view of the inevitable toxicity of AZT, its popularity as an anti-HIV drug can only be explained by the widespread acceptance of the virus- AIDS hypothesis and the failure to consider the enormous difference between the viral and cellular DNA targets.

Conclusions

It is concluded that all American AIDS exceeding the normal low incidence of indicator diseases in the general population is the result of recreational and anti-HIV drugs. Thus the American AIDS epidemic is a subset of the drug epidemic. For example, only the pneumonias, tuberculoses, and dementias of the 50% of American intravenous drug users with HIV [86] are recorded as AIDS, while those of their counterparts are diagnosed by their old names.

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The drug-AIDS hypothesis predicts that the AIDS diseases of the behavioral AIDS risk groups in the US and Europe can be prevented by stopping the consumption of recreational and anti-HIV drugs, but not by safe sex [63] and clean injection equipment [86] for unsterile street drugs. According to the drug-AIDS hypothesis, AZT is AIDS by prescription. Screening of blood for antibodies to HIV is superfluous, if not harmful, in view of the anxiety that a positive test generates among the many believers in the virus-AIDS hypothesis and the toxic AZT prophylaxis, prescribed to many who test positive. Eliminating the test would also reduce the cost of the approximately 12 million annual blood donations in the US [127] by 11 dollars each (personal communication 1990, Irwin Memorial Blood Bank San Francisco) and would lift travel restrictions for antibody-positives to many countries including the US and China. The drug-AIDS hypothesis is testable epidemiologically and experimentally by studying AIDS drugs in animals.

Note added in proof

In Europe 33% of AIDS patients are intravenous drug users and 47% are male homosexuals and 86% of all patients are male [132].

Acknowledgments

I thank B Ellison (Berkeley), J Lauritsen (New York), C Pierach (Minneapolis), P Rabinow (Berkeley), H Rubin (Berkeley, F Rothschild (Berkeley), J Shenton (London), C Thomas Jr (San Diego), and M Verny-Elliott (London) for critical information and T Gardner (Santa Barbara) for a generous donation and encouragment. I am supported by Outstanding Investigator Grant no 5-R35-CA39915-07 from the National Cancer Institute.

References

1 Achard C, Bernard H, Gagneux C (1909) Action de la morphine sur les proprietes leucocytaires; leuco-diagnostic du morphinisme. Bull Mem Soc Med Hop Paris 28 (3^rd Series) 958

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