Substance Use & Misuse, 50:532–533, 2015 C 2015 Informa Healthcare USA, Inc. Copyright ISSN: 1082-6084 print / 1532-2491 online DOI: 10.3109/10826084.2015.978185
BRIEF REPORT
AIDS, People who Use Drugs, and Altruism: Reflection on a Personal Image Don C. Des Jarlais The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel had nothing to gain by participating in the interview. But they were making supreme efforts in the hopes that the research might lead to preventing AIDS in others. Afterword. The 1983 interviews were part of the “Risk Factors” study (DA R01 003574). This grant has continued and provided considerable evidence that it is possible to prevent AIDS among persons who use drugs (Des Jarlais et al., 1995, 1996, 2005). In the current phase of this grant, we are studying how to end the HIV/AIDS epidemic among persons who use drugs. It has taken far too long, but that we are working on ending the HIV/AIDS epidemic among persons who use drugs is the appropriate response to the altruism of our first research participants.
Keywords: HIV/AIDS, substance use, altruism, New York City, Risk Factors
Persons who use drugs, particularly persons who develop dependence on drugs, are among the most stigmatized groups in our society. Part of this stigmatization is the socially constructed and often repeated image that they care about nothing other than their next dose. Friendships, family relationships, conventional social norms and laws are all believed to be of no consequence in their quest for drugs. This image of drug users as being extremely selfish makes it easy to condemn them and to want to punish them – even though it should be quite obvious by now that punishment does not cure drug dependence. In 1983, in my first study of AIDS among people who use drugs, I interviewed AIDS patients in various hospitals in New York City. At that time very little was known about AIDS in persons who used drugs. The only thing known with great certainty was that AIDS was uniformly fatal. A particular episode of an opportunistic infection might not be fatal, but no one who developed the severe immunosuppression of AIDS ever recovered. And dying from an AIDS opportunistic infection was a truly horrible way to die. The people whom I was interviewing were typically emaciated, had difficulties breathing, and were in great pain. The interview I was administering was quite long—about 2 hours—as we wanted to explore the various ways in which people may have contracted the disease and what roles their drug use may have played. There were many detailed questions that required considerable mental effort to answer. Despite these worst possible conditions for conducting an interview, the research participants put great effort into answering the questions as completely and accurately as possible. I could see them fight losing consciousness, fight the pain, and exhaustively search their memory to answer the questions. They clearly knew they personally
Declaration of Interest
The author declares no conflict of interest. The author alone is responsible for the content and writing of this paper. REFERENCES Des Jarlais, D., Hagan, H., Friedman, S., Friedmann, P., Goldberg, D., & Frischer, M. (1995). Maintaining low HIV seroprevalence in populations of injecting drug users. JAMA, 274(15), 1226–1231. Des Jarlais, D. C., Marmor, M., Paone, D., Titus, S., Shi, Q., & Perlis, T. (1996). HIV incidence among injecting drug users in New York City syringe-exchange programmes. Lancet, 348(9033), 987–991. doi: S0140673696025366 [pii] Des Jarlais, D. C., Perlis, T., Arasteh, K., Torian, L. V., Beatrice, S., & Milliken, J. (2005). HIV incidence among injection drug users in New York City, 1990 to 2002: use of serologic test algorithm to assess expansion of HIV prevention services. Am J Public Health, 95(8), 1439–1444. doi: AJPH.2003.036517 [pii] 10.2105/AJPH.2003.036517 [doi]
Address correspondence to Don C. Des Jarlais, The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth, Israel; E-mail: [email protected]
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DRUG USERS AND ALTRUISM
THE AUTHOR Don C. Des Jarlais, Ph.D., behavioral scientist, Director of research the Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center; professor at Columbia University Medical Center, a guest investigator at Rockefeller University in New York, is a leader in the fields of HIV/AIDS and injecting drug use. He has published extensively. Consultant to various institutions, including the Centers for Disease Control and Prevention, the National Institute on Drug Abuse, the National Academy of Sciences and the World Health Organization. He is a former commissioner for the U.S. National Commission on AIDS.
533
Copyright of Substance Use & Misuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
BRIEF REPORT
AIDS, People who Use Drugs, and Altruism: Reflection on a Personal Image Don C. Des Jarlais The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel had nothing to gain by participating in the interview. But they were making supreme efforts in the hopes that the research might lead to preventing AIDS in others. Afterword. The 1983 interviews were part of the “Risk Factors” study (DA R01 003574). This grant has continued and provided considerable evidence that it is possible to prevent AIDS among persons who use drugs (Des Jarlais et al., 1995, 1996, 2005). In the current phase of this grant, we are studying how to end the HIV/AIDS epidemic among persons who use drugs. It has taken far too long, but that we are working on ending the HIV/AIDS epidemic among persons who use drugs is the appropriate response to the altruism of our first research participants.
Keywords: HIV/AIDS, substance use, altruism, New York City, Risk Factors
Persons who use drugs, particularly persons who develop dependence on drugs, are among the most stigmatized groups in our society. Part of this stigmatization is the socially constructed and often repeated image that they care about nothing other than their next dose. Friendships, family relationships, conventional social norms and laws are all believed to be of no consequence in their quest for drugs. This image of drug users as being extremely selfish makes it easy to condemn them and to want to punish them – even though it should be quite obvious by now that punishment does not cure drug dependence. In 1983, in my first study of AIDS among people who use drugs, I interviewed AIDS patients in various hospitals in New York City. At that time very little was known about AIDS in persons who used drugs. The only thing known with great certainty was that AIDS was uniformly fatal. A particular episode of an opportunistic infection might not be fatal, but no one who developed the severe immunosuppression of AIDS ever recovered. And dying from an AIDS opportunistic infection was a truly horrible way to die. The people whom I was interviewing were typically emaciated, had difficulties breathing, and were in great pain. The interview I was administering was quite long—about 2 hours—as we wanted to explore the various ways in which people may have contracted the disease and what roles their drug use may have played. There were many detailed questions that required considerable mental effort to answer. Despite these worst possible conditions for conducting an interview, the research participants put great effort into answering the questions as completely and accurately as possible. I could see them fight losing consciousness, fight the pain, and exhaustively search their memory to answer the questions. They clearly knew they personally
Declaration of Interest
The author declares no conflict of interest. The author alone is responsible for the content and writing of this paper. REFERENCES Des Jarlais, D., Hagan, H., Friedman, S., Friedmann, P., Goldberg, D., & Frischer, M. (1995). Maintaining low HIV seroprevalence in populations of injecting drug users. JAMA, 274(15), 1226–1231. Des Jarlais, D. C., Marmor, M., Paone, D., Titus, S., Shi, Q., & Perlis, T. (1996). HIV incidence among injecting drug users in New York City syringe-exchange programmes. Lancet, 348(9033), 987–991. doi: S0140673696025366 [pii] Des Jarlais, D. C., Perlis, T., Arasteh, K., Torian, L. V., Beatrice, S., & Milliken, J. (2005). HIV incidence among injection drug users in New York City, 1990 to 2002: use of serologic test algorithm to assess expansion of HIV prevention services. Am J Public Health, 95(8), 1439–1444. doi: AJPH.2003.036517 [pii] 10.2105/AJPH.2003.036517 [doi]
Address correspondence to Don C. Des Jarlais, The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth, Israel; E-mail: [email protected]
532
DRUG USERS AND ALTRUISM
THE AUTHOR Don C. Des Jarlais, Ph.D., behavioral scientist, Director of research the Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center; professor at Columbia University Medical Center, a guest investigator at Rockefeller University in New York, is a leader in the fields of HIV/AIDS and injecting drug use. He has published extensively. Consultant to various institutions, including the Centers for Disease Control and Prevention, the National Institute on Drug Abuse, the National Academy of Sciences and the World Health Organization. He is a former commissioner for the U.S. National Commission on AIDS.
533
Copyright of Substance Use & Misuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
