Photo from Amitiel Welfare Society, Pakistan,
courtesy of Photoshare
A man in Bahawalput, Pakistan, injects himself with
drugs from a used syringe.
From Pakistani heroin users sharing needles, to South African prostitutes agreeing to unsafe sex for money to buy methamphetamine, drug addiction is a global problem integrally linked to the spread of HIV and other diseases. To tackle these and other related problems, the NIH's National Institute on Drug Abuse (NIDA) supports international scientists as they make vital research discoveries and build much-needed expertise in low-resource countries. For 20 years, NIDA has hosted an annual International Forum to foster research collaborations and the exchange of scientific information by drug abuse researchers from around the world.
Scientific knowledge gained in the U.S. or elsewhere can deepen understanding of the drivers of drug use, but countless local factors also contribute to addiction - the culture, economic environment, educational opportunities, availability of health services and other influences. To design effective intervention programs and convince policymakers to fund them, locally obtained evidence is key.
"No single country can solve these problems by acting alone," according to NIDA Director Dr. Nora Volkow. "Through international collaboration and scientific exchange, we can translate our domestic successes in reducing the consequences of drug abuse to other countries, as well as allowing us to learn from their strides in disease prevention."
NIDA, which was established in 1974, directs its $1 billion annual budget toward research not only into psychoactive drugs - such as cocaine, heroin and amphetamines - but also into tobacco and a number of other addictive substances. NIDA's International Program works globally to form partnerships, promote new research initiatives, build research capacity and disseminate knowledge.
Drug addiction takes an enormous toll on people's productivity, quality of life and longevity, both directly and from related conditions such as HIV, hepatitis C and suicide, according to the WHO. Up to 7 percent of people aged 15-64 years reported using an illicit drug at least once the previous year, and between 16 and 39 million people worldwide suffer from problem drug use - yet only a sixth receive treatment, UN data show.
People who inject drugs have high rates of HIV infection for a number of reasons. They often share needles and syringes, which can contain remnant blood from an infected person, and are more likely to ignore safe sex precautions. Societal influences, such as stigma and the threat of incarceration, can discourage people who inject drugs from seeking HIV testing or treatment, and thereby raise the risk to themselves, others in their community and the wider population. The UN says about a third of HIV cases outside sub-Saharan Africa are spread by unsafe injecting practices.
NIDA's grantees have investigated previously neglected populations with high rates of HIV infection, including those who inject drugs, at-risk youth, sex workers and men who have sex with men. Their findings have helped shape unique interventions and strategies specifically tailored for each group. As well as injectable substances, NIDA supports global research into other forms of addiction, whether tobacco, khat, marijuana or other products that impair people's health over time, and its grantees study many related aspects, such as smoking in pregnancy, treatments to help wean people from heroin and the effect of addiction on the brain.
NIDA also places a high priority on training scientists around the world, partnering with Fogarty's Global Health Program for Fellows and Scholars (see the related article, Fogarty Fellow documents drugs and HIV risk in Kenya), and supporting a number of other research training programs for scientists at various stages of their careers.
"By investing in research capacity building in strategic world regions, we aim to develop self-sustaining scientific networks of addiction experts that will generate knowledge on the causes, prevention and treatment of drug abuse that will benefit us all," said Volkow.
- Learn more about the NIDA International Program and the annual NIDA International Forum.
- Resources from other organizations on drug abuse:
- Resources and publications related to the article Researchers slow HIV spread among drug users in Vietnam:
- Vietnam HIV and AIDS data from UNAIDS
- Efficacy of a multi-level intervention to reduce injecting and sexual risk behaviors among HIV-infected people who inject drugs in Vietnam: a four-arm randomized controlled trial. PLoS One, May 2015
- Variations in the role of social support on disclosure among newly diagnosed HIV-infected people who inject drugs in Vietnam. AIDS and Behavior, May 2015
- Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam. Journal of the International AIDS Society, November 2013
- Controlling HIV epidemics among injection drug users: eight years of cross-border HIV prevention interventions in Vietnam and China. PLoS One, August 2012
- Perceptions of community- and family-level injection drug user (IDU)- and HIV-related stigma, disclosure decisions and experiences with layered stigma among HIV-positive IDUs in Vietnam. AIDS Care, July 2012
- Perceptions of IDU and HIV related stigma within the community and the family, disclosure decisions and experiences with layered stigma among HIV positive injection drug users in Vietnam. AIDS Care, February 2012
- Accelerated transition to injection among male heroin initiates in Hanoi, Vietnam: implications for early harm reduction interventions. Journal of Community Health, December 2011
- Influence of perceived secondary stigma and family on the response to HIV infection among injection drug users in Vietnam. AIDS Education and Prevention, December 2010
- Prevalence and incidence of HCV infection among Vietnam heroin users with recent onset of injection. Journal of Urban Health, March 2010
- Reducing HIV infection among new injecting drug users in the China-Vietnam cross border project. AIDS, December 2007
- Novel heroin injection practices: implications for transmission of HIV and other bloodborne pathogens. American Journal of Preventive Medicine, June 2007
- Resources and publications related to the article Scientists tackle disease in Kazakhstan drug injectors, including related NIDA-supported projects:
- Resources and publications related to the article NIDA, Fogarty work to reduce smoking in Argentina:
- Impact on cardiovascular disease events of the implementation of Argentina’s national tobacco control law. Tobacco Control, March 2014
- Smoking behavior and use of tobacco industry sponsored websites among medical students and young physicians in Argentina. Journal of Medical Internet Research, February 2014
- Use of alternative tobacco products in multiethnic youth from Jujuy, Argentina. Journal of Environmental and Public Health, March 2010
- Smoking behavior and ethnicity in Jujuy, Argentina: evidence from a low-income youth sample. Substance Use and Misuse, May 2009
- Smoking rates around the world - how do Americans compare? Gallup, August 17, 2007
- Smoking behavior and demographic risk factors in Argentina: a population-based survey. Prevention and Control, December 2006
- Litigation in Argentina: challenging the tobacco industry. Tobacco Control, April 2006