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National Institute on Drug Abuse -  NIDA NOTES
Director's Column
Volume 16, Number 1 (March, 2001)

Meeting the Challenge of Reducing Health Disparities

NIDA Director Dr. Alan I. Leshner

NIDA Director, Alan I. Leshner

Some populations suffer disproportionately from consequences of drug abuse.

Through more than 25 years of scientific research, NIDA has dramatically advanced our understanding of the ways that drugs act on cells, in the brain, and in the lives of individuals. We have also learned how groups of individuals - populations distinguished by race, ethnicity, gender, or other characteristics - are affected by drug abuse.

NIDA research shows that, contrary to a common stereotype, overall rates of drug abuse among racial and ethnic minorities are similar to rates in the general population, although some aspects of drug abuse may differ. For example, the initiation and progression of drug use appear to differ among populations. White youth begin using drugs at a younger age than do minority youth, but evidence suggests young African Americans who begin using drugs are more likely to continue use than are whites.

We also know that some populations suffer disproportionately from consequences of drug abuse. Since the AIDS epidemic began, injection drug use has been directly or indirectly responsible for more than a third of all cases overall, but women with HIV are twice as likely as men to have been infected through injection drug use or through sexual activity with an injecting drug user. Minority populations are disproportionately affected by the relationship between drug abuse and HIV/AIDS. For example, between 1985 and 1999 more than twice as many blacks (94,700 ) as whites (36,800) developed AIDS through injection drug abuse, even though there are only one-fourth as many black injection drug users. Roughly the same number of Hispanics (35,100) and whites developed AIDS through injection drug abuse, even though there are only one-eighth as many Hispanic injection drug users. Of the drug-related AIDS cases in women reported through June 2000, 56 percent were among African-American women, 21 percent among Hispanic women, and 22 percent among white women.

NIDA is committed to building scientific understanding of the environmental, social, and biological factors that influence the different patterns and disproportionate consequences of drug abuse among various populations. To coordinate and accelerate research into the health disparities that complicate efforts to prevent and treat drug abuse among populations, NIDA has developed a Strategic Plan on Reducing Health Disparities that will:

  • improve our understanding of the incidence and causes of drug abuse and addiction in racial and ethnic populations, including Native Americans, Asians, and Pacific Islanders;

  • strengthen and expand the community and institutional infrastructure for conducting research within racial and ethnic populations;

  • provide the scientific foundation for improved prevention and treatment for racial and ethnic groups at highest risk for addiction and medical consequences of drug abuse and addiction; and

  • widely disseminate information that identifies the best approaches to prevention and treatment of drug abuse and the disease of addiction in racial and ethnic communities.

To reach the goals established in the Strategic Plan, NIDA has developed a Health Disparities Initiative, which is directed by the Institute's Special Populations Office and includes activities in each of the Institute's program divisions and offices. The initiative will focus on four major research areas: epidemiology, prevention, treatment, and basic and clinical research. In some cases, these efforts will represent an expanded commitment to existing programs, but the initiative also will include important new activities. For example, NIDA will expand training opportunities to increase the capacity of minority institutions - and the number of minority scientists - involved in drug abuse research. The Center on AIDS and Other Medical Consequences of Drug Abuse and the Division of Epidemiology, Services and Prevention Research have jointly issued a Request for Applications for research projects that will encourage cross-disciplinary biomedical, epidemiological, developmental, and social science research to develop more effective interventions to reduce the impact of HIV/AIDS and other disease consequences of drug abuse in minority populations. NIDA also will convene a national conference on health disparities and drug abuse, to be held in the fall, that will bring together scientists, policymakers, and educators with expertise on minority populations. These experts will explore the underlying reasons for health disparities related to drug abuse and develop insights about prevention and treatment strategies that can be effective in specific minority populations.

These efforts are part of a concerted and comprehensive program of research that will help us fill significant gaps in knowledge about the effects of drug abuse and addiction in minority populations and will allow us to develop and verify effective prevention and treatment services that reduce the disproportionate suffering of these communities.

NIDA NOTES - Volume 16, Number 1

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