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The Acquired Immune Deficiency Syndrome (AIDS) has rapidly emerged as a public health crisis of unusual proportion. Despite the attention given to the association of AIDS and parenteral substance use, the relationship between AIDS and other aspects of substance use disorders such as risk taking, disinhibition and lack of self care has not been emphasized. In vitro and in vivo evidence of immune suppression as a result of substance abuse, coupled with behavioral disinhibition and co-existent psychiatric problems make the relationship between these two public health problems a likely area of concern. Substance abuse, increased risk taking and self destructiveness are co-factors involved in the transmission of AIDS which need to be studied epidemiologically. The authors address the relationship between the addictions and disinhibition, suicidal behavior, and the clinical and therapeutic needs of patients, their families and staff.

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