The studies presented in this symposium volume investigate the mechanisms of the immune dysfunction due to alcohol, heroin, and cocaine use, and attempt to elucidate what their ultimate effects are on AIDS, cancer growth and infectious disease.

Introduction and Perspectives This volume represents the Proceedings of the Fifth Annual Symposium on Drugs of Abuse, Immunomodulation, and AIDS. The meeting was held in Nashville, Tennessee, June 12-14, 1997. In this symposium, as in the past, newer knowledge was reviewed concerning the relationship between the immune and the nervous systems with regard to the effects of drugs of abuse. This symposium focused on the relationship between the immune system and the nervous system with regard to the effects of drugs of abuse and infections such as the immunodeficiency virus that causes AIDS. As in the past symposia, presentations fo cused on the brain-immune axis from the viewpoint of drugs of abuse rather than from the subject of the brain or immunity alone. The aim of this series of conferences has been to clarify the consequences ofimmunomodulation induced by drugs of abuse on susceptibility and pathogenesis of infectious diseases, both in man and in various animal model systems. Recreational use of drugs of abuse, such as morphine, cocaine, and marijuana, as well as alcohol, by large numbers of individuals in this country and around the world has aroused serious concerns about the consequences of use of such drugs, especially on the normal physiological responses of an individual, including immune mechanisms. It is now widely known that many drugs of abuse, including marijuana, are used by millions ofindi viduals in this country and by even more abroad.

This volume is based on the program of the International Conference on Drugs of Abuse, Immunity and Immunodeficiency held in Clearwater Beach, Florida. It was sponsored by the University of South Florida College of Medicine with the support of the National Institute on Drug Abuse. During the past few decades, drugs of abuse, including marijuana, cocaine, opiates and alcohol, have been studied by biomedical scientists in terms of the systemic effects of the drugs as well as alterations in neurophysiology and the psychology. More recently, the scope of such investigations has been broadened to include alterations within the immune system, and the influence of altered immunity on physiological and psychological consequences of drug abuse. In this regard, participants in the Clearwater Beach conference provided new information concern ing both basic and clinical aspects of drugs of abuse and immunity, especially immunodeficiency. Advances have been made in recent years in understanding the nature and mechanisms regulating the immune response and the mechanisms by which drugs may influence immune responses. In particular, the emergence of psychoneuroimmunology as a new discipline has heightened interest in immune responses influenced by psychoactive drugs. This has resulted in interdisciplinary investigations involving clinical and basic scientists including microbiologists, immu nologists, physiologists, psychiatrists, oncologists and others. The recreational use of the above mentioned drugs by large numbers of individuals has aroused serious concern about the consequences of this activity.

This important publication provides up-to-date reviews using data from human patients and animal models. The goal is to understand the relationship between immunological modification by drugs of abuse and disease resistance. Examined are the major drugs of abuse and their effects on lymphoid cell function, numbers, development, and interactions. Also addressed are reviews of how ethanol, cocaine, morphine, and marijuana effect the immune function. The book includes evaluations of the relationship of immunomodulation by drugs of abuse on resistance to infectious diseases. This is critical to understanding how drugs modulate diseases and cancer development. This invaluable publication is important to those in biochemistry, physiology, chemistry, biology, immunology, cancer, medicine, pharmacology, microbiology, psychology, psychiatry, and additive studies. It is also of value to those in nutrition, pathology, pediatrics, family medicine, gerontology, surgery, sociology, and anatomy. Specialty groups, such as those in tropical medicine and public policy, will have a strong interest in the book. It is also of significant interest to organizations that deal with major numbers of patients using drugs of abuse and with their associated diseases including AIDS.

Substance abusers are an immunocompromised population, vulnerable to a wide array of new and resurgent infectious diseases - in spite of modern treatment. For example, opportunistic infections like tuberculosis are the principal cause of morbidity and mortality in HIV positive patients. Alcohol- and drug-induced disorders are wide-ranging, gaining prominence as the spectrum of emerging diseases broadens. Alcohol, Drugs of Abuse, and Immune Functions reviews the role of these immunosuppressants as cofactors in disease. It covers the basic biology and immunology of impairments to defense against infectious disease. Alcohol and drug use is consistently associated with immunosuppression, although it isn't known if it is the substance itself, a metabolite, or an indirect effect that alters disease resistance. This text explores the advances toward answering this question, examines alcohol in different settings, its relationship to important cells, and the effects it can have on vital organs such as the liver and the lungs.