Drugs and the immune system.

My father practiced medicine in Los Angeles for 65 years, retiring when he was more than 91. He always advised smoking patients to quit--decades before any surgeon general's warnings appeared on cigarette packs.

He told of one likable furniture salesman: "Whenever I advised him to quit smoking, he would smile at me and then light up as soon as he got outside the office. Finally he came in with a cough he couldn't get rid of. The first X-ray showed a growth in the right lung; sputum examination revealed cancer cells in abundance. A month before he passed away he said rather wistfully, 'I've thought of the dozens of times you tried to get me to stop smoking. I wish I could back up and take your advice, but it's too late now.'"

My dad knew then what is far more obvious now, that tobacco use greatly increases the risk of lung cancer. Today lawsuits are forcing even the tobacco manufacturers to face that fact. What is understood better today than ever before is the involvement of the body's immune system. It has become clear that use of tobacco, alcohol, and other drugs damages the immune system and makes it vulnerable to all kinds of infections and diseases.

Complicating the picture today is the much wider availability of drugs with greater potency, along with more highly resistant infections and deadly diseases. What comes to mind immediately, of course, is today's human immunodeficiency virus (HIV) and the resulting acquired immunodeficiency syndrome (AIDS), which has ultimately proved fatal.

What is the body's immune system, and how is it affected by drug use?

The immune system is a delicately balanced, wonderful system that enables the body not only to avoid disease, but to heal itself if symptoms of illness arise. According to Arlene Taylor, Ph.D., director of Realizations, Inc., of Napa, California, "Eighty five percent of illnesses are believed to be within reach of the immune system. By our lifestyle choices, we can make its job easier or more difficult. Miracles can and do occur--but in general, if it heals, the body heals itself. Ideally, preventive strategies are our best bet."(1)

The primary organs of the immune system are the thymus gland and bone marrow. Dr. Taylor refers to the thymus as the orchestra conductor, which matures selected white blood cells into three kinds of "T-cells": T4 helper cells, which turn the immune system on; T8 suppressor cells, which turn it off; and T-killer cells, which engage in one-on-one combat with invaders.

Secondary immune system organs include: the spleen, a conference center and an emergency storage depot for blood; the tonsils, which guard the entrance to the throat; the appendix, which samples material passing through the intestines; the approximately 100 lymph nodes, which serve as sieves or strainers to filter lymph fluid and thus guard various parts of the body; and Peyer's patches, special lymph glands that function similarly to the appendix.

In addition, the system includes some helpers: independent cells, such as the T-cells mentioned above, B-cells (antibodies and memory cells), phagocytes (cells that ingest and destroy foreign particles and bacteria), and natural killer cells; and the lymph vessels, approximately 240,000 miles of one-way canals that circulate lymph fluid.

All of these parts work together to identify threats to the system, to mount an attack against such threats, and to keep things clean and tidy in the body. Dr. Taylor says, "The immune system can take a great deal of abuse before the proverbial last straw breaks the camel's back--the point at which we develop disease." If and when that point comes, however, it is often the result of a complex interaction of factors, some of which we can't modify, but many of which we can.

One of the factors that we can control is the use of drugs. Those drugs that can stress the immune system include antibiotics, birth control pills, corticosteroids, cytotoxic chemicals, amyl nitrite, street drugs, general anesthetics, and alcohol. Of course, some of these, such as anesthesia for a necessary operation, may be the lesser of two evils. A decision to take any prescription drug should be made only after weighing all the factors with a physician.

Cigarette smoking, either our own or somebody else's, chemically stresses the immune system. So do other chemicals, such as insecticides, herbicides, and preservatives. Mayo Clinic researchers tell us that "chemicals in tobacco may alter your immune system's ability to recognize unwanted substances. Some T-cell activity may also be lower in people who smoke."(2)

When we think of drugs today, we often forget that alcohol too is a drug. It can harm the immune system in a number of ways, but most particularly through damage to the liver. A recent newsletter from the National Institute on Alcohol Abuse and Alcoholism of the U.S. Department of Health and Human Services suggests that the immune system relates to alcohol-induced liver disease in complex ways, some of them not yet fully understood. We do know that the liver converts alcohol into acetaldehyde. This chemical then changes proteins in the liver so that they trigger various negative immune responses, which weaken the immune system.(3)

Alcohol not only causes liver damage, but damages the pancreas (which hinders digestion and upsets the blood-sugar balance), impairs absorption of nutrients in the intestines (causing malnutrition), and generally impairs the immune system.(4)

Health workers in America are concerned about the high incidence of HIV and AIDS among teenagers today. Alcohol is clearly a contributing factor leading to infection. One publication for educators warns, "In addition to the high risk of HIV infection associated with intravenous drug use, drug use, including alcohol use, lowers inhibitions toward risky sexual behavior and can lower the body's immune response."

The article then goes on to stress the interrelationship of factors that make teens vulnerable to HIV: "Some teenagers are at greater risk of HIV infection than others because of an increased probability that they will engage in high-risk behaviors or because of an increased prevalence of HIV infection in their communities. Young people may be more likely to engage in risky behaviors in communities where IV drug use is common and where many teenagers become sexually active at an early age. In such places, the prevalence of HIV infection may be or has the potential for being high, thus increasing the risk."(5)

Common street drugs lower the immune response in a number of ways. Here is just a partial list:(6)

Amphetamines depress the appetite. Without adequate, balanced nutrition it is impossible to maintain a healthy immune system.

Barbiturates cause lethargy and sleep, and sometimes anemia. Two essentials for a strong immune system are sufficient and regular exercise and a healthy blood supply to carry nutrients and antibodies to all parts of the body, and to remove waste on a frequent, regular basis.

Marijuana is known to weaken the immune system directly.

Heroin increases the risk of infections from contaminated needles. It is almost always taken by injection, and few users bother to sterilize their needles. Studies have shown that natural killer cells, which may be the body's first defense against many types of tumor cells and some viral infections, are significantly reduced in heroin addicts.(7)

Cocaine causes chronic nausea or vomiting and impairs the appetite, leading to the malnourishment mentioned earlier. It also causes chronic fatigue, exhaustion, and sleep problems. Regular, sufficient rest is essential to keeping the immune system in good repair.

How much better to keep the immune system in tiptop shape. Dr. Taylor offers the following suggestions for doing so, based on those factors we can control:

Learn all you can about your immune system. Knowledge is power. Begin making desirable lifestyle changes a few at a time--but the sooner the better. Awareness is the first step.

Make dietary changes, eliminating known immune system suppressors and increasing strengtheners. Greatly reduce or eliminate the oil you use in cooking and baking. Instead, saute onions in a little water in the microwave, "fry" in nonstick pans, and even make an acceptable white sauce by mixing flour, milk, and salt, without fat, in a shaker or blender before cooking. Increase green and yellow vegetables and fresh fruits in your diet to be sure your immune system gets antioxidants, enzymes, vitamins, and amino acids.

Regularly breathe deeply, using your abdominal muscles. This will supply the blood with adequate oxygen and help keep your body's circulatory system in good condition.

Obtain optimum amounts of rest and relaxation, geared to personal needs. Some of us need less sleep than others, but many people are chronically short on sleep without realizing it. Emotional stress can also damage the immune system, and relaxation offers a chance to rebuild defenses. Often a change can be as good as a rest.

Balance this with consistent moderate exercise, such as a 30-minute brisk walk every day. Excessive strenuous exercise can suppress the immune system, so strive for balance.

Obtain moderate exposure to natural light, indoors as well as outdoors. Some people need more natural light than do others. But avoid sunburn, sunlamps, and tanning parlors.

Keep your body clean inside and outside. To ensure a consistent supply of water, aim to drink eight glasses of water a day in addition to other liquids. Daily bathing helps to remove impurities from the skin.

Cultivate a good sense of humor. Studies have shown that laughter and a positive mental attitude strengthen the immune system.

Develop a social support system. Immune system function is boosted when we consistently interact with a nurturing support group of selected individuals.

Underlying all of these should be trust in a higher power. Many find it helpful to work through the famous 12 steps, with or without a group. Studies show that prayer actually enhances the function of the immune system and that individuals who regularly attend church are healthier than those who do not. These acts themselves may not make the difference, but the trust in God that prompts them probably does.

Armed with these tools, we may take a purposeful, deliberate part in improving our immune system and thus our health and longevity. Then we won't need to tell the doctor, "I wish I could back up and take your advice, but it's too late now."

(1)Most of the information for this article is taken from materials provided by Dr. Taylor, a specialist in studying and presenting seminars on the immune system. Her help is greatly appreciated.

(2)"Immune System: An Internal Force Armed and Ready for Battle," Supplement to the Mayo Clinic Health Letter, February 1995, p. 5 (published by the Mayo Foundation for Medical Education and Research, Rochester, Minn.).

(3)From Alcohol Alert, No. 19 (PH 329) (National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, January 1993), p. 2.

(4)Dan Sperling, "Drug Roundup," Adventist Review, Apr. 9, 1987, pp. 12, 13.

(5)From "Facts About AIDS," adapted from Reducing the Risk: A School Leader's Guide to AIDS Education (U.S. National School Boards Association, 1989).

(6)Sperling, and others as noted individually.

(7)Mary Jeanne Kreek, "Immunological Function in Active Heroin Addicts and Methadone-maintained Former Addicts: Observations and Possible Mechanisms," Problems of Drug Dependency 1990: Proceeding of the 52nd Annual Scientific Meeting. Research Monograph 105, ed. Louis Harris (Rockville, Md.: National Institute on Drug Abuse, 1990), p. 76.