213. Vaughan Rees and Connor Kubeisy | The Burden of Disease related to Drugs213. Vaughan Rees and Connor Kubeisy | The Burden of Disease related to Drugs
High Truths on Drugs and Addiction
Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity or other indicators. When it comes to drugs, we are always talking about overdoses and deaths. The CDC predicted deaths in the US for the 12 months preceding March 2024, are over 103,000. That is horrible and unacceptable. Death is just the tip of the iceberg. For every death there are many more with a substance use disorder, as well as a host of medical and mental health conditions associated with drugs. There are proponents of judging drugs like we do other health problems like injuries or cardiovascular disease. That is looking at the total disease burden, not just deaths. For example, disability for depression and back pain rated much higher in disease burden compared to diabetes, emphysema and asthma combined. Yet we know emphysema is more lethal than back pain. In this episode we will discuss the disease burden of drugs and alcohol. Vaughan Rees, pHD Dr. Rees is Director of the Center for Global Tobacco Control, whose mission is to reduce the global burden of tobacco-related death and disease through training, research, and the translation of science into public health policies and programs. He directs the Tobacco Research Laboratory at the Harvard Chan School, where the design and potential for dependence of tobacco products are assessed. Studies examine the impact of dependence potential on product use and individual risk, to inform policy and other interventions to control tobacco harms. Current research uses conventional and innovative strategies to evaluate new and novel tobacco products. Examples of these products include modified risk tobacco products such as e-cigarettes; reduced ignition propensity cigarettes; hookah (tobacco waterpipe); and novel smokeless tobacco products such as snus. Clinical research methods are used to evaluate the influence of tobacco product design features on consumer responses, and their role in promoting initiation or maintenance of use among targeted populations. Findings have been used to inform tobacco control policy, develop resources for communicating risks of tobacco products, and to enhance understanding of factors that contribute to tobacco dependence. Other research involves development of strategies to reduce secondhand smoke (SHS) exposure in domestic environments, with a focus on evaluating interventions for reducing domestic SHS exposure among children. Dr. Rees also leads an NIH funded study which seeks to reduce secondhand smoke exposure among children from low income and racially/ethnically diverse backgrounds. This research utilizes the principles of community based participatory research (CBPR) to develop and evaluate a cognitive behavioral intervention to help caregivers maintain a smoke free home environment. He has conducted studies on SHS emissions of tobacco waterpipe, and SHS monitoring in indoor environments, including private homes and cars. Dr. Rees' academic background is in health psychology (substance use and dependence), and he trained at the National Drug and Alcohol Research Centre at the University of New South Wales in Sydney, Australia, and did postdoctoral training through the National Institute on Drug Abuse. He has also published research on the role of cue reactivity in tobacco and alcohol abuse and dependence; and clinical trials on interventions for alcohol and cannabis dependence. Towards a Comprehensive Measure of Drug Attributable Harm, JAMA Connor Kubeisy Connor Kubeisy is a Policy Analyst with the Foundation for Drug Policy Solutions and its sister organization, Smart Approaches to Marijuana, after having joined them as a Communications and Policy Associate in January 2022. He began his career as an intern in the White House Office of National Dru...
56:08•20 Jan 2025
Understanding the Full Impact of Drug Use: Beyond Overdoses
Episode Overview
- Drug-related deaths are just a small part of the overall harm caused by substance use.
- The full burden of disease includes disability and mental health conditions.
- Lessons from tobacco control can be applied to other substances like cannabis.
- A comprehensive measure of drug harm should consider both fatal and non-fatal health losses.
- Effective drug policies need to address the broader impacts beyond just overdose deaths.
“Death is just the tip of the iceberg when it comes to the full toll of the drug crisis.”
In this episode of High Truths on Drugs and Addiction, Dr. Roneet Lev dives into the heavy topic of the disease burden related to drug use. Joined by experts Dr. Vaughan Rees and Connor Kubeisy, the discussion centres around the broader impacts of substance use beyond just overdoses and deaths. Dr.
Rees, Director of the Center for Global Tobacco Control at Harvard, shares his extensive knowledge on the harms of tobacco and alcohol, while Kubeisy, a young but accomplished policy analyst, brings fresh perspectives from his work with Smart Approaches to Marijuana. The conversation highlights how measuring the full burden of disease – including disability and mental health conditions – provides a more comprehensive understanding of the true impact of drug use on society.
They also explore how lessons from tobacco control could be applied to other substances, such as cannabis. This episode is a must-listen for anyone interested in the multifaceted challenges of drug policy and public health.

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