213. Vaughan Rees and Connor Kubeisy | The Burden of Disease related to Drugs

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 Drug Control Policy during the Trump and Biden administrations. In 2022, he served as the Campaign Manager of the group that helped defeat the ballot measure to legalize recreational marijuana in North Dakota. He co-authored a chapter in the ASAM Principles of Addiction Medicine, 7th edition, about the impact of the cannabis industry on cannabis use disorder. Additionally, he is a member of the National Safety Council’s Impairment Advisory Board and the Global Burden of Disease Study’s Collaborator Network.

Connor received the Director’s Award from Stanford University’s Hoover Institution and was selected to attend the Harvard Kennedy School’s Public Policy Leadership Conference. He was recognized by the Washington Examiner as “an emerging voice in the drug policy field.” Connor graduated Phi Beta Kappa from the University of California, Berkeley, with a B.A. in Political Science, where he was a student manager with the school’s Division 1 baseball team and won the Kavanagh Award from the Society for American Baseball Research. He previously received an A.A. from Moorpark College, where he was named a member of the First Team All-California Community College Academic Team. He is currently a Master of Public Health student, in health policy, at the Harvard T.H. Chan School of Public Health, where he was elected to serve as the Public Relations Coordinator for the Harvard Chan Student Association.