Infectious Diseases And Substance Abuse

The use of recreational drugs of abuse by large numbers of individuals in this country and abroad has aroused serious concerns about the consequences of this activity. For example, it is recognized that marijuana is currently widely used as a recreational drug in the United States as well as other countries. Similarly, abuse of cocaine, especially crack cocaine, is considered to be an epidemic. “The war on drugs” by the US Government was directly aimed at the illicit use of cocaine, marijuana, and opiates as well as other drugs of abuse. Furthermore, alcohol is also considered a major problem of abuse in this country as well as in many other countries. It is estimated there are at least 10 million alcoholics in the United States alone. A signi?cant portion of those hospitalized with infectious diseases are alcoholics. Similarly, there have been many reports of association between marijuana use and increased susceptibility to infection as well as a re- tion between use of opiates and infections. The relationship between drug abuse and increased incidence of various infections has stimulated increased investi- tion of whether and how such drugs affect immune function, especially imp- tant for resistance against infectious agents. During the last decades, a wide variety of studies have shown that drugs of abuse, including marijuana, cocaine, or opiates, as well as alcohol, alter both neurophysiological as well as pathological responses of individuals.

Opioid use and infectious diseases are intertwined epidemics. Despite the fact that the United States is more than two decades into the opioid crisis - the cause of tens of thousands of deaths every year on its own - the health system has not sufficiently addressed the morbidity and mortality of drug use coupled with infectious diseases. This is at least in part due to traditional models of substance use disorder care wherein substance use disorder treatment is delivered independently of other medical care, thereby inhibiting the delivery of comprehensive care. As a result, the United States is experiencing a drastic increase in infectious diseases that spread with drug use. Opportunities to Improve Opioid Use Disorder and Infectious Disease Services examines current efforts to integrate care and describes barriers, such as inadequate workforce and training; lack of data integration and sharing; and stigma among people who use drugs and have also been diagnosed with an infectious disease. The conclusions and recommendations of this report will help to promote patient-centered, integrated programs to address this dual epidemic.

The use of recreational drugs of abuse by large numbers of individuals in this country and abroad has aroused serious concerns about the consequences of this activity. For example, it is recognized that marijuana is currently widely used as a recreational drug in the United States as well as other countries. Similarly, abuse of cocaine, especially crack cocaine, is considered to be an epidemic. “The war on drugs” by the US Government was directly aimed at the illicit use of cocaine, marijuana, and opiates as well as other drugs of abuse. Furthermore, alcohol is also considered a major problem of abuse in this country as well as in many other countries. It is estimated there are at least 10 million alcoholics in the United States alone. A signi?cant portion of those hospitalized with infectious diseases are alcoholics. Similarly, there have been many reports of association between marijuana use and increased susceptibility to infection as well as a re- tion between use of opiates and infections. The relationship between drug abuse and increased incidence of various infections has stimulated increased investi- tion of whether and how such drugs affect immune function, especially imp- tant for resistance against infectious agents. During the last decades, a wide variety of studies have shown that drugs of abuse, including marijuana, cocaine, or opiates, as well as alcohol, alter both neurophysiological as well as pathological responses of individuals.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Defines guidelines in establishing funding, monitoring, and evaluating treatment programs that screen for infectious diseases in substance abusers.

Offering timely guidance on the junction of the opioid crisis and infectious diseases, this practical handbook by Dr. Brianna L. Norton provides concise yet comprehensive coverage of a growing patient population. Infectious disease specialists are increasingly seeing patients who previously used opiods and now use intravenous drugs. Many challenges are unique to this patient population, including new and growing infections such as hepatitis C, endocarditis, HIV, and hepatitis B. The Opioid Epidemic and Infectious Diseases is an up-to-date, real-world guide that covers the scope of the problem, management guidelines, and much more. Describes the new landscape of the opioid crisis in the U.S. and its intersection with infectious diseases, including epidemiology, Opioid Use Disorder (OUD) and rural America, and more. Offers practical guidance on (OUD) and infectious co-morbidities like hepatitis C, STDs, endocarditis, HIV, and hepatitis B. Covers prevention, treatment, and harm reduction. Discusses OUD, infectious diseases, and the criminal justice system. Consolidates today’s available information and guidance into a single, convenient resource.

According to the Centers for Disease Control and Prevention (CDC), 115 Americans die each day from an opioid overdose, which averages one death every 12.5 minutes. Between 1999 and 2016, the number of drug overdoses catapulted by 300 percent, with injection drug use increasing by 93 percent between 2004 and 2014 and opioid-related hospital admissions increasing by 58 percent over the past decade. And an inexorable sequela of the opioid epidemic is the spread of infectious diseases. To address these infectious disease consequences of the opioid crisis, a public workshop titled Integrating Infectious Disease Considerations with Response to the Opioid Epidemic was convened on March 12 and 13, 2018, by the National Academies of Sciences, Engineering, and Medicine. Participants discussed strategies to prevent and treat infections in people who inject drugs, especially ways to work efficiently though the existing public health and medical systems. This publication summarizes the presentations and discussions from the workshop.

This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs.