For example, both COVID-19 and substance use can affect heart and lung function, amplifying the negative health effects of each. To identify eligible studies, the titles and abstracts of studies retrieved were screened by two reviewers, with a sample of 15% screened independently by both reviewers and achieving 98.5% agreement (SH, NJ). For full text screening, ten reviews (7%) were initially signs of drug use screened by three reviewers (SH, NJ, SW), with results later discussed and discrepancies resolved. Following this, the full text screening was divided across reviewers and any reviews that were not a clear exclude/include (20%) were discussed and agreed between reviewers. This meant that, across all reviews screened by full text, 27% were discussed and agreed by more than one reviewer.
Medical Consequences: Brief Review and Research at NIDA
- Global changes may differentially affect the risk of emergence, the dynamics of disease within a local population and the global spread of diseases between populations.
- Clearly, additional research in this area will be needed to target prevention strategies and to model the future course of the AIDS epidemic.
- As noted earlier, the program was begun in 1984, during which 25,000 sterile needles and syringes were distributed.
- Along with partners at the National Institutes of Health (NIH), NIDA researchers are assessing the impact of COVID-19 policies on mental health, suicide, substance use, and drug overdoses in adults.
- In particular, Boston recently documented a cluster of HIV cases among PWID,118 serving as a reminder that surveillance of drug use trends could serve as an indicator about when and where screening for STIs and PrEP for HIV infection should be stepped up.
One consistent finding with significant implications for treatment and prevention efforts is that of multiple drug use among those who inject drugs. Studies of treatment populations (B. D. Johnson et al., 1985; Ball et al., 1986) suggest that a majority (60-90 percent) of IV heroin users report regular use of at least one other nonopiate. (A survey of approximately 100 former heroin users enrolled in methadone maintenance clinics in the New York City area found that 91 percent also reported IV cocaine use [Brown and Primm, 1988].) The choice of drugs for injection varies among different drug subcultures and over time. Heroin was the dominant injected drug a few years ago, but today, IV drug users may also inject cocaine, heroin and cocaine in combination, or a variety of other drugs, including amphetamines (Black et al., 1986).
International Patients
The Amsterdam program had actually been established prior to concerns about AIDS, but it was greatly expanded when AIDS cases were diagnosed in the city. In another study conducted in Amsterdam (van den Hoek et al., 1987), increased use of the needle exchange program occurred simultaneously with reductions in the reported frequency of drug injection among the respondents. As local conditions alter demographically, or as a result of climate change potentially expanding the range of locations suitable to a particular pathogen or vector, increased global connectivity will enable pathogens to reach these new environments more rapidly (Figs 3,4).
Are people who have substance use disorders at greater risk for COVID-19?
Approaches intended to reduce infectious diseases among people who inject drugs include interventions geared towards preventing infection and reducing the risk of transmission, in addition to those that focus on treatment when infection does occur. Furthermore, broader public health approaches, such as the provision of outreach and low-threshold services and enabling environments, can lower the barriers to accessing treatment and thus reduce people’s vulnerability to infection. Empowering people who inject drugs to protect themselves may also provide an environment in which the transmission of infection is less likely to occur.
Non-Injection Drug Users
- While there are still not enough studies to assess the effect on HIV, considering the positive effect on HCV, experts assume the same positive effect on HIV infections.
- Although the full impact of the pandemic on PWID has not been defined, PWID are likely at risk for infection and severe disease, due to high rates of comorbid health conditions, homelessness, and other suboptimal social conditions [5–11].
- Obesity was reported to increase the risk of contracting influenza [30] and pneumonia [31, 32].
- For example, researchers assessed how MOUD providers are using telemedicine, COVID-19-related changes in how they treat opioid use disorder, and the impact of telemedicine on MOUD care.
- Unfortunately, researchers simply are not yet proficient at measuring and conceptualizing that variation.
- Considering that prisons are high-risk environments for the transmission of blood-borne infections, a comprehensive approach to harm reduction in this setting is expected to play a significant role in the health of the prison population, as well as in the community in general.
- Several researchers have attempted to collect data from probability samples of the street population (Des Jarlais et al., 1985; McAuliffe et al., 1987).
Combined with the intensification of trade at the global scale, this pattern has driven a rise in long-distance transmission and disease emergence98,99. Trade drives the emergence of novel plant diseases by creating novel interactions between hosts and pathogens100. One pathway through which this can occur is the introduction of novel pathogens to native plants.
Drug-Impaired Driving: The Contribution of Emerging and Undertested Drugs
Although the exact nature or source of any future epidemic or pandemic threat is speculative, behavioural risk factors have also been found to increase the risk of infection and subsequent poorer outcomes across a range of other communicable diseases [12–14]. Although previous research has explored links between behavioural risk factors and individual communicable diseases, few studies have synthesised information across a wider range of communicable diseases and their relationships with behavioural risks. Indeed, such relationships may elucidate how future pandemics threats will exploit behavioural risk factors. The problem of HIV infection among IV drug users and its transmission to their sexual partners and offspring requires both immediate action and long-term research. Immediate action is necessary because of the potential for the rapid spread of HIV among IV drug users within short periods.
Infections common to HIV/AIDS
Hepatitis infection among people who use or Inject drugs – CDC
Hepatitis infection among people who use or Inject drugs.
Posted: Mon, 24 Aug 2020 07:00:00 GMT [source]
If you have HIV, substance use can make it hard to focus and affect your ability to stick to an HIV treatment regimen. Skipping HIV medicines allows HIV to multiply and damages your immune system, making it harder for your body to fight infections and certain cancers. Drug interactions between HIV medicines and recreational drugs can also increase the risk of dangerous side effects. Testing is the gateway to accessing treatment, and in order to achieve the elimination of HCV, particular efforts are needed to reach the undiagnosed and those at risk of infection.
A number of methadone programs in Amsterdam are also sites for the syringe exchange program (Buning et al., 1986; Buning, 1987b). In a study of Baltimore STD clinics, 57% of clients had SUD (35% alcohol, 31% cannabis, 11% opioids, and 8% stimulants),84 which is higher than expected for the general U.S population. Additional variations in prevalence of substance use, misuse and SUD are observed by sexual orientation with sexual minorities having higher prevalence compared to their heterosexual peers (through age 25),85-87 with less consistent findings in later age groups.
HIV Overview
Most laboratories test for Tier I drugs, but only test for select Tier II drugs when they are regionally relevant. Therefore, the frequency and the types of Tier II substances contributing to drug-impaired driving cases and fatal crashes is not well understood. In 2007, the National Safety Council (NSC) introduced testing scope and cutoff standardization for impaired driving cases and traffic fatalities to improve testing consistency. Since 2013, it has recommended that forensic toxicology labs regularly test blood for 35 of the most often encountered drugs and metabolites. Referred to as Tier I drugs (Figure 1), they are now included as a testing standard in many forensic toxicology labs.[3] Furthermore, these compounds can be detected and confirmed with commonly used analytical instrumentation. This narrative review describes the relationship between the U.S. opioid epidemic, its relationship with the epidemiology of sexually transmitted infections, and opportunities for integrated interventions.