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Citing the spread of infections linked to rising rates of opioid use across the country including HIV, viral hepatitis, skin and soft tissue infections, bone and joint infections and endocarditis, an article published in the Journal of Infectious Diseases calls on the federal government to support coordinated and strengthened responses by infectious diseases and substance use specialists.
The article, written by a team of authors from the University of Maryland School of Medicine, and from the National Institute of Allergy and Infectious Diseases that includes NIAID director Anthony Fauci, MD, notes that opioid use has climbed since the late 1990s, leading to increased use of injecting drugs. By 2016, the authors note, injecting drug use was linked to 13 percent of new HIV diagnoses and the majority of new hepatitis C infections.
The article notes that infectious disease physicians confronting outbreaks of infections linked to injection drug use increasingly find themselves on the frontlines of the nation's opioid epidemic, and must be equipped to recognize, refer, and treat substance use disorders. In turn, the authors recommend that providers of substance use disorder responses, including mental health professionals, nurses and social workers, be prepared to screen clients for infections, and to refer those at risk to programs providing sterile needles and syringes and other supports to reduce the risk of infection. Limited numbers of providers in both fields, as well as a lack of sterile needle and syringe programs, the authors note, exacerbate the challenges providers face in addressing the growing crisis.
The authors call for investments by the federal government ensuring the expansion of evidence-based interventions, and support for the needed workforce.
The Infectious Diseases Society of America (IDSA) and the HIV Medicine Association also continue to call on Congress and the administration to ensure the resources and workforce needed to reverse climbing rates of infectious diseases fueled by the opioid epidemic. The organizations have supported the President's request for Congress to provide a minimum of $58 million for Centers for Disease Control and Prevention (CDC) to support surveillance, prevention, detection and linkages to care to address the full range of infectious diseases associated with substance use disorders, and support collaboration with state and local health departments, healthcare facilities, and providers in these responses.
In addition, the groups urge Congress to fund the Loan Repayment for Substance Use Treatment Disorder Treatment Workforce Program at a minimum of $25 million as recommended in the SUPPORT Act and have urged the Health and Human Resources Administration to include infectious diseases and HIV physicians who diagnose and treat infections associated with substance use in programs providing education loan repayment, including by designating Ryan White-funded clinics as eligible National Health Service Corps sites.
IDSA and the HIV Medicine Association say they will continue to urge support for evidence-based, innovative and responsive care models and for addressing the challenges faced by the workforce that will be essential to ending the impacts of the opioid crisis.