National Academies target opioid abuse and infectious disease consequences

July 13, 2018

The National Academies of Sciences, Engineering, and Medicine (NASEM) today released proceedings of a March 12 workshop exploring the rise in infectious diseases accompanying opioid abuse, and possible strategies for reducing both epidemics. The workshop was requested by the Department of Health and Human Services in response to an alarming increase in the spread of infectious diseases resulting from the opioid abuse epidemic, including hepatitis C virus (HCV), hepatitis B virus (HBV) and HIV infection, in addition to an increase in related infections requiring hospitalization.

Carlos del Rio, MD, professor of medicine in Emory University School of Medicine and the Hubert Chair of the Hubert Department of Global Health at Emory's Rollins School of Public Health, chaired the NASEM workshop committee that released the report, Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics.

del Rio and two other workshop participants - Sandra A. Springer, MD, from Yale University, and P. Todd Korthuis, MD, MPH, from Oregon Health and Science University -- also co-coauthored a commentary published online today in Annals of Internal Medicine, entitled "Action Steps to Integrate Treatment of Opioid and Infectious Epidemics."

According to the Centers for Disease Control and Prevention (CDC), 115 Americans die each day from an opioid overdose, and between 1999 and 2016 the number of drug overdoses rose by 300 percent. Also according to CDC, HCV infections nearly tripled between 2010 and 2015, including an increase in HCV in pregnant women and risk of transmission to their unborn children. HBV infections increased by 20 percent between 2014 and 2015. HIV infections among people who inject drugs increased by four percent between 2014 and 2015. Hospitalization for serious infections associated with opioid use have quadrupled in the last decade. These include bacteremia, endocarditis, skin and soft tissue infections, and osteomyelitis.

According to the Workshop Proceedings, providers and medical facilities that manage infectious diseases resulting from opioid use disorder have a unique opportunity to engage people in treatment for OUD while managing their infection. However, few of these providers and hospitals have the needed resources and capabilities. "Thus, there is an urgent need to implement and scale up effective OUD treatment in healthcare settings to address the intersecting epidemics of OUD and its infectious disease consequences."

Workshop members cited important parallels between the current opioid epidemic and the early HIV epidemic. According to del Rio, "Both the early HIV epidemic and the current opioid epidemic have a particular impact on younger people. Care of HIV patients greatly benefited from the development of a highly trained, interdisciplinary workforce and expanded public resources for treatment. Unfortunately, both epidemics have been intensified by social stigma and discrimination. Beyond just treatment, we must intervene against the social determinants of health that are driving the opioid epidemic."

Based on the workshop discussions, Springer, Korthuis and del Rio agreed on five action steps to target both opioid use disorder and the resulting rise in infectious diseases. The steps were published in the Annals of Internal Medicine article: The authors state:

"All healthcare providers are needed to combat the OUD epidemic and its infectious consequences. Those who treat infectious complications of OUD are well suited to screen for OUD and begin treatment with effective FDA-approved medications. Integrating our collective skills may make the difference between life and death for patients living with OUD."
-end-
To download a free copy of the workshop proceedings, please visit: nationalacademies.org/OpioidsandInfections

Emory Health Sciences

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.