New data released by the Centers for Disease Control and Prevention document that invasive methicillin-resistant Staphylococcus aureus (MRSA) infections occurring in people who inject drugs more than doubled, from 4.1 percent to 9.2 percent between 2011 and 2016. This dramatic increase highlights the immediate need for robust federal and local responses to prevent, identify and treat infectious diseases acquired through injection drug use as a key component of the opioid response. Increased cases of hepatitis C (HCV), HIV and infective endocarditis due to injection drug use have previously been reported.
Congress is considering a number of bills to bolster the national response to the opioid epidemic including new funding for the CDC to support increased surveillance, prevention and provider training to eliminate infectious disease associated with injection drug use. The Infectious Diseases Society of America and HIV Medicine Association urge swift passage and funding of H.R. 5353, Eliminating Opioid Related Infectious Diseases Act of 2018 and its companion provision included in S 2680, the Opioid Crisis Response Act of 2018.
Equally essential, investment is needed to have an adequate workforce necessary to care for patients with infections due to opioid or other injection drug use. In recent years, 20% fewer physicians have entered the fields of infectious diseases and HIV medicine, raising great concern about shortfalls in expertise exactly when most needed. We call on Congress to promptly approve the Substance Use Disorder Loan Repayment Act of 2018, HR 5102, and its companion provision in S. 2680 that would attract more healthcare providers to careers in addiction, mental health, and infectious diseases/HIV.
HIV, HCV, endocarditis, MRSA and other viral and bacterial infections can be prevented when sterile syringes and equipment are available to individuals who inject drugs. While the goal ultimately is to get individuals with substance use disorder into treatment, strategies to reduce the harms associated with injection drug use must also be employed to prevent infectious diseases outbreaks. Legalized syringe exchanges on the state and local level and enhanced funding for programs that provide access to sterile syringes, counseling on safer injection practices, and access to other healthcare services are essential to the health of individuals affected by addiction and the public health of our communities. We urge Congress to ensure that these strategies are included in upcoming legislation and appropriations addressing the opioid epidemic.
Read the CDC report Invasive Methicillin-Resistant Staphylococcus aureus Infections Among Persons Who Inject Drugs — Six Sites, 2005–2016. (MMWR / June 8, 2018 / 67(22);625–628)