The U.S. House of Representatives voted overwhelmingly last night to approve the Eliminating Opioid-Related Infectious Disease Act and the Substance Use Disorder Loan Repayment Act of 2018. The Infectious Diseases Society of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society strongly support these bills. They will expand surveillance of infections (including HIV, hepatitis B and C, endocarditis, and other communicable health threats) associated with substance use disorders, authorize provider training to coordinate care for both infectious diseases arising from substance use and addiction, and provide loan repayment for health professionals caring for patients with substance use disorders (including those treating related infections).
As Societies with more than 12,000 infectious diseases, pediatric, and HIV physicians, IDSA, HIVMA, and PIDS made recommendations reflected in the Eliminating Opioid-Related Infectious Diseases Act, including the addition of endocarditis, a heart valve infection, to the list of infections related to the opioid epidemic. Not currently under national surveillance, endocarditis in most cases is a severe, acute illness requiring hospitalization that is different from viral infections associated with injection drug use such as HIV and hepatitis C virus (HCV). For HIV and HCV, individuals can live with the conditions for years before prominent symptoms occur requiring acute care and engagement with the medical system. Surveillance or monitoring of endocarditis and other bacterial infections will lead to more timely identification of injection drug-related outbreaks. We also strongly support the provider training component of the bill and are pleased that the bill now recognizes the importance of training and care coordination for infectious diseases and addiction to help ensure better patient outcomes.
The Substance Use Disorder Loan Repayment Act will address the need for a trained health workforce sufficient to detect, control and deliver coordinated care for infections with an escalating incidence as a result of increasing injecting drug use. Compared to five years ago there are 20 percent fewer physicians entering training programs for infectious diseases and HIV medicine, raising great concern about shortfalls in expertise exactly when most needed. This bill will help to attract the diversity of healthcare providers necessary to provide prevention, care, and treatment services to individuals with substance use disorders, including infectious diseases and HIV providers.
These bills are part of a package of legislation passed by the House yesterday to address the opioid crisis, and the effort reflects a bipartisan commitment to confronting the combined public health threats of the growing opioid epidemic and the outbreaks of infectious diseases the crisis has fueled. We urge the U.S. Senate to advance these measures so that they may rapidly become law.