In-Hospital Illicit Drug Use and Patient-Directed Discharge: Barriers to Care for Patients With Injection-Related Infections PMC

As some have suggested (Anglin et al., 1993), accurate estimates of injection drug use may be less important to policy makers than a constellation of data that helps to assess need and allocate limited resources. If this is the case, then more systematic efforts need to be directed toward monitoring patterns and trends in injection drug use, including improvements in recording the route of administration in secondary drug abuse indicator reporting systems. NIDA’s Community Epidemiology Work Group provides one mechanism that may prove useful, particularly if expanded to incorporate more specific data on route of administration in its monitoring purview.

PWID may also engage in risky sexual behaviors, such as having sex without protection (like condoms or medicine to prevent or treat HIV), having sex with multiple partners, or trading sex for money or drugs. Studies have found that young PWID are more likely than older PWID to have sex iv drug use without a condom, have more than one sex partner, and have sex partners who also inject drugs. Keeping an undetectable viral load also likely reduces the risk of transmitting HIV through shared needles, syringes, or other drug injection equipment, though we don’t know by how much.

Methods

We conducted a meta-analysis of national surveys to estimate the proportion of persons in the U.S. who have injected drugs, used these estimates to calculate disease metrics for PWID using national surveillance data for HIV infection, and calculated rate ratios by gender, race/ethnicity, and age. We used other methods to estimate rates of HIV infection among PWID in Puerto Rico and rates of HCV infection among adult PWID in the U.S. The estimates of the number of PWID and rates of HIV and HCV infection among PWID are needed to effectively plan, implement at an appropriate scale, and evaluate programs that serve PWID with or at risk for bloodborne infections such as HIV, HBV, or HCV. The studies included for the meta-analysis were sufficiently homogeneous in terms of sampling methods, participants, and outcomes to provide a meaningful summary measure. All were national probability surveys designed to make inference to the U.S. household-based population, and collected self-reported data on injection drug use. Despite these similarities, it is possible that differences in characteristics of the surveys, such as question wording, could result in heterogeneity.

Studies were excluded if they provided inadequate description of methods or were not ongoing national, population-based surveys. We restricted to ongoing surveys to allow for multiple years of data to provide a more robust estimate of PWID. In addition, we manually searched for national household surveys that measured injection drug use and applied the Phase 2 selection criteria. Five reports identified in Phase 1 were excluded and 2 national surveys were included from the manual search for a total of 4 surveys used in meta-analysis (Figure 1). Notwithstanding data input limitations, this updated estimate provides a data point for monitoring the US PWID population size over time and can inform strategies to reduce transmission of infectious diseases. In recent years, political will has been building to eliminate HCV and HIV infections in the United States [27, 28].

Teen Drug Abuse Warning Signs

In 1999, the sample design expanded to include all 50 states and the District of Columbia, and the survey shifted from paper-and-pencil data collection to computer-assisted interviewing (CAI). Please scroll to the bottom of the IV Drug Abuse Facts Infographic to Verify Sources and Citations. Please note that some data provided is correlated to a certain time frame or specific group of study subjects or individuals. Therefore, careful review of the citations listed is necessary in order to fully understand U.S.

• The present investigation examines these issues in the National Comorbidity Survey–Adolescent Supplement (NCS-A), a nationally representative survey that used direct diagnostic interviews with youth aged 13 to 18 years.
• It is estimated that between 10 and 20 percent of injection drug users are in drug treatment at any give time (Centers for Disease Control and Prevention, 1990; Office of Technology Assessment, 1990; Wiley and Samuel, 1989; Schuster, 1988).
• In other words, are all PWID at risk of bingeing or is it a pattern of use that can be maintained as a primary pattern?
• Using transparent, replicable methods and largely publicly available data, we provide the first update to the number of people who inject drugs in the United States in nearly 10 years.

To combine the distinct estimates into a summary measure, we applied meta-analytic methods recently extended to survey data [14]. For each recall period (ever, past year) we first multiplied each survey estimate by a weight inversely proportionate to its variance, summed the weighted estimates across studies, and then divided by the sum of the weights. Adult and adolescent PWIDa accounted for 10% (3,864)b of the 37,968 new HIV diagnoses in the United States (US) and dependent areasc in 2018 (2,492 cases were attributed to injection drug use and 1,372 to male-to-male sexual contactd and injection drug use). These drugs also have a high potential for abuse; this may or may not be due to addictive properties.