Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics Proceedings of a Workshop (2018) / Chapter Skim
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1 Introduction
1 Introduction
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Hospitalizations for serious infections associated with opioid use have also quadrupled in the last decade at an added cost of nearly $15 billion to the health care system, according to estimates using data from the Agency for Healthcare Research and Quality. The increase in injection drug use appears to be the main driver for these infections.
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He tasked workshop attendees with finding ways to move forward and integrate strategies into robust structures that already exist, such as settings for HIV and HCV care. WORKSHOP OBJECTIVES To address these infectious disease consequences of the opioid crisis, a public workshop titled Integrating Infectious Disease Considerations with Response to the Opioid Epidemic was convened on March 12 and 13, 2018, by the Board on Population Health and Public Health Practice in the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine.
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Many service members are already stationed in communities of extreme need, working to respond to the opioid epidemic and the infectious disease crises in collaboration with agencies such as the Indian Health Service and the Bureau of Prisons; other commissioned officers are working with the Food and Drug Administration, the National Institutes of Health, and CDC implementing and managing critical programs to support our response to the epidemics. He envisioned the corps as playing an everincreasing role in the national fight against opioids, infectious disease, and persistent health inequalities.
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In his charge to the attendees, Richard Wolitski, director of the HHS OHAIDP, was optimistic that the workshop would represent an inflection point toward a new paradigm that recognizes fully the urgent need for a more inclusive and comprehensive approach that addresses the disastrous consequences of the opioid epidemic and the life-threatening infectious diseases that are intertwined with each other. These infections are shortening the lives of Americans, challenging families and communities, straining service delivery systems, and adding to an already increasing health care cost, he said.
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Wolitski conceded that developing and implementing such a system will not be easy, but there are precedents for success in integrated care in the numerous HIV programs that have broken down the walls of clinics and have created new interactions and partnerships for information sharing among health care providers, health departments, and community-based organizations that allow people to be retained in care. Other movements are already under way that align with this approach, he added.
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Notably, new cases of hepatitis C among women increased by more than 260 percent between 2010 and 2014, likely increasing the risk of perinatal hepatitis C transmission to their infants. Finally, Tytel said, women who are parents and family caregivers may face additional barriers to accessing health care services, including treatment for substance use disorders, such as lack of child care.
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These resources include information about the link between opioid use and the risk of viral hepatitis and HIV, and the potentially significant effect on the health of both the mother and the baby. Tytel hoped that the workshop would provide opportunities to gain new insight into how the opioid epidemic affects women's health across the life course and how it affects their access to health care services (see Box 1-1)
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