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Public Health and Injection Drug Use
This issue of MMWR focuses on injection drug use and highlights ways
that state and local health departments monitor injection drug use-related
health issues and develop interventions to prevent substance abuse and
infections among injection drug users (IDUs). Substance abuse and addiction are
major underlying causes of preventable morbidity and mortality in the United
States (1). The risks increase when illicit substances are injected, which contributes
to multiple health and social problems for IDUs, including transmission
of bloodborne infections (e.g., human immunodeficiency virus [HIV] and hepatitis
B and C infections) through sharing unsterile drug injection equipment
and practicing unsafe sex (2). In the United States, approximately one third
of acquired immunodeficiency syndrome cases
(3) and one half of new hepatitis C cases
(4) are associated with injection drug use. Fatal drug overdoses
also contribute to death among IDUs (5). Although the number of persons who
inject illicit drugs (primarily heroin, cocaine, and amphetamine) is not
available, approximately one million persons in the United States are active IDUs
(6).
References
McGinnis JM, Foege WH. Mortality and morbidity attributable to use of
addictive substances in the United States. Proceedings of the Association of American
Physicians 1999;111:109--18.
Cherubin CE, Sapira JD. The medical complications of drug addiction and the
medical assessment of the intravenous drug user: 25 years later. Ann Intern
Med 1993;119:1017--28.
CDC. HIV/AIDS surveillance report, 2000. Atlanta, Georgia. US Department of
Health and Human Services, Public Health Service, CDC, 2000;12.
Alter MJ, Moyer LA. The importance of preventing hepatitis C virus infection
among injection drug users in the United States. J Acquir Immune Defic Syndr Hum
Retrovirol 1998;18(suppl 1):S6--S10.
Gibbs DA, Hamill DN, Magruder-Habib K. Populations at increased risk of HIV
infection: current knowledge and limitations. J Acquir Immune Defic Syndr 1991;4:881--9.
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