The Opioid Epidemic and Infectious Diseases

1st Edition - November 15, 2019
Editor: Brianna L. Norton
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 6 8 3 2 8 - 9
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 8 3 2 9 - 6

Offering timely guidance on the junction of the opioid crisis and infectious diseases, this practical handbook by Dr. Brianna L. Norton provides concise yet comprehensive co… Read more

The Opioid Epidemic and Infectious Diseases

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Offering timely guidance on the junction of the opioid crisis and infectious diseases, this practical handbook by Dr. Brianna L. Norton provides concise yet comprehensive coverage of a growing patient population. Infectious disease specialists are increasingly seeing patients who previously used opiods and now use intravenous drugs. Many challenges are unique to this patient population, including new and growing infections such as hepatitis C, endocarditis, HIV, and hepatitis B. The Opioid Epidemic and Infectious Diseases is an up-to-date, real-world guide that covers the scope of the problem, management guidelines, and much more.

Cover image
Title page
Table of Contents
Copyright
Contributors
Chapter 1. The epidemiology of the opioid overdose epidemic in the United States
Introduction
National trends and demographics
The triple-wave epidemic: opioid pills, heroin, and synthetic opioids
Conclusion
Chapter 2. The case of Scott County: injection drug use and the HIV and hepatitis C virus outbreak
Background
Outbreak
Burden of injection drug use throughout the United States and the world, and association of injection drug use with HIV and hepatitis C virus infections
Acute hepatitis C virus infection and injection drug use in areas at risk for HIV outbreaks
Management of HIV outbreaks, methods for amelioration of existing outbreaks, and prevention of future outbreaks
Other recent outbreaks
Scott County may be the harbinger of things to come
Chapter 3. Opioid use disorder and rural America
Opioid use disorder burden in rural communities
Human immunodeficiency virus
Hepatitis C, B, and A virus infections
Factors that drive illicit drug use in rural communities
Barriers to care in rural communities
Developing and training the rural healthcare workforce
Community stigma, support, and policy
Promising models for prevention and treatment in rural communities
Current studies on rural injection drug use
Chapter 4. Opioid use disorder, infectious diseases, and the criminal justice system
Background on criminal justice in the United States
Bloodborne illnesses in criminal justice settings
Medications for addiction (opioid use disorder) treatment
Chapter 5. Opioid use disorder and HIV
Injection drug use is an important HIV risk factor
Factors contributing to declining HIV incidence among PWID: 1992–2015
The current opioid epidemic threatens decades of decline in PWID-related HIV
Treatment of HIV-positive people with opioid use disorder or who inject drugs
Conclusion
Chapter 6. Opioid use disorder and HCV (hepatitis C virus)
Introduction
Epidemiology
Natural history of HCV and mortality
Screening of HCV among PWID and point-of-care testing
Staging of liver disease and HCC screening
SVR outcomes in PWID
Barriers to care for PWID
Cascade of care and Co-located models of care
HCV treatment adherence
HCV reinfection
Treatment as prevention
Policy issues and restrictions
Cost-effectiveness studies
Conclusions
Chapter 7. Opioid use disorder and Chronic Hepatitis B
Introduction
Natural history of hepatitis B virus infection
Hepatitis B virus infection epidemiology, with focus on persons who inject drugs
Hepatitis B and other coinfections in persons who inject drugs
Hepatitis B virus screening and diagnosis
Prevention: Hepatitis B virus vaccination
Treatment of hepatitis B
Chapter 8. Opioid use disorder and endocarditis
Opioid use disorder and endocarditis
IDU-associated endocarditis: diagnosis and treatment
Other treatment issues
Addiction treatment for hospitalized patients: an opportunity to intervene
Chapter 9. Outpatient opioid use disorder treatment for the ID physician
Benefits of opioid use disorder treatment
To treat opioid use disorder successfully, recognize that it is a chronic, relapsing and remitting disease of the brain
Barriers to opioid use disorder treatment
Scale-up of opioid use disorder treatment is a critical public health priority: an overview of expansion strategies
Expansion of opioid use disorder pharmacologic treatment in nonaddiction specialty clinics is a promising public health strategy
Legislative history for expanding access to pharmacotherapy in the ambulatory setting
Clinician-level barriers to prescribing treatment for opioid use disorder
Screening for opioid use disorder, the benefit of treatment initiation, and additional work up
Available pharmacotherapy options for treating opioid use disorder
Special considerations in opioid use disorder pharmacologic treatment
Conclusion
Chapter 10. Inpatient opioid use disorder treatment for the infectious disease physician
Introduction
Pathophysiology of infections related to OUD
Inpatient OUD screening in the infectious disease consultation
Withdrawal treatment with transition to medication maintenance
Medications for OUD
Inpatient infections
Patient-centered care
Acute pain
Opioid-related medical conditions
Future directions
Chapter 11. HIV pre-exposure prophylaxis for people who inject drugs
HIV prevention in people who inject drugs
Evidence of efficacy of preexposure prophylaxis in people who inject drugs
Preexposure prophylaxis effectiveness in the “real world”
Indications for preexposure prophylaxis in people who inject drugs
The HIV prevention or preexposure prophylaxis care continuum
Challenges facing scale-up and widespread adoption
Strategies for preexposure prophylaxis scale-up among people who inject drugs
Advances in preexposure prophylaxis modalities and the future of preexposure prophylaxis for people who inject drugs
Chapter 12. Notes on harm reduction and the opioid epidemic in the United States
Introduction
What harm reduction is not
Positive principles of harm reduction
Historical timeline of harm reducing and harm-increasing events in the United States
Harm reduction and the current opioid epidemic
Tips for clinicians
Chapter 13. Modeling the impact of harm reduction for opioid use disorder on infectious disease prevention
Introduction
Empirical evidence for harm reduction on acquiring HIV and hepatitis C virus infections
Modeling the impact of harm reduction on HIV epidemics among people who inject drugs in the United States
Modeling hepatitis C virus infection and harm reduction in the United States
Modeling the impact of harm reduction among the incarcerated population on infectious diseases
Cost-effectiveness of harm reduction interventions in the United States
Conclusion
Index