Primary Care for Persons Who Inject Drugs

Area of Science:

• Public Health
• Infectious Diseases
• Addiction Medicine

Background:

• Over 750,000 individuals in the United States inject drugs, with numbers rising due to the opioid epidemic.
• Persons who inject drugs (PWID) face elevated risks for infectious and noninfectious complications, impacting skin, lungs, heart, and neurological systems.
• Injection drug use is linked to significant morbidity and mortality.

Purpose of the Study:

• To highlight the critical health risks associated with injection drug use.
• To emphasize the importance of nonjudgmental screening for addiction treatment readiness and risk factors.
• To outline essential screening, vaccination, and preventative care strategies for PWID.

Main Methods:

• Review of medical complications and risks associated with injection drug use.
• Discussion of recommended screenings (HIV, TB, Hepatitis B/C) and vaccinations (Hepatitis A/B, tetanus, pneumonia).
• Emphasis on offering pre-exposure prophylaxis for HIV and naloxone for overdose prevention.

Main Results:

• Skin and soft tissue infections are the most frequent medical complication and primary cause of hospitalization for PWID.
• PWID have a higher incidence of community-acquired pneumonia and pulmonary complications.
• Infectious endocarditis is a common cardiac complication, often affecting right-sided heart valves.

Conclusions:

• Comprehensive screening, vaccinations, and preventative measures like HIV pre-exposure prophylaxis and naloxone are vital for PWID.
• Prompt medical attention, including hospitalization and diagnostic tests, is necessary for systemic infections.
• Injection drug use increases the risk of serious conditions such as osteomyelitis and abscesses.