Opportunities to Offer Harm Reduction to People who Inject Drugs During Infectious Disease Encounters: Narrative...

Area of Science:

• Infectious Diseases
• Public Health
• Addiction Medicine

Background:

• Injection drug use (IDU) is associated with increased overdose (OD) and blood-borne infections.
• The opioid OD crisis, particularly with synthetic opioids, has intensified the overlap between IDU and infectious diseases (ID).
• People who inject drugs (PWID) face higher risks due to more frequent injections from faster-acting synthetic opioids.

Purpose of the Study:

• To highlight the critical role of infectious disease (ID) specialists in addressing the opioid OD crisis among PWID.
• To advocate for the expansion of harm reduction services within ID settings for PWID.
• To propose targeted strategies to mitigate OD, infection, and hospitalization rates in this population.

Main Methods:

• Leveraging clinical encounters between ID specialists and PWID for intervention.
• Expanding harm reduction services, including safer injection education and supplies (sterile needles, fentanyl test strips, naloxone).
• Increasing access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and initiating medications for opioid use disorder (MOUD).

Main Results:

• ID specialists can significantly impact the opioid OD crisis by engaging PWID during clinical visits.
• Implementing harm reduction strategies can decrease OD, infection, and hospitalization rates among PWID.
• Integrating safer injection practices, infection prevention, and MOUD can improve patient outcomes and reduce stigma.

Conclusions:

• ID specialists are crucial in mitigating the harms associated with IDU and the opioid crisis.
• Expanding harm reduction services in ID settings is essential for reducing OD and infection rates.
• A multi-faceted approach including safer injection, infection prophylaxis, and MOUD can improve care for PWID and reduce stigma.