The confluence of HIV/AIDS, drug abuse, and hepatitis C is becoming a public health nightmare. HIV/AIDS and hepatitis C are moving at an alarming rate into the minority community, where the poorest and most vulnerable are at risk through injection drug use and unprotected sex.
To counteract this public health emergency, the Substance Abuse and Mental Health Services Administrations's Center for Substance Abuse Treatment (CSAT) and the National Institute on Drug Abuse (NIDA) released publications designed to provide information to the public and health professionals on the intertwined problems of substance abuse and diseases such as HIV/AIDS and hepatitis C. CSAT released its new Treatment Improvement Protocol "Substance Abuse Treatment for Persons With HIV/AIDS" and NIDA released its new "Community Drug Alert Bulletin on Hepatitis C."
The publications were released at a meeting in Baltimore, "Bringing It All Together," hosted by CSAT, NIDA and the Centers for Disease Control and Prevention. The meeting was called to disseminate current research-based information about the prevention and treatment of HIV/AIDS and hepatitis C, focusing on drug users.
CSAT's "Substance Abuse Treatment for Persons With HIV/AIDS" provides the latest information on what is now known about the intersection of HIV/AIDS and substance abuse. The TIP includes chapters on demographic trends; what is needed in medical assessments; how to determine mental health needs; issues for substance abuse counselors, including their own prejudices; how to integrate services; using a case manager; managing pain; ethical issues; legal issues and privacy; and funding and policy considerations.
CSAT Director H. Westley Clark, M.D., J.D., M.P.H., noted that "substance abuse increases the risk of contracting HIV. There is no question that injection drug users are at great risk. Combine this with the tendency of substance abusers to engage in risky sexual behaviors in exchange for drugs or money, and you have a dangerous public health situation."
NIDA's "Community Drug Abuse Bulletin on Hepatitis C" will provide basic information to the public on hepatitis C that can lay latent for many years before inflicting permanent liver damage.
NIDA Director Alan I. Leshner emphasized that "hepatitis C is the most common, chronic blood borne infection in the United States, and young adults who inject drugs have the highest rate of new infections." He added that "for this reason, it's very important to get the word out to health care professionals and the public about how to prevent this infection, which is estimated to affect 80 percent of the nation's drug injecting population."
The "Bringing It All Together" Conference was designed to help professionals in substance abuse, primary care, mental health, and other health specialists, improve coordination of care for individuals who are suffering from the harm caused by addiction and its related medical consequences. The goal of the conference was to foster creation of systems that will advance integration of best practices in prevention, outreach, assessment, case management, medical treatment and monitoring to ensure that people with drug problems who are at risk for, or have contracted chronic infections, timely, coordinated and comprehensive delivery of treatment services.
Leading experts from across the country discussed prevention and treatment of HIV and hepatitis among drug users in various settings--from communities to prisons. Issues included the impact of drug use-related HIV and/or hepatitis among adolescents, women, the aging, criminal offenders and families. Emphasis was placed on finding practical, culturally relevant methods to reach drug users such as motivational interviewing, psychodrama and effective case management.
The conference featured workshops on specific challenges such as compliance with treatment, mental health problems, maintaining confidentiality, engaging families and coping with death and dying.
The meeting is expected to lead to creation of a national coalition of outreach workers involved in prevention activities with drug-using populations.