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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Integrating Responses
at the Intersection of
Opioid Use Disorder
and Infectious Disease
Epidemics

PROCEEDINGS OF A WORKSHOP

Anna Nicholson, Rapporteur

Board on Population Health and Public Health Practice

Health and Medicine Division

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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This activity was supported by Contract No. 10003842 between the National Academy of Sciences and the Department of Health and Human Services. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-47794-9
International Standard Book Number-10: 0-309-47794-8
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Integrating responses at the intersection of opioid use disorder and infectious disease epidemics: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25153.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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WORKSHOP PLANNING COMMITTEE ON INTEGRATING INFECTIOUS DISEASE CONSIDERATIONS WITH RESPONSE TO THE OPIOID EPIDEMIC1

CARLOS M. DEL RIO (Chair), Hubert Professor and Chair, Rollins School of Public Health, Emory University

JOHN DREYZEHNER, Commissioner, Tennessee Department of Health

TRACI G. GREEN, Adjunct Associate Professor of Emergency Medicine, Adjunct Associate Professor of Epidemiology, Boston Medical Center

VAN INGRAM, Executive Director, Kentucky Office of Drug Control Policy

P. TODD KORTHUIS, Associate Professor of Medicine, Program Director, Addiction Medicine Fellowship, and Chief, Addiction Medicine Section, Oregon Health & Science University

NATASHA K. MARTIN, Associate Professor, University of California, San Diego

SANDRA ANN SPRINGER, Associate Professor of Medicine, Associate Clinical Professor of Nursing, Yale School of Medicine; Director, Infectious Disease Outpatient Clinic–Newington, and Attending Physician–West Haven, Veterans Affairs Connecticut Healthcare System, Newington

DACE SVIKIS, Deputy Director, Institute for Women’s Health, Virginia Commonwealth University

CHUCK WEXLER, Executive Director, Police Executive Research Forum

Health and Medicine Division Staff

KATHLEEN STRATTON, Scholar, Study Director

HOPE HARE, Administrative Assistant

ALEXIS WOJTOWICZ, Senior Program Assistant

ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

JUDITH FEINBERG, West Virginia University

JAMES HUGHES, Emory University

P. TODD KORTHUIS, Oregon Health & Science University

CHARLES P. O’BRIEN, University of Pennsylvania

SANDRA SPRINGER, Yale University

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by HUGH H. TILSON, University of North Carolina School of Public Health. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
×
Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Acronyms and Abbreviations

ACA

Patient Protection and Affordable Care Act

ACO

accountable care organization

AHRQ

Agency for Healthcare Research and Quality

ART

antiretroviral therapy

ASAM

American Society of Addiction Medicine

CDC

Centers for Disease Control and Prevention

CER

clinical effectiveness research

CMS

Centers for Medicare & Medicaid Services

CROI

Conference on Retroviruses and Opportunistic Infections

DOPE

Drug Overdose Prevention and Education

DUHI

Drug User Health Initiative

ED

emergency department

HBV

hepatitis B virus

HCUP

Healthcare Cost and Utilization Project

HCV

hepatitis C virus

HHS

Department of Health and Human Services

HIV

human immunodeficiency virus

HRSA

Health Resources and Services Administration

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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ICER

incremental cost-effectiveness ratio

IDSA

Infectious Diseases Society of America

IMPACT

Improving Addiction Care Team

MAT

medication(s) for addiction treatment (or therapy); medication-assisted therapy (or treatment)

MERT

medically enhanced residential treatment

MOUD

medication for opioid use disorder

MSM

men who have sex with men

NHANES

National Health and Nutrition Examination Survey

NIS

Nationwide Inpatient Sample

NOSE

Naloxone prescription for Opioid Safety Evaluation

NSP

needle services program

OAT

opiate agonist therapy

OHAIDP

HHS Office of HIV/AIDS and Infectious Disease Policy

OHSU

Oregon Health & Science University

OWH

HHS Office on Women’s Health

PCORI

Patient-Centered Outcomes Research Institute

PDMP

prescription drug monitoring program

PICC

peripherally inserted central catheter

PrEP

preexposure prophylaxis

PWID

people who inject drugs

PWUD

people who use drugs

RODS

rapid opioid dependence screen

SAMHSA

Substance Abuse and Mental Health Services Administration

SEP

syringe exchange program

SFDPH

San Francisco Department of Public Health

SSP

syringe services program

SUD

substance use disorder

WWID

women who inject drugs

WWUD

women who use drugs

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Medications1

Term Definition
Buprenorphine A partial opioid agonist
Naloxone An opioid antagonist; the active ingredient in Narcan®
Naltrexone An opioid antagonist
Suboxone® Trade name for a combination of buprenorphine and naloxone
Vivitrol® Trade name for an extended release form of naltrexone

___________________

1 This text was revised after prepublication release.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25153.
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According to the Centers for Disease Control and Prevention (CDC), 115 Americans die each day from an opioid overdose, which averages one death every 12.5 minutes. Between 1999 and 2016, the number of drug overdoses catapulted by 300 percent, with injection drug use increasing by 93 percent between 2004 and 2014 and opioid-related hospital admissions increasing by 58 percent over the past decade. And an inexorable sequela of the opioid epidemic is the spread of infectious diseases.

To address these infectious disease consequences of the opioid crisis, a public workshop titled Integrating Infectious Disease Considerations with Response to the Opioid Epidemic was convened on March 12 and 13, 2018, by the National Academies of Sciences, Engineering, and Medicine. Participants discussed strategies to prevent and treat infections in people who inject drugs, especially ways to work efficiently though the existing public health and medical systems. This publication summarizes the presentations and discussions from the workshop.

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