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Improving the Health of Individuals Who Inject Drugs
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Improving the Health of Individuals Who Inject Drugs

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 5431

Special Issue Editors

Dr. Mai Tuyet Pho

E-Mail Website
Guest Editor
Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, IL 60637, USA
Interests: harm reduction; community-based integrated care; Hepatitis C; HIV; public health
Dr. Elizabeth Salisbury-Afshar

E-Mail Website
Guest Editor
School of Medicine and Public Health, Department of Family Medicine and Community Health, University of Wisconsin Madison, Madison, WI 53715, USA
Interests: harm reduction; low-barrier treatment; medications for opioid use disorder; co-location service delivery models; overdose prevention and response

Special Issue Information

Dear Colleagues,

Morbidity and mortality related to injection drug use—including substance use disorder, overdose, serious mental illness, and infectious diseases—have been exacerbated by the COVID-19 pandemic. Health disparities amongst drug users have been driven by criminalization of drug use, stigma, limited healthcare access, and social determinants including homelessness, educational and job opportunities, racism, and social isolation. These disparities have been worsened by COVID-19, as well as the effects of mitigation measures such as physical distancing, lockdowns, and subsequent economic downturn. While measures such as medication for opioid use disorder, naloxone for overdose reversal, treatment for hepatitis C, and pre-exposure prophylaxis for HIV have proven to improve health outcomes for this population, the lack of adequate reach and adoption of these interventions has limited their impact at both an individual and public health level.

This Special Issue of the International Journal of Environmental Research and Public Health, “Improving the Health of Individuals who Inject Drugs”, seeks to explore innovations in care and services for people who use drugs, with particular focus on advancing new approaches to implementing evidence-informed interventions. This may include non-traditional venues for clinical/integrated care delivery, hospital-based substance use treatment and harm reduction service delivery, overdose prevention sites, drug checking services, and peer-led approaches. Interventions serving under-researched populations, including highly marginalized, minority, and/or rural communities, are of special interest. This call includes approaches that embrace harm reduction and extend beyond traditional measures with the vision of providing holistic care and advancing the well-being of those who use drugs. Descriptive reports regarding cutting-edge public health interventions centered on community implementer (i.e., non-researcher) contributions and/or manuscripts that provide policy analyses are welcome.

Dr. Mai Tuyet Pho
Dr. Elizabeth Salisbury-Afshar
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • integrated care delivery models
  • low-barrier treatment
  • medications for opioid use disorder
  • hospital-based interventions
  • culturally appropriate care
  • harm reduction
  • hepatitis C testing and treatment
  • pre-exposure prophylaxis
  • drug checking services
  • overdose prevention sites

Published Papers (3 papers)

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Research

14 pages, 350 KiB  
Article
I Don’t Believe a Person Has to Die When Trying to Get High: Overdose Prevention and Response Strategies in Rural Illinois
by Suzan M. Walters, Marisa Felsher, David Frank, Jessica Jaiswal, Tarlise Townsend, Brandon Muncan, Alex S. Bennett, Samuel R. Friedman, Wiley Jenkins, Mai T. Pho, Scott Fletcher and Danielle C. Ompad
Int. J. Environ. Res. Public Health 2023, 20(2), 1648; https://doi.org/10.3390/ijerph20021648 - 16 Jan 2023
Cited by 2 | Viewed by 2577
Abstract
Background: Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths. Methods: Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service [...] Read more.
Background: Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths. Methods: Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service providers) from rural southern Illinois. Data were analyzed using constant comparison and theoretical sampling methods. Results: Participants were concerned about the growing presence of fentanyl in both opioids and stimulants, and many disclosed overdose experiences. Strategies participants reported using to lower overdose risk included purchasing drugs from trusted sellers and modifying drug use practices by partially injecting and/or changing the route of transmission. Approximately half of persons who inject drugs sampled had heard of fentanyl test strips, however fentanyl test strip use was low. To reverse overdoses, participants reported using cold water baths. Use of naloxone to reverse overdose was low. Barriers to naloxone access and use included fear of arrest and opioid withdrawal. Conclusions: People who inject drugs understood fentanyl to be a potential contaminant in their drug supply and actively engaged in harm reduction techniques to try to prevent overdose. Interventions to increase harm reduction education and information about and access to fentanyl test strips and naloxone would be beneficial. Full article
(This article belongs to the Special Issue Improving the Health of Individuals Who Inject Drugs)
15 pages, 1555 KiB  
Article
Pilot Outreach Program in Remedis—The Promising Step toward HCV Elimination among People Who Inject Drugs
by Laura Krekulová, Tomáš Damajka, Zuzana Krumphanslová and Vratislav Řehák
Int. J. Environ. Res. Public Health 2023, 20(1), 501; https://doi.org/10.3390/ijerph20010501 - 28 Dec 2022
Viewed by 1046
Abstract
The global effort to eliminate HCV infection requires new approaches to accessing and testing the affected population in a setting with as low of a threshold as possible. The focus should be on socially marginalized people who inject drugs (PWIDs) and who are [...] Read more.
The global effort to eliminate HCV infection requires new approaches to accessing and testing the affected population in a setting with as low of a threshold as possible. The focus should be on socially marginalized people who inject drugs (PWIDs) and who are not willing or able to visit standard medical services. With this vision, we established an outreach service—a testing point in an ambulance in the park in front of the Main Railway Station of the capital city of Prague—to provide bloodborne disease testing and treatment. The service was available every week on Wednesday afternoon. Over the initial two years of our experience, 168 unique people were tested. Of them, 82 (49%) were diagnosed with chronic HCV infection and were eligible for treatment with antivirals. Of these, 24 (29%) initiated antiviral treatment over the study period, and 17 (71%) of these individuals achieved a documented sustained virological response. Offering medical services in PWIDs’ neighborhoods helps overcome barriers and increase the chances that they will become patients and begin HCV treatment. The described outcomes appear promising for reaching the vision of linkage to the care of such a hard-to-reach population and can serve as a feasible model of care for further expansion. Full article
(This article belongs to the Special Issue Improving the Health of Individuals Who Inject Drugs)
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10 pages, 462 KiB  
Article
Barriers and Facilitators of Hepatitis C Care in Persons Coinfected with Human Immunodeficiency Virus
by Nir Bar, Noa Bensoussan, Liane Rabinowich, Sharon Levi, Inbal Houri, Dana Ben-Ami Shor, Oren Shibolet, Orna Mor, Ella Weitzman, Dan Turner and Helena Katchman
Int. J. Environ. Res. Public Health 2022, 19(22), 15237; https://doi.org/10.3390/ijerph192215237 - 18 Nov 2022
Cited by 1 | Viewed by 1259
Abstract
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are often co-transmitted. Viral coinfection results in worse outcomes. Persons who inject drugs (PWIDs) face barriers to medical treatment, but HCV treatment is indicated and effective even with ongoing active drug use. We aimed [...] Read more.
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are often co-transmitted. Viral coinfection results in worse outcomes. Persons who inject drugs (PWIDs) face barriers to medical treatment, but HCV treatment is indicated and effective even with ongoing active drug use. We aimed to assess access to HCV care and treatment results in patients coinfected with HIV-HCV. This is a real-world retrospective single-center study of patients followed in the HIV clinic between 2002 and 2018. Linkage to care was defined as achieving care cascade steps: (1) hepatology clinic visit, (2) receiving prescription of anti-HCV treatment, and (3) documentation of sustained virologic response (SVR). Of 1660 patients with HIV, 254 with HIV-HCV coinfection were included. Only 39% of them achieved SVR. The rate limiting step was the engagement into hepatology care. Being a PWID was associated with ~50% reduced odds of achieving study outcomes, active drug use was associated with ~90% reduced odds. Older age was found to facilitate treatment success. Once treated, the rate of SVR was high in all populations. HCV is undertreated in coinfected young PWIDs. Further efforts should be directed to improve access to care in this marginalized population. Full article
(This article belongs to the Special Issue Improving the Health of Individuals Who Inject Drugs)
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