There are additional costs to the rapid rise in injection-drug use, with far greater public health implications than many previously realized. In just the last five years, the number of new hepatitis C virus cases nationwide has nearly tripled. HCV is now the deadliest of all infectious diseases, killing more Americans than all other 60 notifiable infectious diseases combined. Hepatitis B virus infections are also on the rise because of the opioid crisis. Meanwhile, rates of sexually transmitted diseases are at an all-time high, especially rates of syphilis and gonorrhea. And while HIV infections are on the decline in the United States, the opioid crisis risks stalling or reversing decades of progress. In fact, recent Centers for Disease Control and Prevention surveillance data has shown increases in HIV infections tied to IDU in some populations.
While the Trump administration’s recent declaration that the crisis constitutes a “public health emergency” and its request for $6 billion in funding is an important start, Congress and the administration must be more decisive in how the funding will be used by public health agencies. Funding must go beyond support for addiction treatment, overdose prevention, and law enforcement. Critical resources must also be made available to the CDC, the agency tasked with identifying, monitoring and preventing the spread of infectious diseases in the United States.
In the same budget proposal that he requested additional funds to combat the opioid epidemic, Trump also proposed cutting already underfunded HIV prevention and other related programs. We must better equip agencies to tackle the recent increases in viral hepatitis, HIV, and STDs associated with opioid misuse by providing funds to help jurisdictions scale-up infectious disease prevention efforts. Current funding is simply insufficient to support a national viral hepatitis surveillance system; increased testing, linkage to care and treatment; and implementation of a comprehensive drug user health programs, including syringe service programs, overdose prevention, and medication assisted treatment.
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