Journal of Studies on Alcohol and Drugs, 81(5), 556–560 (2020).
              
Matthew Bonn , a,* Adam Palayew , M.Sc.,b Sofia Bartlett , Ph.D.,c Thomas D. Brothers , M.D.,d Natasha Touesnard , a & Show All...
+ Affiliations
*Correspondence may be sent to Matthew Bonn via email at: matthewbonn00@gmail.com.
https://doi.org/10.15288/jsad.2020.81.556

Abstract    People who use drugs (PWUD) face concurrent public health emergencies from overdoses, HIV, hepatitis C, and COVID-19, leading to an unprecedented syndemic. Responses to PWUD that go beyond treatment—such as decriminalization and providing a safe supply of pharmaceutical-grade drugs—could reduce impacts of this syndemic. Solutions already implemented for COVID-19, such as emergency safe-supply prescribing and providing housing to people experiencing homelessness, must be sustained once COVID-19 is contained. This pandemic is not only a public health crisis but also a chance to develop and maintain equitable and sustainable solutions to the harms associated with the criminalization of drug use.
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​The syndemic argumentThe criminalization of personal drug use marginalizes people who use drugs (PWUD), affecting their life, liberty, and security. Prohibition forces PWUD to engage in illegal activities to procure and consume drugs. This creates an international underground economy that generates billions of dollars despite escalating enforcement efforts (United Nations Office on Drugs and Crime, 2020b). This foments an environment in which drugs have inflated prices and unpredictable content, are potentially toxic, and are often consumed in unsafe ways. Along with deaths caused by the unintentional consumption of toxic drugs, there are also severe social punishments for drug use, such as being unemployed due to a low-level drug possession charge and/or being denied housing because of a criminal record, resulting in persistent homelessness. These conditions greatly increase the risk of overdose and overdose deaths, as well as injection-related infections—including HIV and hepatitis C virus (HCV)—while pushing PWUD away from the traditional health care system (Csete et al., 2016).

The coronavirus disease-2019 (COVID-19) pandemic, and the associated public health response of social distancing, physical isolation, and international border restrictions, creates greater harms for PWUD who rely on an illicit drug supply (United Nations Human Rights Office of the High Commissioner, 2020). Without a regular supply of drugs, PWUD are less able to physically isolate and will need to travel to obtain funds or purchase drugs. Physical isolation leads to using drugs alone, which increases the risk of overdose death. Many harm reduction and addiction treatment services have had to scale back based on social distancing guidelines (Bartholomew et al., 2020; Dunlop et al., 2020). International border restrictions related to COVID-19 have made the illicit drug supply even more unpredictable and deadly (Canadian Centre for Substance Use & Addiction & Canadian Community Epidemiology Network, 2020; United Nations Office on Drugs and Crime, 2020a).
As a consequence, PWUD face concurrent public health emergencies (United Nations Office on Drugs and Crime, 2019): increasing overdoses, HIV, HCV, and COVID-19. The confluence of these factors is leading to an unprecedented syndemic. A syndemic occurs when multiple health and social issues intersect and interact to worsen or accelerate disease progression and social outcomes (Singer et al., 2017; Tsai et al., 2017). Health issues such as HIV and HCV overlap with each other because they share similar routes of transmission and risk factors, and multiple social issues frequently co-occur with these infections, such as poverty, homelessness, and injection drug use (Butt et al., 2017; Cleland et al., 2017; Morano et al., 2013). For example, among people living with HCV infection, HIV co-infection accelerates liver disease progression. Poverty and homelessness are frequently found to reduce the likelihood of HIV antiretroviral medication adherence, so when HIV/HCV coinfection, poverty, and homelessness co-occur, they result in accelerated disease progression and poorer health outcomes (Klein et al., 2013).

TO CONTINUE READING:
https://www.jsad.com/doi/full/10.15288/jsad.2020.81.556fbclid=IwAR0CNHeD6S_wKe17xgbE17NFruCHlibCWAOISw8Oe4_RojvH2h7WoNwfgk4
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This year, the medicine prize carries particular significance amid the corona virus pandemic, which has highlighted the importance of medical research.

Oct. 5, 2020, 5:37 AM EDT / Updated Oct. 5, 2020, 6:55 AM EDT
By Yuliya TalmazanResearchers Harvey J. Alter, Michael Houghton and Charles M. Rice have won the Nobel Prize in physiology or medicine for the discovery of Hepatitis C virus, the committee announced on Monday.
Prior to their work, the committee said, the discovery of the Hepatitis A and B viruses had been critical steps forward, but the majority of blood-borne hepatitis cases was still unexplained.
“The discovery of Hepatitis C virus revealed the cause of the remaining cases of chronic hepatitis and made possible blood tests and new medicines that have saved millions of lives,” the statement shared by the committee said.
Alter and Rice were both born in the US while Hougton was born in the U.K.
An estimated 71 million people have chronic hepatitis C virus infection, according to the World Health Organization. A significant number of those who are chronically infected will develop cirrhosis, scarring of the liver caused by long-term liver damage, or liver cancer.

Thanks to their work, highly sensitive blood tests and antiviral treatments for the virus are now available.
TO CONTINUE READING: https://www.nbcnews.com/news/world/three-win-nobel-prize-medicine-discovery-hepatitis-c-virus-n1242090​


Recommendedories

By Hilary Swift and Abby Goodnough New York Times
Photographs by Hilary Swift ,Sept. 29, 2020, 2:59 a.m. ET

BARRE, Vermont — On the first Friday in June, Jefrey Cameron, 29, left his home around midnight to buy heroin. He had been struggling with addiction for seven years but had seemingly turned a corner, holding down a job that he loved at Basil’s Pizzeria, driving his teenage sister to the mall to go shopping and sharing a home with his grandmother. But then the coronavirus pandemic hit.
When he returned home that night and tried the product, it was so potent that he fell and hit his head in the bathroom. Mr. Cameron texted a friend soon after, saying that he had messed up and would go to a 12-step meeting with a friend that weekend.
“I promise I’m good and I can’t get in any more trouble tonight,” he wrote. “Sweet dreams, if you wake up before you hear from me definitely call me. The sooner I get up and into town the better.” When Mr. Cameron woke up, he used the rest of the powder — largely fentanyl, not heroin, his family would later learn — from a small bag with a bunny stamped on it. Less than five hours after he sent the text, his grandmother found him dead.
TO CONTINUE READING: https://www.nytimes.com/2020/09/29/health/coronavirus-overdose-opioids-addi.html?campaign_id=2&emc=edit_th_20200929&instance_id=22606&nl=toda​

NATIONAL INSTITUTE OF HEALTH- NEWS RELEASES

A National Institutes of Health-funded study found that people with substance use disorders (SUDs) are more susceptible to COVID-19 and its complications. The research, published today in Molecular Psychiatry, was co-authored by Nora D. Volkow, M.D., director of the National Institute on Drug Abuse (NIDA). The findings suggest that health care providers should closely monitor patients with SUDs and develop action plans to help shield them from infection and severe outcomes.
By analyzing the non-identifiable electronic health records (EHR) of millions of patients in the United States, the team of investigators revealed that while individuals with an SUD constituted 10.3% of the total study population, they represented 15.6% of the COVID-19 cases. The analysis revealed that those with a recent SUD diagnosis on record were more likely than those without to develop COVID-19, an effect that was strongest for opioid use disorder, followed by tobacco use disorder. Individuals with an SUD diagnosis were also more likely to experience worse COVID-19 outcomes (hospitalization, death), than people without an SUD.
“The lungs and cardiovascular system are often compromised in people with SUD, which may partially explain their heightened susceptibility to COVID-19,” said Dr. Volkow. “Another contributing factor is the marginalization of people with addiction, which makes it harder for them to access health care services. It is incumbent upon clinicians to meet the unique challenges of caring for this vulnerable population, just as they would any other high-risk group.”
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​TO CONTINUE READING: https://www.nih.gov/news-events/news-releases/substance-use-disorders-linked-covid-19-susceptibility

September 12, 2020

NEW YORK & MAINZ, Germany--(BUSINESS WIRE)-- Pfizer Inc. (NYSE: PFE) and BioNTech SE (NASDAQ: BNTX) announced today that they have submitted an amended protocol to the U.S. Food and Drug Administration to expand the enrollment of their Phase 3 pivotal COVID-19 vaccine trial to up to approximately 44,000 participants which also allows for the enrollment of new populations.
This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200912005013/en/
Enrollment in the trial has been proceeding as planned and the company expects to reach its initial target of up to 30,000 participants next week. The proposed expansion would allow the companies to further increase trial population diversity, and include adolescents as young as 16 years of age and people with chronic, stable HIV (human immunodeficiency viruses), Hepatitis C, or Hepatitis B infection, as well as provide additional safety and efficacy data.
The pivotal trial is event-based and there are many variables that will ultimately impact read-out timing. As stated previously, based on current infection rates, the companies continue to expect that a conclusive readout on efficacy is likely by the end of October.

To Continue Reading:
View source version on businesswire.com: https://www.businesswire.com/news/home/20200912005013/en/
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BY MORGAN MCKAY NEW YORK STATE
PUBLISHED 5:01 AM ET AUG. 25, 2020   SPECTRUM NEWS

Restaurants and bars are now joining a growing list of businesses that will be able to carry opioid antagonists, like Narcan, in the case of an opioid-related overdose. 
Governor Andrew Cuomo signed legislation on Monday that expands the list of establishments that are allowed to possess and administer opioid overdose reversal medication. This list will now include malls, beauty parlors, theaters, hotels, restaurants, bars and retail establishments. 
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​We have made tremendous progress in combating addiction across New York and while we have seen a reduction in opioid deaths over the past 10 years, there is still work to be done," Cuomo said.
The bill will also give these businesses protection under the "Good Samaritan Law," so they will not be penalized for providing medical attention.

"By authorizing the use of these reversal drugs without fear of liability, this new law will also provide peace of mind to residents and business owners around the state who are inclined to help those in desperate need of help," bill sponsor Senator Pete Harckham said. 

​TO CONTINUE READING: https://spectrumlocalnews.com/nys/buffalo/ny-state-of-politics/2020/08/25/cuomo-signs-bill-to-expand-narcan-use?cid=id-app15_m-share_s-web_cmp-app_launch_august2020_c-producer_posts_po-organic

July 31, 2020 | by Samar Khurshid GOTHAMGAZETTE

With the pandemic blowing a hole in the economy and leading to a drastic drop in state tax revenue, budget officials have for months been withholding payments for state contracts to manage cash flows. Among the victims of that fiscal approach are substance use treatment providers who are being forced to cut already-limited services and consider staff layoffs and furloughs, which they say will likely lead to a sharp increase in overdoses and new disease outbreaks around the state. 
The pandemic caused a 14% drop in expected revenue for the state in the current fiscal year, roughly $13.3 billion, leading the state to reduce $4 billion in spending so far by withholding contract payments across the board and imposing freezes on new contracts, hiring, and pay raises, according to the Division of Budget. Governor Andrew Cuomo has said the state cannot meet the shortfall unless the federal government provides aid, failing which he would cut about 20%, or $8.2 billion, of funding for local governments for everything from education and social services to health care programs. 
But several nonprofit providers that contract with the state to run substance use treatment programs – including syringe exchanges, sexually-transmitted infection (STI) screenings, naloxone overdose rescue training, and more – are already feeling the crunch, having gone months without being paid by the state. The state has also cut local funding for substance use and addiction treatment programs by 31%, according to news reports, exacerbating providers’ worries about being able to provide services.
In interviews, providers and harm reduction advocates painted a dire picture. They say that the already rising rate of overdoses that they are witnessing is at risk of spiking to the same levels as 2016, when the opioid epidemic reached its peak and spurred local and state officials into action. Since official data lags behind and could be unavailable until even a year after the fact, they fear that by the time the actual numbers become apparent, it will be too late. A generational crisis could be underway.  
TO CONTINUE READING:   https://www.gothamgazette.com/state/9637-state-withholds-contract-payments-nonprofits-substance-use-treatment-providers-overdoses-disease?mc_cid=5

​Yale University News|August 7, 2020

Researchers at the Yale Liver Center found that patients with COVID-19 presented with abnormal liver tests at much higher rates than suggested by earlier studies. They also discovered that higher levels of liver enzymes — proteins released when the liver is damaged — were associated with poorer outcomes for these patients, including ICU admission, mechanical ventilation, and death.
The study appeared online onJuly 29 in Hepatology.
Previous studies in China found that approximately 15% of patients with COVID-19 had abnormal liver tests. The Yale study, which looked retrospectively at 1,827 COVID-19 patients who were hospitalized in the Yale New Haven Health system between March and April, found that the incidence of abnormal liver tests was much higher — between 41.6% and 83.4% of patients, depending on the specific test.
In all, the Yale researchers examined five liver tests, looking at factors such as elevations in aspartate aminotransferase (AST) and alanine transaminase (ALT), which indicate liver cell inflammation; an increase in bilirubin, which indicates liver dysfunction; and increased levels of alkaline phosphatase (ALP), which may indicate inflammation of bile ducts.

Although the researchers do not know why the incidence of abnormal liver tests was so much higher than in previous studies from China, senior author Dr. Joseph Lim, professor of medicine and director of the Yale Viral Hepatitis Program, said other health differences between the Chinese and U.S. populations could account for it.
“We can speculate that U.S. patients may have an increased rate of other risk factors such as alcoholic or non-alcoholic fatty liver disease,” he said.

TO CONTINUE READING: https://www.mdlinx.com/news/strong-link-found-between-abnormal-liver-tests-and-poor-covid-19-outcomes/62T02X3quARxyENd5XKdnn?utm_medium=e

Terri Wilder, M.S.W.Aug. 3, 2020- The Body Pro

​The 23rd International AIDS Conference (AIDS 2020) was held virtually for the very first time and featured discussion about the current direction and future prospects for HIV prevention, diagnosis, and treatment. It was followed by a virtual COVID-19 conference on July 10 and 11. This conference was the first abstract-driven scientific conference dedicated to the global COVID-19 pandemic. It featured 140 late-breaking studies addressing urgent questions related to COVID-19 epidemiology, prevention, treatment, and care.
During the summit, researchers gave a presentation entitled, “Sofosbuvir and Daclatasvir as a Potential Candidate for Moderate or Severe COVID-19 Treatment, Results from a Randomised Control Trial.” During the official press briefing, Andrew Hill, Ph.D., the principal investigator, reviewed promising results from the study.
Hill graduated from Oxford University and then gained his Ph.D. from the University of Amsterdam. He’s been working on clinical trials of drugs to treat HIV and hepatitis C for the past 28 years. He’s a senior visiting research fellow at Liverpool University and also works as a consultant for the World Health Organization and Unitaid. Hill spoke with Terri Wilder, M.S.W., after the COVID-19 conference.
Terri Wilder: Dr. Hill, can you start by giving me an overview of the trial, the preliminary results, and how you were involved?
Andrew Hill: There were three studies conducted in Iran at the peak of their first epidemic there in March and April 2020. I was involved with them because they had used the same drug to cure thousands of people with hepatitis C in Iran. I actually contacted them at the beginning of the epidemic and suggested they try using the hepatitis C drugs to actually treat COVID-19, as well, because there were some early studies suggesting that these drugs might be active, not just against hep C, but against the SARS-CoV-2 virus, as well.
TW: The drugs that were used, as you mentioned, were hepatitis C drugs. Can you talk a little bit about the dosage of the drugs that were given to the patients? And then also, what was the control treatment that was given?

TO CONTINUE READING:​https://www.thebodypro.com/article/can-hepatitis-c-drugs-treat-covid-19-research

By Josh Katz, Abby Goodnough and Margot Sanger-Katz July 15, 2020 NY Times- The Upshot

Drug deaths in America, which fell for the first time in 25 years in 2018, rose to record numbers in 2019 and are continuing to climb, a resurgence that is being complicated and perhaps worsened by the coronavirus pandemic.
Nearly 72,000 Americans died from drug overdoses last year, according to preliminary data released Wednesday by the Centers for Disease Control and Prevention — an increase of 5 percent from 2018. Deaths from drug overdoses remain higher than the peak yearly death totals ever recorded for car accidents, guns or AIDS, and their acceleration in recent years has pushed down overall life expectancy in the United States.

71,999 people died from drug overdoses in the U.S. in 2019
Drug overdose deaths in the U.S. reached a record last year
Source: Centers for Disease Control and Prevention

It looks as if 2020 will be even worse. Drug deaths have risen an average of 13 percent so far this year over last year, according to mortality data from local and state governments collected by The New York Times, covering 40 percent of the U.S. population. If this trend continues for the rest of the year, it will be the sharpest increase in annual drug deaths since 2016, when a class of synthetic opioids known as fentanyls first made significant inroads in the country’s illicit drug supply.

TO CONTINUE READING: https://www.nytimes.com/interactive/2020/07/15/upshot/drug-overdose-deaths.html