NASTAD (National Alliance of State and Territorial AIDS Directors), Harm Reduction Coalition, and The AIDS Institute today called upon Congress to include $100 million in new funding for the Centers for Disease Control and Prevention’s (CDC) Viral Hepatitis programs to confront the looming threat of infectious diseases linked to the opioid crisis.
“The CDC has documented 30 states determined to be experiencing, or at risk for, significant increases in viral hepatitis or an HIV outbreak due to injection drug use,” said Ann Lefert, NASTAD’s Senior Director of Policy and Legislative Affairs. “Resource-strapped health departments are struggling to get ahead of a new wave of infections, and in desperate need of dedicated resources from Congress.”
A new CDC study demonstrates that a dramatic rise in new hepatitis C infections is linked to the opioid crisis. Between 2004 and 2014, admissions to drug treatment programs for patients who inject opioids increased by 93%, while acute hepatitis C infections rose in parallel by 133%. The sharpest increases in new hepatitis C cases were among 18- to 29-year olds – a staggering 400% rise over a ten-year period.
“Comprehensive community-based outreach and engagement programs for people who inject drugs have a strong track record in prevention and linkage to care and treatment, but remain woefully underfunded,” said Daniel Raymond, Harm Reduction Coalition’s Deputy Director of Planning and Policy. “These programs are vital for addressing not only infectious disease risk, but overdose prevention and linkage to substance use disorder treatment and recovery. But they won’t reach their potential without additional resources.”
The Scott County, Indiana HIV and hepatitis C outbreak cast a spotlight on the risk of rapid transmission of infectious disease among people who inject drugs. While several states have passed legislation and developed programs to reduce this risk, federal resources have lagged behind. These funding gaps are already having an impact: the Northern Kentucky Health Department recently reported a significant rise in new HIV infections among people who inject drugs, following a similar health alert from the Massachusetts Department of Public Health sounding the alarm on increased HIV transmission linked to injection drug use.
“We commend Congress for committing additional resources to the opioid crisis through 21st Century CURES Act funding and the Comprehensive Addiction and Recovery Act,” said Carl Schmid, Deputy Executive Director of The AIDS Institute. “Now is the time, as Congress works to finalize the fiscal year 2018 spending bills, to build on these efforts to ensure that CDC has the necessary resources to tackle the infectious disease consequences of the opioid crisis.”
With $100 million in additional funding, CDC’s Viral Hepatitis programs could effectively:
- Increase hepatitis and HIV testing and linkages to substance use prevention services, care and treatment, including medication-assisted therapies and overdose prevention medications, such as naloxone.
- Increase education to high risk groups and affected communities, including pregnant women, about the intersection of the opioid epidemic and infectious diseases, such as hepatitis and HIV.
- Increase training for Disease Intervention Specialists (DIS) and other clinicians and providers about substance use, risk of infectious disease and current medical treatments and effective linkage techniques.
- Increase hepatitis surveillance infrastructure in state health departments to detect acute hepatitis infections and enhance ability to conduct cluster identification and investigations.
- Increase capacity of community coalitions, state health departments, and community based organizations to implement effective primary infectious disease prevention programs and services tailored to persons who use drugs and have opioid use disorders.
- Increase access to, and proper disposal of, sterile injection equipment, where legal and with community support.