Rampant opioid injection: ‘A ticking time bomb’ that puts all Americans at risk for disease

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by Laura Ungar

ATLANTA — First came the opioid epidemic. Then, a wave of drug-fueled infections.

Now, after years of quietly spreading across the nation, diseases such as hepatitis and HIV are prompting action by a critical mass of top doctors, health officials and policymakers.

Such infections were among many issues tackled at the recent National Rx Drug Abuse & Heroin Summit in Atlanta. Experts said disease threatens not only drug users but the entire population, hitting especially hard in Kentucky, Indiana and other rural states awash in addiction.

“If you don’t do anything, it’s a ticking time bomb,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “I think we can contain it, but we need to move rapidly.”

The fight is being waged on several fronts: Lawmakers at the state and national levels are introducing legislation. Federal health officials are issuing guidance on detecting and responding to outbreaks. And doctors are calling for more disease testing, treatment and education, as well as preventive measures such as needle exchanges.

The stakes are high — and getting higher.

With more people shooting up, new hepatitis C infections reported to the U.S. Centers for Disease Control and Prevention tripled from 850 in 2010 to 2,436 in 2015 — and officials acknowledge the insidious liver disease is vastly underreported. Hep C kills 20,000 Americans each year, more than any other infectious disease reported to CDC.

Drug-fueled HIV is also on the rise after a decade-long decline, with more than 3,400 infections diagnosed among IV drug users in 2016. The largest outbreak ever to hit rural America struck Scott County, Ind., in 2015, ultimately infecting 230 people. The epicenter was the struggling city of Austin, which has a population of 4,200 and an HIV rate comparable to many countries in Africa.

“Indiana was the wake-up call for the nation,” said Dr. Anne Schuchat, CDC’s acting principal deputy director.

Since then, the CDC has identified 220 counties as vulnerable to similar outbreaks. Kentucky had the most — 54 — as well as the nation’s highest rate of acute hep C infections from 2008 to 2015, with 1,089 cases.

Lesser-known diseases linked to shooting up also are rising in Kentucky and elsewhere, including hep A, hep B and endocarditis, an infection of the inner lining of the heart chambers and valves.

Drug-fueled infections are “a big issue for the nation,” said U.S. Surgeon General Jerome Adams, formerly Indiana’s health commissioner.

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