Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University, St. Louis, MO.
Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH.
J Appl Lab Med. 2021 Jan 12;6(1):180-193. doi: 10.1093/jalm/jfaa150.
Opioid use disorder, defined as a pattern of problematic opioid use leading to clinically significant impairment, has resulted in considerable morbidity and mortality throughout the world. This is due, at least in part, to the marginalized status of patients with opioid use disorder, limiting their access to appropriate laboratory testing, diagnosis, and treatment. Infections have long been associated with illicit drug use and contribute considerably to morbidity and mortality. However, barriers to testing and negative stigmas associated with opioid use disorder present unique challenges to infectious disease testing in this patient population.
This review addresses the associations between opioid use disorder and infectious organisms, highlighting the health disparities encountered by patients with opioid use disorder, and the important role of laboratory testing for diagnosing and managing these patients.
Infections are among the most frequent and adverse complications among patients with opioid use disorder. As a result of health disparities and systemic biases, patients that misuse opioids are less likely to receive laboratory testing and treatment. However, laboratories play a crucial in identifying patients that use drugs illicitly and infections associated with illicit drug use.
阿片类药物使用障碍是一种以问题性阿片类药物使用为特征的疾病,导致了全世界范围内相当大的发病率和死亡率。这至少部分归因于阿片类药物使用障碍患者的边缘化地位,限制了他们获得适当的实验室检测、诊断和治疗的机会。感染长期以来与非法药物使用有关,并对发病率和死亡率有很大的影响。然而,检测的障碍和与阿片类药物使用障碍相关的负面污名,给该患者群体的传染病检测带来了独特的挑战。
本文回顾了阿片类药物使用障碍与感染病原体之间的关联,强调了阿片类药物使用障碍患者所面临的健康差距,以及实验室检测在诊断和管理这些患者方面的重要作用。
感染是阿片类药物使用障碍患者中最常见和最严重的并发症之一。由于健康差距和系统偏见,滥用阿片类药物的患者接受实验室检测和治疗的可能性较低。然而,实验室在识别非法使用药物的患者和与非法药物使用相关的感染方面发挥着至关重要的作用。