Division of Infectious Disease, Washington University School of Medicine, Campus Box 8051, 4523 Clayton Avenue, St. Louis, MO, USA.
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Harm Reduct J. 2024 Jan 19;21(1):16. doi: 10.1186/s12954-024-00939-6.
The rise in injection drug use in the USA has led to an increase in injection site infections. We performed a national survey of people who use drugs to evaluate common drug use preparation, harm reduction practices, and experiences with injection site infections.
A survey was disseminated to members of the Survey of Key Informants' Patients Program from 2021 to 2022 and distributed to patients 18 years or older newly entering one of 68 substance use disorder treatment programs across the USA with a primary diagnosis of an opioid use disorder. Participants were surveyed about practices when preparing and using drugs, along with self-reported infections and drug use complications.
1289 participants responded to the survey. Sexually transmitted infections were common, with 37.6% reporting ever having had any sexually transmitted infection. Injection-associated infections had affected 63.4% of participants who had ever used injection drugs. Many respondents reported not seeking professional medical assistance for infection management, including 29% draining abscesses without seeking medical care and 22.8% obtaining antibiotics through non-healthcare sources. Non-sterile injection practices included sharing needles with others who were febrile or ill (18%), using needles previously used to drain wounds/abscesses (9.9%) for subsequent injection drug use, and licking needles (21.2%).
Patients entering treatment for opioid use disorder reported a high burden of infectious diseases. A number of easily-modifiable high risk behaviors for developing injection-related infections were identified. Efforts are needed to disseminate targeted harm reduction education to PWID on how to reduce their risks for injection-related infections.
美国注射毒品使用的增加导致注射部位感染的增加。我们对吸毒者进行了一项全国性调查，以评估常见的吸毒准备、减少伤害的做法以及注射部位感染的经历。
从 2021 年到 2022 年，我们向调查关键信息提供者的患者计划的成员分发了一份调查，并分发给美国 68 个药物使用障碍治疗项目中的 18 岁或以上的新入组的患者，这些患者的主要诊断为阿片类药物使用障碍。参与者接受了关于准备和使用毒品的实践、自我报告的感染和药物使用并发症的调查。
1289 名参与者对调查做出了回应。性传播感染很常见，有 37.6%的人报告曾患有任何性传播感染。有注射药物使用史的参与者中，63.4%的人曾出现过与注射相关的感染。许多受访者报告说，他们没有寻求专业医疗援助来管理感染，包括 29%的人自行排脓而不寻求医疗护理和 22.8%的人通过非医疗途径获得抗生素。非无菌注射行为包括与发热或生病的人共用针头（18%）、使用以前用于引流伤口/脓肿的针头（9.9%）进行随后的注射药物使用，以及舔针头（21.2%）。
接受阿片类药物使用障碍治疗的患者报告了传染病的高负担。确定了一些容易改变的、与注射相关的感染高风险行为。需要努力向吸毒者传播有针对性的减少伤害教育，以减少他们与注射相关的感染风险。
