intravenous drug abuse (IVDA, injection drug use, IDU)
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Complications
- endocarditis[4]
- septic arthritis[7]
- TIA & stroke
- HIV-1
- 10% positive for HIV-1
- half of HIV-1 positive injection drug users are unaware of their HIV-1 serostatus
- 1/3 of HIV1-infected IVDA are unaware their infection[5]
- 1/3 admit sharing syringes
- 2/3 report unprotected vaginal sex
- HIV counseling (~20%), HIV testing (~50%)[2]
- other infections: (characteristic pathogens)
- viruses
- bacteria
- fungi: Candida
Management
- if patient is not read to quit, counsel on sterile practice
- opioid treatment program with buprenorphine-naloxone
- methadone maintenance associated with reduced risk of HIV1[3]
More general terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 2.0 2.1 Centers for Disease Control and Prevention HIV Infection and HIV-Associated Behaviors Among Injecting Drug Users - 20 Cities, United States, 2009 MMWR March 2, 2012 / 61(08);133-138 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6108a1.htm
- ↑ 3.0 3.1 MacArthur GJ et al. Opiate substitution treatment and HIV transmission in people who inject drugs: Systematic review and meta-analysis. BMJ 2012 Oct 4; 345:e5945. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23038795
- ↑ 4.0 4.1 4.2 Wakeman SE et al Case 35-2014 - A 31-Year-Old Woman with Fevers, Chest Pain, and a History of HCV Infection and Substance-Use Disorder. N Engl J Med 2014; 371:1918-1926. November 13, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25390743 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1407131
- ↑ 5.0 5.1 Spiller MW et al HIV Infection and HIV-Associated Behaviors Among Persons Who Inject Drugs - 20 Cities, United States, 2012 MMWR Weekly. March 20, 2015 / 64(10);270-275 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6410a3.htm
- ↑ 6.0 6.1 Jackson KA, Bohm MK, Brooks JT, et al. Invasive Methicillin-Resistant Staphylococcus aureus Infections Among Persons Who I nject Drugs - Six Sites, 2005-2016. MMWR Morb Mortal Wkly Rep 2018;67:625-628 https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a2.htm
- ↑ 7.0 7.1 Allison DC et al. Microbiology of bone and joint infections in injecting drug abusers. Clin Orthop Relat Res 2010 Aug; 468:2107 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20174899 PMCID: PMC2895841 Free PMC article