Infectious complications of addiction: A call for a new subspecialty within infectious diseases.

Infectious diseases (ID) physicians are increasingly responsible for the management of infectious consequences of substance use disorders (SUD). While we are often consulted for recommendations regarding diagnosis and treatment of the infectious disease, it is clear that successful management of these infections requires a holistic approach, including acknowledgement and treatment of the underlying SUD. As we have learned through years of treating HIV and hepatitis C virus infections, ID physicians have unique expertise in addressing both the infection and the complex biopsychosocial factors that underpin the infection. Many ID physicians have incorporated management of addiction as part of their scope of practice and here we seek to give a name and define the role of these ID/addiction dual specialists. We define the potential role of ID/addiction physicians in clinical care, health administration, and research as well as provide recommendations to bolster the supply and reach of this burgeoning subspecialty.

[1]  P. Seth,et al.  Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018 , 2020, MMWR. Morbidity and mortality weekly report.

[2]  J. Brooks,et al.  Bacterial and Fungal Infections in Persons Who Inject Drugs — Western New York, 2017 , 2019, MMWR. Morbidity and mortality weekly report.

[3]  C. Beckwith,et al.  Sociodemographic factors and social determinants associated with toxicology confirmed polysubstance opioid-related deaths. , 2019, Drug and alcohol dependence.

[4]  J. Ward,et al.  Scaling-up Hepatitis C Prevention and Treatment Interventions for Achieving Elimination in the United States - a Rural and Urban Comparison. , 2019, American journal of epidemiology.

[5]  K. Freedberg,et al.  Cost-effectiveness of integrating buprenorphine-naloxone treatment for opioid use disorder into clinical care for persons with HIV/hepatitis C co-infection who inject opioids. , 2019, The International journal on drug policy.

[6]  Lawrence Scholl,et al.  Drug Overdose Deaths Involving Cocaine and Psychostimulants with Abuse Potential — United States, 2003–2017 , 2019, MMWR. Morbidity and mortality weekly report.

[7]  R. Lechtenberg,et al.  Outbreak of Human Immunodeficiency Virus Infection Among Heterosexual Persons Who Are Living Homeless and Inject Drugs — Seattle, Washington, 2018 , 2019, MMWR. Morbidity and mortality weekly report.

[8]  T. Barlam,et al.  Actions to Integrate Treatment of Opioid and Infectious Disease Epidemics , 2019, Annals of Internal Medicine.

[9]  Ellsworth M. Campbell,et al.  Notes from the Field: HIV Diagnoses Among Persons Who Inject Drugs — Northeastern Massachusetts, 2015–2018 , 2019, MMWR. Morbidity and mortality weekly report.

[10]  A. Karchmer,et al.  High Morbidity and Mortality Among Patients With Sentinel Admission for Injection Drug Use-Related Infective Endocarditis , 2019, Open forum infectious diseases.

[11]  P. Korthuis,et al.  Medications for Treatment of Opioid Use Disorder among Persons Living with HIV , 2019, Current HIV/AIDS Reports.

[12]  L. Fanucchi,et al.  Substance Use Disorder Assessment, Diagnosis, and Management for Patients Hospitalized With Severe Infections Due to Injection Drug Use , 2019, Journal of addiction medicine.

[13]  A. Fleischauer,et al.  Trends in Drug UseAssociated Infective Endocarditis and Heart Valve Surgery, 2007 to 2017 , 2018, Annals of Internal Medicine.

[14]  D. Warren,et al.  Addiction Medicine Consultations Reduce Readmission Rates for Patients With Serious Infections From Opioid Use Disorder. , 2018, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  Aaron C. Miller,et al.  Many Opportunities to Record, Diagnose, or Treat Injection Drug–related Infections Are Missed: A Population-based Cohort Study of Inpatient and Emergency Department Settings , 2018, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  A. Leshner,et al.  Medications for Opioid Use Disorder Save Lives , 2019 .

[17]  S. Wakeman,et al.  Buprenorphine Deregulation and Mainstreaming Treatment for Opioid Use Disorder: X the X Waiver. , 2019, JAMA psychiatry.

[18]  M. Silverman,et al.  Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs , 2018, JAMA network open.

[19]  G. Dore,et al.  Direct-acting antiviral treatment for hepatitis C among people who use or inject drugs: a systematic review and meta-analysis. , 2018, The lancet. Gastroenterology & hepatology.

[20]  F. Altice,et al.  Extended-release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living with HIV and Alcohol use Disorders Transitioning to the Community: Results From a Double-Blind, Placebo-Controlled Trial , 2018, Journal of acquired immune deficiency syndromes.

[21]  M. Olfson,et al.  Causes of Death After Nonfatal Opioid Overdose , 2018, JAMA psychiatry.

[22]  P. Polgreen,et al.  Infectious Diseases Physicians’ Perspectives Regarding Injection Drug Use and Related Infections, United States, 2017 , 2018, Open forum infectious diseases.

[23]  F. Altice,et al.  Extended-Release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living With HIV With Opioid Use Disorders Transitioning to the Community: Results of a Double-Blind, Placebo-Controlled Randomized Trial , 2018, Journal of acquired immune deficiency syndromes.

[24]  Lawrence Scholl,et al.  Drug and Opioid-Involved Overdose Deaths — United States, 2013–2017 , 2018, MMWR. Morbidity and mortality weekly report.

[25]  S. Verma,et al.  Endocarditis in the setting of IDU: multidisciplinary management , 2017, Current opinion in cardiology.

[26]  Mona Doshani,et al.  Using Population Based Hospitalization Data to Monitor Increases in Conditions Causing Morbidity Among Persons Who Inject Drugs , 2018, Journal of Community Health.

[27]  D. Bell,et al.  High Mortality Among Patients With Opioid Use Disorder in a Large Healthcare System , 2017, Journal of addiction medicine.

[28]  M. Mclean,et al.  Impact of a brief addiction medicine training experience on knowledge self-assessment among medical learners. , 2017, Substance abuse.

[29]  V. Murthy Surgeon General's Report on Alcohol, Drugs, and Health. , 2017, JAMA.

[30]  S. Mars,et al.  Nationwide increase in hospitalizations for heroin-related soft tissue infections: Associations with structural market conditions. , 2016, Drug and alcohol dependence.

[31]  D. Snydman,et al.  Increasing Infectious Endocarditis Admissions Among Young People Who Inject Drugs , 2016, Open forum infectious diseases.

[32]  A. Karchmer,et al.  Suboptimal Addiction Interventions for Patients Hospitalized with Injection Drug Use-Associated Infective Endocarditis. , 2016, The American journal of medicine.

[33]  J. Samet,et al.  Substance Use Disorders , 2016, Annals of Internal Medicine.

[34]  J. Skarbinski,et al.  Ryan White HIV/AIDS Program Assistance and HIV Treatment Outcomes. , 2016, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[35]  John W. Ward,et al.  Increases in Hepatitis C Virus Infection Related to Injection Drug Use Among Persons Aged ≤30 Years — Kentucky, Tennessee, Virginia, and West Virginia, 2006–2012 , 2015, MMWR. Morbidity and mortality weekly report.

[36]  B. Anderson,et al.  Buprenorphine treatment for hospitalized, opioid-dependent patients: a randomized clinical trial. , 2014, JAMA internal medicine.

[37]  E. Campbell,et al.  Internal Medicine Residents’ Training in Substance Use Disorders: A Survey of the Quality of Instruction and Residents’ Self-Perceived Preparedness to Diagnose and Treat Addiction , 2013, Substance abuse.

[38]  F. Altice,et al.  Retention on Buprenorphine Is Associated with High Levels of Maximal Viral Suppression among HIV-Infected Opioid Dependent Released Prisoners , 2012, PloS one.