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Lessons from HIV epidemic could help address opioid abuse

A workshop convened by the National Academies of Sciences, Engineering and Medicine, or NASEM, drew lessons learned from the HIV epidemic to develop recommendations for treating opioid use disorder, according to a paper published in Annals of Internal Medicine.

“As a result of the opioid use disorder (OUD) epidemic, new epidemics of hepatitis C virus (HCV) and HIV infection have arisen ...,” Sandra A. Springer, MD, from Yale School of Medicine, and colleagues wrote. “Optimal treatment of these conditions is often impeded by untreated OUD resulting in long hospital stays, frequent readmissions due to lack of adherence to antibiotic regimens or reinfection, substantial morbidity and a heavy financial toll on the health care system.”

Therefore, effective OUD treatment is crucial to address its infectious disease consequences, according to Spring and colleagues.

In a workshop in March, NASEM pointed out similarities between the current opioid crisis and the beginning of the HIV epidemic. NASEM drew lessons from the HIV epidemic, noting that developing a highly trained interdisciplinary workforce and expanding access to treatment improved the lives of patients with HIV, according to the authors.

NASEM and workshop participants applied these lessons to the opioid epidemic and agreed that to turn the epidemic around, partnerships across treatment settings and specialties are needed, access to addiction care and funding should be increased and addiction treatment among physicians who manage the infectious complications of OUD should be improved, according to Springer and colleagues.

The workshop led to the recommendation of five action steps for treating opioid abuse and intersecting infections:

• screening for OUD should be conducted in all relevant health care settings;
• effective medication for OUD and/or opioid withdrawal symptoms should be immediately prescribed to patients with positive screening results;
• hospitals should develop protocols that aid in the initiation of OUD treatment, as well as the continuation of community-based treatment upon discharge;
• training to identify and treat OUD should be improved within hospitals, medical schools, physician assistant schools, nursing schools and residency programs; and
• state access to addiction care and funding should be increased.

“All health care providers have a role in combating the OUD epidemic and its [infectious disease] consequences,” Springer and colleagues concluded. “Those who treat infectious complications of OUD are well-suited to screen for OUD and begin treatment with effective FDA-approved medications. Integrating our collective skills may make the difference between life and death for patients with OUD.” – by Alaina Tedesco

Disclosure: Springer reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.