Substance Use and Co-occurring Infections (Including Immunology)

Infectious diseases account for over 50% of mortality among substance users. About 1.7 million worldwide are known to be infected with HIV and 6.1 million have chronic HCV infection. Skin and soft tissue infections affect 40% or more of active substance users, while more serious bacterial infections (including endocarditis, osteomyelitis, and epidural abscesses) are much more common than in the general population. Addressing them in a systematic manner will be an important part of a worldwide response to the two great pandemics of this era, namely, HIV and HCV infections. Bacterial infections may be the cause of initial presentation to care, which may provide a unique opportunity to secure engagement in long-term, multidisciplinary programs. If we treat substance users as complex human beings with multiple needs, not only will we treat their infections more effectively, we will also help them become better functioning members of society. This must be our ultimate goal.