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Current HIV/AIDS Reports
Erschienen in: Current HIV/AIDS Reports 2/2018

19.02.2018 | The Global Epidemic (SH Vermund, Section Editor)

The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions

verfasst von: David C. Perlman, Ashly E. Jordan

Erschienen in: Current HIV/AIDS Reports | Ausgabe 2/2018

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Abstract

Purpose of Review

This article reviews the case for recognizing (1) the epidemics of opioid misuse, overdose, hepatitis C virus, and HIV as a syndemic and (2) the importance of examining and addressing structural factors in responses to this syndemic. We focus on the current syndemic in the US, but also consider data from other locations to highlight the issues existing and arising in various contexts.

Recent Findings

Advances in multi-level theory and statistical methods allow sound ecologic and multi-level analyses of the impact of structural factors on the syndemic. Studies of opioid misuse, overdoses, hepatitis C virus, and HIV demonstrate that area-level access to healthcare, medication-assisted treatment of opioid use disorders, sterile injection equipment, and overdose prevention with naloxone, as well as factors such as opioid marketing, income inequality, intensity of policing activities, and health care policies, are related to the prevalence of substance misuse, overdoses, infection risk, and morbidity. Structural variables can predict area-level vulnerability to the syndemic. The implementation of combined prevention and treatment interventions can control and reverse components of the syndemic.

Summary

Recognizing and monitoring potent structural factors can facilitate the identification of areas at risk of vulnerability to the syndemic. Further, many structural factors are modifiable through intervention and policy to reduce structural vulnerability and create health-enabling environments. Evidence supports the immediate implementation of broader HCV and HIV testing and substance use screening, medication-assisted treatment, needle/syringe exchange programs, naloxone programs, increased population-level implementation of HCV treatment, and further attention to structural-level factors predicting, and contributing to, area-level vulnerability, such as degrees of opioid marketing, distribution, and prescribing.
Literatur
1.
Centers for disease control and prevention. Increases in drug and opioid-involved overdose deaths–United States, 2010–2015. MMWR. 2016;65:1445–52.
2.
Quinones S. Dreamland: the true tale of America’s opiate epidemic. 1st ed. New York: Bloomsbury Press; 2015.
3.
Degenhardt L, Charlson F, Mathers B, Hall WD, Flaxman AD, Johns N, et al. The global epidemiology and burden of opioid dependence: results from the global burden of disease 2010 study. Addiction. 2014;109:1320–33.CrossRefPubMed
4.
Valdiserri R, Khalsa J, Dan C, Holmberg S, Zibbell J, Holtzman D, et al. Confronting the emerging epidemic of HCV infection among young injection drug users. Am J Public Health. 2014;104:816–21.CrossRefPubMedPubMedCentral
5.
Centers for disease control and prevention. Increases in hepatitis C virus infection related to injection drug use among persons aged </=30 years–Kentucky, Tennessee, Virginia, and West Virginia, 2006–2012. MMWR. 2015;64:453–8.
6.
Centers for disease control and prevention. Community outbreak of HIV infection linked to injection drug use of oxymorphone–Indiana, 2015. MMWR. 2015;64:443–4.
7.
Unick GJ, Rosenblum D, Mars S, Ciccarone D. Intertwined epidemics: national demographic trends in hospitalizations for heroin- and opioid-related overdoses, 1993-2009. PLoS One. 2013;8:e54496.CrossRefPubMedPubMedCentral
8.
Dowell D, Zhang K, Noonan RK, Hockenberry JM. Mandatory provider review and pain clinic laws reduce the amounts of opioids prescribed and overdose death rates. Health Aff. 2016;35:1876–83.CrossRef
9.
McLean K. “There’s nothing here”: deindustrialization as risk environment for overdose. Int J Drug Policy. 2016;29:19–26.CrossRefPubMed
10.
Storr CL, Chen CY, Anthony JC. “Unequal opportunity”: neighbourhood disadvantage and the chance to buy illegal drugs. J Epidemiol Community Health. 2004;58:231–7.CrossRefPubMedPubMedCentral
11.
Friedman SR, Tempalski B, Brady JE, West BS, Pouget ER, Williams LD, et al. Income inequality, drug-related arrests, and the health of people who inject drugs: reflections on seventeen years of research. Int J Drug Policy. 2016;32:11–6.CrossRefPubMedPubMedCentral
12.
Mizuno Y, Purcell DW, Knowlton AR, Wilkinson JD, Gourevitch MN, Knight KR. Syndemic vulnerability, sexual and injection risk behaviors, and HIV continuum of care outcomes in HIV-positive injection drug users. AIDS Behav. 2015;19:684–93.CrossRefPubMedPubMedCentral
13.
Singer M, Clair S. Syndemics and public health: reconceptualizing disease in bio-social context. Med Anthropol Q. 2003;17:423–41.CrossRefPubMed
14.
Courtwright DT, Courtwright DT. Forces of habit: drugs and the making of the modern world. 1st ed. Cambridge: Harvard University Press; 2009.
15.
Singer M. Drugging the poor: legal and illegal drugs and social inequality. 1st ed. Long Grove: Waveland Press; 2008.
16.
Singer M, Bulled N, Ostrach B, Mendenhall E. Syndemics and the biosocial conception of health. Lancet. 2017;389:941–50.CrossRefPubMed
17.
Dean HD, Fenton KA. Addressing social determinants of health in the prevention and control of HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis. Public Health Rep. 2010;125(Suppl 4):1–5.CrossRefPubMedPubMedCentral
18.
Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;Spec No:80–94.
19.
Auerbach JD, Parkhurst JO, Caceres CF. Addressing social drivers of HIV/AIDS for the long-term response: conceptual and methodological considerations. Glob Public Health. 2011;6(Suppl 3):S293–309.CrossRefPubMed
20.
21.
Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005;61:1026–44.CrossRefPubMed
22.
23.
Braveman P, Egerter S, Williams DR. The social determinants of health: coming of age. Ann Rev Public Health. 2011;32:381–98.CrossRef
24.
Ford JA, Sacra SA, Yohros A. Neighborhood characteristics and prescription drug misuse among adolescents: the importance of social disorganization and social capital. Int J Drug Policy. 2017;46:47–53.CrossRefPubMed
25.
Van Handel MM, Rose CE, Hallisey EJ, Kolling JL, Zibbell JE, Lewis B, et al. County-level vulnerability assessment for rapid dissemination of HIV or HCV infections among persons who inject drugs, United States. J Acquir Immune Defic Syndr. 2016;73:323–31.CrossRefPubMedPubMedCentral
26.
Sewell AA, Jefferson KA. Collateral damage: the health effects of invasive police encounters in new York City. J Urban Health. 2016;93(Suppl 1):42–67.CrossRefPubMedPubMedCentral
27.
Cooper H, Des Jarlais D, Ross Z, Tempalski B, Bossak BH, Friedman SR. Spatial access to sterile syringes and the odds of injecting with an unsterile syringe among injectors: a longitudinal multilevel study. J Urban Health. 2012;89:678–96.CrossRefPubMedPubMedCentral
28.
Krieger N. Epidemiology and the people’s health: theory and context. 1st ed. New York: Oxford University Press; 2011.CrossRef
29.
Siegler A. Effect of the New York City overdose prevention program on unintentional heroin-related overdose death, 2000–2012. New York: City University of New York, Graduate Center; 2016.
30.
Zoorob MJ, Salemi JL. Bowling alone, dying together: the role of social capital in mitigating the drug overdose epidemic in the United States. Drug Alcohol Depend. 2017;173:1–9.CrossRefPubMed
31.
Monnet E, Ramee C, Minello A, Jooste V, Carel D, Di Martino V. Socioeconomic context, distance to primary care and detection of hepatitis C: a French population-based study. Soc Sci Med. 2008;66:1046–56.CrossRefPubMed
32.
Diez-Roux AV. Multilevel analysis in public health research. Ann Rev Public Health. 2000;21:171–92.CrossRef
33.
Snijders TAB, Bosker RJ. Multilevel analysis: an introduction to basic and advanced multilevel modeling. 2nd ed. Thousand Oaks: Sage Publishing; 2012.
34.
Nikolopoulos GK, Sypsa V, Bonovas S, Paraskevis D, Malliori-Minerva M, Hatzakis A, et al. Big events in Greece and HIV infection among people who inject drugs. Subst Use Misuse. 2015;50:825–38.CrossRefPubMedPubMedCentral
35.
McLaughlin KA, Nandi A, Keyes KM, Uddin M, Aiello AE, Galea S, et al. Home foreclosure and risk of psychiatric morbidity during the recent financial crisis. Psychol Med. 2012;42:1441–8.CrossRefPubMed
36.
Sewell AA, Jefferson KA, Lee H. Living under surveillance: gender, psychological distress, and stop-question-and-frisk policing in New York City. Soc Sci Med. 2016;159:1–13.CrossRefPubMed
37.
Sundquist J, Johansson SE, Yang M, Sundquist K. Low linking social capital as a predictor of coronary heart disease in Sweden: a cohort study of 2.8 million people. Soc Sci Med. 2006;62:954–63.CrossRefPubMed
38.
Holtgrave DR, Crosby RA. Social capital, poverty, and income inequality as predictors of gonorrhoea, syphilis, chlamydia and AIDS case rates in the United States. Sex Transm Infect. 2003;79:62–4.CrossRefPubMedPubMedCentral
39.
Belani H, Chorba T, Fletcher F, Hennessey K, Kroeger K, Lansky A, et al. Integrated prevention services for HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis for persons who use drugs illicitly: summary guidance from CDC and the US Department of Health and Human Services: US Department of Health and Human Services. Recommendations and Reports from the Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. 2012;61(RR05);1–40.
40.
Wilson PA, Nanin J, Amesty S, Wallace S, Cherenack EM, Fullilove R. Using syndemic theory to understand vulnerability to HIV infection among Black and Latino men in New York City. J Urban Health. 2014;91:983–98.CrossRefPubMedPubMedCentral
41.
42.
43.
Helmerhorst GT, Teunis T, Janssen SJ, Ring D. An epidemic of the use, misuse and overdose of opioids and deaths due to overdose, in the United States and Canada: is Europe next? Bone Joint J. 2017;99-b:856–64.CrossRefPubMed
44.
Peters PJ, Pontones P, Hoover KW, Patel MR, Galang RR, Shields J, et al. HIV infection linked to injection use of oxymorphone in Indiana, 2014-2015. N Engl J Med. 2016;375:229–39.CrossRefPubMed
45.
Jordan AE, Des Jarlais DC, Arasteh K, McKnight C, Nash D, Perlman DC. Incidence and prevalence of hepatitis c virus infection among persons who inject drugs in New York City: 2006-2013. Drug Alcohol Depend. 2015;152:194–200.CrossRefPubMedPubMedCentral
46.
47.
Wright ER, Kooreman HE, Greene MS, Chambers RA, Banerjee A, Wilson J. The iatrogenic epidemic of prescription drug abuse: county-level determinants of opioid availability and abuse. Drug Alcohol Depend. 2014;138:209–15.CrossRefPubMed
48.
Substance Abuse and Mental Health Services Administration. Results from the 2015 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD. Series H-48,Series H-48, HHS Publication No. (SMA) 14–4863.
49.
50.
Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007;11:1–171.PubMed
51.
Centers for Disease Control and Prevention. Community-based opioid overdose prevention programs providing naloxone–United States, 2010. MMWR. 2012;61:101–5.
52.
Clark AK, Wilder CM, Winstanley EL. A systematic review of community opioid overdose prevention and naloxone distribution programs. J Addict Med. 2014;8:153–63.CrossRefPubMed
53.
Hansen HB, Siegel CE, Case BG, Bertollo DN, DiRocco D, Galanter M. Variation in use of buprenorphine and methadone treatment by racial, ethnic, and income characteristics of residential social areas in New York City. J Behav Health Serv Res. 2013;40:367–77.CrossRefPubMed
54.
Blankenship KM, Friedman SR, Dworkin S, Mantell JE. Structural interventions: concepts, challenges and opportunities for research. J Urban Health. 2006;83:59–72.CrossRefPubMedPubMedCentral
55.
Bassols MN, Vall Castello J. Effects of the great recession on drugs consumption in Spain. Econ Hum Biol. 2016;22:103–16.CrossRef
56.
Cooper HL, Des Jarlais DC, Tempalski B, Bossak BH, Ross Z, Friedman SR. Drug-related arrest rates and spatial access to syringe exchange programs in New York City health districts: combined effects on the risk of injection-related infections among injectors. Health Place. 2012;18:218–28.CrossRefPubMed
57.
Nandi A, Galea S, Ahern J, Bucciarelli A, Vlahov D, Tardiff K. What explains the association between neighborhood-level income inequality and the risk of fatal overdose in New York City? Soc Sci Med. 2006;63:662–74.CrossRefPubMed
58.
Paraskevis D, Nikolopoulos G, Fotiou A, Tsiara C, Paraskeva D, Sypsa V, et al. Economic recession and emergence of an HIV-1 outbreak among drug injectors in Athens metropolitan area: a longitudinal study. PLoS One. 2013;8:e78941.CrossRefPubMedPubMedCentral
59.
Nikolopoulos GK, Fotiou A, Kanavou E, Richardson C, Detsis M, Pharris A, et al. National income inequality and declining GDP growth rates are associated with increases in HIV diagnoses among people who inject drugs in Europe: a panel data analysis. PLoS One. 2015;10:e0122367.CrossRefPubMedPubMedCentral
60.
Ransome Y, Galea S, Pabayo R, Kawachi I, Braunstein S, Nash D. Social capital is associated with late HIV diagnosis: an ecological analysis. J Acquir Immune Defic Syndr. 2016;73:213–21.CrossRefPubMedPubMedCentral
61.
Ransome Y, Kawachi I, Dean LT. Neighborhood social capital in relation to late HIV diagnosis, linkage to HIV care, and HIV care engagement. AIDS Behav. 2017;21:891–904.CrossRefPubMed
62.
Ransome Y, Terzian A, Addison D, Braunstein S, Myers J, Abraham B, et al. Expanded HIV testing coverage is associated with decreases in late HIV diagnoses. AIDS. 2015;29:1369–78.CrossRefPubMedPubMedCentral
63.
Uuskula A, McMahon JM, Raag M, Silm S, Ruutel K, Talu A, et al. Emergent properties of HIV risk among injection drug users in Tallinn, Estonia: synthesis of individual and neighbourhood-level factors. Sex Transm Infect. 2010;86(Suppl 3):iii79–84.CrossRefPubMed
64.
Zierler S, Krieger N, Tang Y, Coady W, Siegfried E, DeMaria A, et al. Economic deprivation and AIDS incidence in Massachusetts. Am J Public Health. 2000;90:1064–73.CrossRefPubMedPubMedCentral
65.
Cagney KA, Browning CR, Iveniuk J, English N. The onset of depression during the great recession: foreclosure and older adult mental health. Am J Public Health. 2014;104:498–505.CrossRefPubMedPubMedCentral
66.
Dauria EF, Elifson K, Arriola KJ, Wingood G, Cooper HL. Male incarceration rates and rates of sexually transmitted infections: results from a longitudinal analysis in a Southeastern US City. Sex Transm Dis. 2015;42:324–8.CrossRefPubMedPubMedCentral
67.
Des Jarlais DC, Arasteh K, McKnight C, Feelemyer J, Campbell AN, Tross S, et al. Consistent estimates of very low HIV incidence among people who inject drugs: New York City, 2005-2014. Am J Public Health. 2016;106:503–8.CrossRefPubMedPubMedCentral
68.
Becker WC, Fiellin DA. Limited evidence, faulty reasoning, and potential for a global opioid crisis. BMJ. 2017;358:j3115.CrossRefPubMed
69.
Marx K, Wheen F, Ledbetter J. Dispatches for the New York tribune: selected journalism of Karl Marx. 1st ed. London: Penguin Classics; 2007.
70.
Merwin S. Drugging a nation: the story of China and the opium curse. New York: Fleming H. Revell Company; 1908.
71.
Slavova S, Costich JF, Bunn TL, Luu H, Singleton M, Hargrove SL, et al. Heroin and fentanyl overdoses in Kentucky: epidemiology and surveillance. Int J Drug Policy. 2017;46:120–9.CrossRefPubMed
72.
Perlman DC, Des Jarlais DC, Feelemyer J. Can HIV and hepatitis C virus infection be eliminated among persons who inject drugs? J Addict Dis. 2015;34:198–205.CrossRefPubMedPubMedCentral
73.
Friedman SR, West BS, Pouget ER, Hall HI, Cantrell J, Tempalski B, et al. Metropolitan social environments and pre-HAART/HAART era changes in mortality rates (per 10,000 adult residents) among injection drug users living with AIDS. PLoS One. 2013;8:e57201.CrossRefPubMedPubMedCentral
74.
Martin NK, Hickman M, Hutchinson SJ, Goldberg DJ, Vickerman P. Combination interventions to prevent HCV transmission among people who inject drugs: modeling the impact of antiviral treatment, needle and syringe programs, and opiate substitution therapy. Clin Infect Dis. 2013;57:S39–45.CrossRefPubMedPubMedCentral
75.
Canary LA, Klevens RM, Holmberg SD. Limited access to new hepatitis C virus treatment under state Medicaid programs. Ann Intern Med. 2015;613(3):226–8.CrossRef
76.
Do A, Mittal Y, Liapakis A, Cohen E, Chau H, Bertuccio C, et al. Drug authorization for Sofosbuvir/Ledipasvir (Harvoni) for chronic HCV infection in a real-world cohort: a new barrier in the HCV care cascade. PLoS One. 2015;10:e0135645.CrossRefPubMedPubMedCentral
77.
Kuniholm MH, Leach T, Lunievicz J, Olivo N, Anastos K, Vazquez Y, et al. Hepatitis C direct acting antiviral therapies in a new York City HIV/AIDS special needs plan: uptake and barriers. AIDS Patient Care STDs. 2015;29:643–5.CrossRefPubMedPubMedCentral
78.
79.
McNeil R, Kerr T, Anderson S, Maher L, Keewatin C, Milloy M, et al. Negotiating structural vulnerability following regulatory changes to a provincial methadone program in Vancouver, Canada: a qualitative study. Soc Sci Med. 2015;133:168–76.CrossRefPubMedPubMedCentral
80.
Linton SL, Cooper HL, Kelley ME, Karnes CC, Ross Z, Wolfe ME, et al. Cross-sectional association between ZIP code-level gentrification and homelessness among a large community-based sample of people who inject drugs in 19 US cities. BMJ Open. 2017;7:e013823.CrossRefPubMedPubMedCentral
81.
Linh NN, Huong NT, Thuy HT. Evolving trade policy and the trans-Pacific partnership agreement: does it threaten Vietnam’s access to medicine and its progress towards scaling up HIV prevention, treatment and care? Glob Public Health. 2015;10(Supppl 1):S149–60.CrossRefPubMed
82.
Cooper HL, Linton S, Kelley ME, Ross Z, Wolfe ME, Chen YT, et al. Risk environments, race/ethnicity, and HIV status in a large sample of people who inject drugs in the United States. PLoS One. 2016;11:e0150410.CrossRefPubMedPubMedCentral
83.
Beletsky L, Heller D, Jenness SM, Neaigus A, Gelpi-Acosta C, Hagan H. Syringe access, syringe sharing, and police encounters among people who inject drugs in New York City: a community-level perspective. Int J Drug Policy. 2014;25:105–11.CrossRefPubMed
84.
Drucker E. A plague of prisons: the epidemiology of mass incarceration in America. Reprint Edition. New York: New Press; 2011.
85.
86.
87.
Milloy M, Kerr T, Buxton J, Rhodes T, Guillemi S, Hogg R, et al. Dose-response effect of incarceration events on nonadherence to HIV antiretroviral therapy among injection drug users. J Infect Dis. 2011;203:1215–21.CrossRefPubMedPubMedCentral
88.
89.
Ruckert A, Labonté R. The financial crisis and global health: the International Monetary Fund’s (IMF) policy response. Health Promot Int. 2012;28(3):357–66.CrossRefPubMed
90.
91.
Krieger N, Waterman PD, Spasojevic J, Li W, Maduro G, Van Wye G. Public health monitoring of privilege and deprivation with the index of concentration at the extremes. Am J Public Health. 2016;106:256–63.CrossRefPubMedPubMedCentral
92.
Woolhandler S, Himmelstein DU. The relationship of health insurance and mortality: is lack of insurance deadly? Ann Intern Med. 2017;167:424–31.CrossRefPubMed
93.
Baker BK. Trans-pacific partnership provisions in intellectual property, transparency, and investment chapters threaten access to medicines in the US and elsewhere. PLoS Med. 2016;13:e1001970.CrossRefPubMedPubMedCentral
94.
Perlman DC, Jordan AE, Uuskula A, Huong DT, Masson CL, Schackman BR, et al. An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: structural barriers and public health potential. Int J Drug Policy. 2015;26:1056–63.CrossRefPubMedPubMedCentral
95.
Ford N, Wiktor S, Kaplan K, Andrieux-Meyer I, Hill A, Radhakrishnan P, et al. Ten priorities for expanding access to HCV treatment for people who inject drugs in low-and middle-income countries. Int J Drug Policy. 2015;26:1088–93.CrossRefPubMed
96.
Baum FE, Laris P, Fisher M, Newman L, Macdougall C. “Never mind the logic, give me the numbers”: former Australian health ministers’ perspectives on the social determinants of health. Soc Sci Med. 2013;87:138–46.CrossRefPubMed
97.
Embrett MG, Randall GE. Social determinants of health and health equity policy research: exploring the use, misuse, and nonuse of policy analysis theory. Soc Sci Med. 2014;108:147–55.CrossRefPubMed
98.
Carey G, Crammond B. Action on the social determinants of health: views from inside the policy process. Soc Sci Med. 2015;128:134–41.CrossRefPubMed
99.
Perlman DC, Jordan AE. Considerations for the development of a substance-related care and prevention continuum model. Front Public Health. 2017;5:180.CrossRefPubMedPubMedCentral
100.
Perlman DC, Jordan AE, Nash D. Conceptualizing care continua: lessons from HIV, hepatitis C virus, tuberculosis and implications for the development of improved care and prevention continua. Front Public Health. 2017;4:296.CrossRefPubMedPubMedCentral
101.
102.
103.
Zibbell JE, Asher AK, Patel RC, Kupronis B, Iqbal K, Ward JW, et al. Increases in acute hepatitis C virus infection related to a growing opioid epidemic and associated injection drug use, United States, 2004 to 2014. Am J Public Health. 2018;108(2):175–81.CrossRefPubMedPubMedCentral
104.
Rickles M, Rebeiro PF, Sizemore L, Juarez P, Mutter M, Wester C, et al. Tennessee’s in-state vulnerability assessment for a ‘rapid dissemination of HIV or HCV infection’ event utilizing data about the opioid epidemic. Clin Infect Dis. 2017; https://​doi.​org/​10.​1093/​cid/​cix1079.
Metadaten
Titel
The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions
verfasst von
David C. Perlman
Ashly E. Jordan
Publikationsdatum
19.02.2018
Verlag
Springer US
Erschienen in
Current HIV/AIDS Reports / Ausgabe 2/2018
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-018-0390-3

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