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Communicable Disease and Substance Use Disorders  

Relationship between substance use and communicable disease

How can drug users reduce their risks for HIV/AIDS? 

HIV/AIDS prevention strategies for drug users    

Communicable Disease information    

Find Testing and Treatment Services    

 The Relationship between Substance Use and Communicable Disease

Reusing and sharing syringes, needles, and other drug injection equipment exposes injecting drug users (IDUs) to the risk of contracting or transmitting HIV and other blood-borne infections (e.g., hepatitis B (HBV) and hepatitis C (HCV). In addition to injecting drug use, unprotected sexual contact with infected individuals is a major way that these and other sexually transmitted diseases (STDs) are transmitted.    
 
Adolescents and other young adults who use drugs and alcohol often take risks that endanger their health and the health of others. One of the most harmful risks is that of engaging in risky sexual activities. Scientific research has demonstrated that the use of alcohol and drugs is related to the occurrence of unsafe sexual behavior that places adolescents at risk for pregnancy or contracting sexually transmitted diseases (STDs), such as HIV/AIDS. Young people need to recognize the deadly consequences of HIV/AIDS, and that they are potential targets for infection.
 
How can drug users reduce their risks for HIV/AIDS?  
Drug users should be advised that stopping all drug use, including drug injection, is the most effective way to reduce their risks for contracting HIV/AIDS and other blood-borne diseases, including hepatitis B and hepatitis C. However, not every drug user is ready to stop using drugs, and many of those who stop may relapse.
 
A variety of HIV/AIDS prevention strategies to protect against becoming infected are available for individuals who may be considering or already injecting drugs. These are described in a hierarchy of HIV/AIDS risk-reduction messages, beginning with the most effective behavioral changes that drug users can make:
  • Stop using and injecting drugs.
  • Enter and complete drug use disorder treatment, including relapse prevention.
  • If you continue to inject drugs, take the following steps to reduce personal and public health risks:   
    • Never re-use or "share" syringes, water, or drug preparation equipment. Use only sterile syringes obtained from a reliable source (e.g., a pharmacy or a syringe access program).
       
    • Always use a new, sterile syringe to prepare and inject drugs.
       
    • If possible, use sterile water to prepare drugs; otherwise use clean water from a reliable source (e.g., fresh tap water).
       
    • Always use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs.
       
    • Clean the injection site with a new alcohol swab before injecting drugs. Safely dispose of syringes after one use.
As the hierarchy shows, drug injectors can best reduce their risks by stopping all drug use. If they inject drugs, they should always use sterile supplies and never share them. When this is not possible, cleaning and disinfecting techniques should be considered. Full-strength bleach is the most effective disinfectant when safer options are not available. However, sterile, unused injection equipment is safer than previously used injection equipment disinfected with bleach (1). Drug users should never share their other injection equipment, such as cookers, cottons, rinse water, and drug solutions prepared for injection. Sharing these materials presents an important but often overlooked HIV transmission risk. In addition to learning how to make the behavioral changes described in the hierarchy, drug users and their sex partners should be counseled about sexual risks for HIV and other STDs and the importance of avoiding unprotected sex.  
 
Community-based outreach workers, treatment providers, and other public health professionals should use any contact with a drug user as an opportunity to convey these important HIV/AIDS risk-reduction messages. The messages should be delivered along with referrals for testing and counseling services for HIV and other blood-borne infections, drug use disorder treatment programs, and other services. (Source)
 
 
What is the best HIV/AIDS prevention strategy for drug users? 
Given the diversity of drug users and their sex partners, no single HIV/AIDS prevention strategy will work effectively for everyone. A comprehensive approach is the most effective strategy for preventing HIV/AIDS and other blood-borne infections in drug-using populations and their communities.
 
A comprehensive approach readily adapts and responds to changing patterns of drug use and HIV/AIDS risk behaviors, to the characteristics of the local setting, and to the varied service needs of drug users and their sex partners. At every contact with a drug user, outreach workers, interventionists, and counselors deliver drug- and sex-related risk-reduction messages and provide the means to reduce or eliminate their risks for transmitting HIV and other blood-borne infections.
 
Communicable Disease Information
What is HIV/AIDS?
The human immunodeficiency virus (HIV) is a retrovirus that infects cells of the human immune system, destroying or impairing their function. In the early stages of infection, the person has no symptoms. However, as the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to so-called opportunistic infections.
 
The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS). It can take 10-15 years for an HIV-infected person to develop AIDS; antiretroviral drugs can slow down the process even further.
 
HIV is transmitted through unprotected sexual intercourse (anal or vaginal), transfusion of contaminated blood, sharing of contaminated needles, and between a mother and her infant during pregnancy, childbirth and breastfeeding. 
 
What is TB? 
Tuberculosis (TB) is a contagious disease. Like the common cold, it spreads through the air. Only people who are sick with TB in their lungs are infectious. When infectious people cough, sneeze, talk or spit, they propel TB germs, known as bacilli, into the air. A person needs only to inhale a small number of these to be infected.
 
Left untreated, each person with active TB disease will infect on average between 10 and 15 people every year. But people infected with TB bacilli will not necessarily become sick with the disease. The immune system "walls off" the TB bacilli which, protected by a thick waxy coat, can lie dormant for years. When someone's immune system is weakened, the chances of becoming sick are greater.  
  • Someone in the world is newly infected with TB bacilli every second.
  • Overall, one-third of the world's population is currently infected with the TB bacillus.
  • 5-10% of people who are infected with TB bacilli (but who are not infected with HIV) become sick or infectious at some time during their life. People with HIV and TB infection are much more likely to develop TB. 
 What is Hepatitis?
Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E.
 
Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids (e.g. from blood transfusions or invasive medical procedures using contaminated equipment). Hepatitis B is also transmitted by sexual contact.
 
The symptoms of hepatitis include jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
Find local testing and treatment services 
Contact your local health department to find resources for testing and treatment.  Health Departments serving the Lakeshore region are as follows:
Allegan County Health Department
3255 122nd Ave., Suite 200
Allegan, MI 49010
 
Berrien County Health Department
769 Pipestone St. P.O. Box 706
Benton Harbor, MI 49023-0706
 
Muskegon County Health Department
209 E. Apple Ave.
Muskegon, MI 49442
Ottawa County Health Department
12251 James St., Suite 400
Holland, MI 49424