Synopsis for May 18, 2001

MMWR articles are embargoed until 4 p.m. E.S.T. Thursdays.

1. Trends in Injection Drug Use Among Persons Entering Addiction Treatment — New Jersey, 1992–1999
2. Soft Tissue Infections Among Injection-Drug Users — San Francisco, California, 1996–2000
3. Update: Syringe Exchange Programs — United States, 1998
4. Hepatitis B Vaccination for Injection-Drug Users — Pierce County, Washington, 2000

MMWR Reports & Recommendations
May 18, 2001/Vol. 50/No. RR-7

Contact: Sandy Bonzo, M.L.I.S.
CDC, National Center for Injury Control
and Prevention
(770) 488–4902

Motor-Vehicle Occupant Injury: Strategies for Increasing Use of Child Safety Seats, Increasing Use of Safety Belts, and Reducing Alcohol-Impaired Driving
A new systematic review of studies related to motor-vehicle injuries demonstrates that a variety of interventions are effective at reducing motor vehicle crash-related deaths, the leading cause of death for Americans aged 1-34. The Task Force on Community Preventive Services, an independent panel of public health experts, worked with injury prevention scientists from CDC to conduct this review.

Synopsis for May 18, 2001

Trends in Injection Drug Use Among Persons Entering Addiction Treatment — New Jersey, 1992–1999

The increase in injection heroin use among young people in New Jersey has raised concerns about drug overdose, HIV infection and the spread of other blood-borne infections.

Addiction treatment data from New Jersey suggest a substantial increase in the likelihood that young heroin users will inject the drug. This apparent increase reverses a 15-year decline in injection drug use, which may have contributed to the decline in HIV infection in New Jersey and other parts of the Northeast. These findings suggest that a new population of young heroin users may be at increased risk of drug overdose, HIV infection and other blood-borne infections, such as hepatitis B and C. From 1993 to 1999, admission for all types of heroin use decreased for young people from urban areas and increased for young people from suburban and rural areas. The latter raises the possibility that heroin use is becoming more common in these less populated regions of the state.

Soft Tissue Infections Among Injection-Drug Users — San Francisco, California, 1996–2000

Soft tissue infections (abscesses and cellulitis) are a major health problem among injection drug users in San Francisco.

Bacterial soft tissue infections (abscesses and cellulitis), primarily among injection drug users (IDUs), are among the most common reasons for admission to San Francisco General Hospital. During 1996-2000, the number of visits for soft tissue infections at San Francisco General Hospital increased 41 percent, peaking in 1999 with approximately 4000 visits. In-patient costs for treatment of soft tissue infections average $10 million per year. Public health recommendations for preventing these type of infections include: a) increasing substance abuse treatment capacity (particularly methadone maintenance), b) increasing access to sterile injection equipment for IDUs who continue to inject drugs, and c) increasing medical and surgical services in both community and hospital settings reaching IDUs.

Update: Syringe Exchange Programs — United States, 1998

This survey found that syringe exchange programs are an increasingly common HIV prevention approach that offer a range of public health services in addition to syringe exchange.

A survey of syringe exchange programs (SEPs) in the United States found that 110 SEPs reported operating in 1998 in 81 cities in 31 states, the District of Columbia and Puerto Rico. The largest numbers of SEPs were in California (21), New York (14), Washington (12,) and New Mexico (9). In 1998, 107 SEPs programs reported exchanging (giving new syringes to participants in exchange for used ones) 19.4 million syringes (compared to the 8 million syringes exchanged in 1994-1995). Most SEPs provided services in addition to exchanging syringes: 95% made referrals to drug abuse treatment centers; 64% provided on-site HIV counseling and testing; 24% provided hepatitis C counseling and testing; and 19% provided on-site medical care.

Hepatitis B Vaccination for Injection-Drug Users — Pierce County, Washington, 2000

Hepatitis B vaccination programs for injection drug users can be successfully implemented in community settings such as syringe exchange programs and jails.

Hepatitis B vaccination has been recommended for injection drug users (IDUs) since 1982, but vaccination coverage remains low. In response to an outbreak of hepatitis B in April 2000 among IDUs in Pierce County, Washington, hepatitis B vaccination clinics were established at the syringe exchange, county health department, county jail, a soup kitchen, and a substance abuse treatment program for women. During May-December, approximately 2000 high-risk adults initiated the hepatitis B vaccination series. This report illustrates how effective hepatitis B vaccination programs targeted at IDUs can be implemented in community based settings such as syringe exchange programs and jails using modest reimbursements.

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