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Public Health and Injection Drug Use

This issue of MMWR focuses on injection drug use and highlights ways that state and local health departments monitor injection drug use-related health issues and develop interventions to prevent substance abuse and infections among injection drug users (IDUs). Substance abuse and addiction are major underlying causes of preventable morbidity and mortality in the United States (1). The risks increase when illicit substances are injected, which contributes to multiple health and social problems for IDUs, including transmission of bloodborne infections (e.g., human immunodeficiency virus [HIV] and hepatitis B and C infections) through sharing unsterile drug injection equipment and practicing unsafe sex (2). In the United States, approximately one third of acquired immunodeficiency syndrome cases (3) and one half of new hepatitis C cases (4) are associated with injection drug use. Fatal drug overdoses also contribute to death among IDUs (5). Although the number of persons who inject illicit drugs (primarily heroin, cocaine, and amphetamine) is not available, approximately one million persons in the United States are active IDUs (6).


  1. McGinnis JM, Foege WH. Mortality and morbidity attributable to use of addictive substances in the United States. Proceedings of the Association of American Physicians 1999;111:109--18.
  2. Cherubin CE, Sapira JD. The medical complications of drug addiction and the medical assessment of the intravenous drug user: 25 years later. Ann Intern Med 1993;119:1017--28.
  3. CDC. HIV/AIDS surveillance report, 2000. Atlanta, Georgia. US Department of Health and Human Services, Public Health Service, CDC, 2000;12.
  4. Alter MJ, Moyer LA. The importance of preventing hepatitis C virus infection among injection drug users in the United States. J Acquir Immune Defic Syndr Hum Retrovirol 1998;18(suppl 1):S6--S10.
  5. CDC. Unintentional opiate overdose deaths---King County, Washington, 1990--1999. MMWR 2000;48:636--40.
  6. Gibbs DA, Hamill DN, Magruder-Habib K. Populations at increased risk of HIV infection: current knowledge and limitations. J Acquir Immune Defic Syndr 1991;4:881--9.

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This page last reviewed 5/17/2001