04/26/2018
Paul Auwaerter, MD, MBA, President IDSA
Melanie Thompson, MD, Chair, HIVMA Board of Directors
Paul Spearman, MD, FPIDS, President PIDS
The Infectious Diseases Society of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society commend House and Senate panels approving legislation this week that demonstrated a commitment to confronting the opioid crisis comprehensively and effectively. As societies comprising more than 12,000 infectious diseases, pediatric and HIV physicians, we deeply appreciate provisions in the bills responding to the escalating incidence of infections including HIV, hepatitis C, hepatitis B, bacterial endocarditis and other communicable health threats that accompany the epidemic of opioid use and other addictive substance use disorders. Testing and treatment for infections transmitted through injection drug use must be integrated into responses to the opioid epidemic to avert some of the most serious consequences of this crisis.
The bills put forward by the Senate HELP Committee and the House Health Subcommittee of the Committee on Energy and Commerce recognize that responses to the opioid crisis must address accompanying threats to individual and public health. The Senate Opioid Crisis Response Act and the House Eliminating Opioid Related Infectious Disease Act both address needs for expanded and coordinated surveillance of infections associated with substance use disorders. The inclusion, in both bills, of surveillance of infective endocarditis, represents an important and urgently needed advance. Rates of this serious heart valve infection, which generally requires costly inpatient care, are increasing dramatically among young people who inject drugs, but there is currently no system for monitoring it.
Both the Senate Committee and House Subcommittee also recognize the need for a ready, trained and sufficient health workforce to detect, control and deliver coordinated care for the infections that accompany the opioid epidemic. The Senate Committee bill and the Substance Use Disorder Workforce Loan Repayment Act, approved by the House Health Subcommittee would provide loan repayment for clinicians whose primary role is caring for patients with substance use disorder, including treating infectious diseases associated with substance use. These bills address a significant factor leading to fewer physicians pursuing training in infectious diseases and HIV care, at a time when the need for that expertise is increasing.In addition, the House Eliminating Opioid Related Infectious Disease Act also authorizes provider training to coordinate care for infectious diseases and addiction.
The Senate bill also addresses demonstrated needs for expanded access to interventions critical to addressing and treating substance use disorders and infectious diseases among individuals who inject drugs. A provision that includes testing for diseases commonly associated with substance use disorders in Comprehensive Opioid Recovery Centers will ensure that individuals with viral hepatitis and HIV will be diagnosed faster, leading to more prompt treatment that will improve their health outcomes and help stop transmission. Provisions easing restrictions on access to medication assisted treatment for substance use disorder will help optimize use of a proven intervention that can reduce opioid-related deaths by half.
We applaud the panels for the leadership they have shown in confronting the combined public health threats of the growing opioid epidemic and the infectious diseases that continue to spread in its wake. The needs noted in their bills will continue until the resources, policies, healthcare access and workforce are in place to address all the health impacts of the opioid crisis. We strongly support these bills and urge our legislators to move forward swiftly to bring them to fruition to make a difference in the many communities across the country confronting these devastating epidemics.