Two major public health issues are colliding,’ CDC official warns <\/p>\n
Public health officials grappling with record-high syphilis rates around the nation have pinpointed what appears to be a major risk factor: drug use. <\/p>\n
\u201cTwo major public health issues are colliding,\u201d said Dr. Sarah Kidd, a medical officer at the Centers for Disease Control and Prevention and lead author of a new report issued Thursday on the link between drugs and syphilis.
\nThe report shows a large intersection between drug use and syphilis among women and heterosexual men. In those groups, reported use of methamphetamine, heroin and other injection drugs more than doubled from 2013 to 2017.
\nThe data did not reveal the same increases in drug use among gay men with syphilis, the group with the highest rates of the disease. <\/p>\n
Researchers said the results suggest that drug use \u2014 and the risky sexual behaviors associated with it \u2014 may be driving some of the increase in syphilis transmission among heterosexuals.
\nPeople who use drugs are more likely to engage in unsafe sexual behaviors, which put them at higher risk for sexually transmitted diseases, experts said. The CDC also saw increases in syphilis among heterosexuals during the crack cocaine epidemic of the 1980s and 1990s, and use of the drug was associated with higher syphilis transmission.
\n\u201cThe addiction takes over,\u201d said Patricia Kissinger, an epidemiology professor at Tulane University School of Public Health and Tropical Medicine. <\/p>\n
For example, people using drugs may avoid condoms, have multiple sex partners or exchange sex for drugs or money \u2014 all significant risk factors for sexually transmitted diseases, said Dr. Sara Kennedy, medical director of Planned Parenthood Northern California.
\n\u201cI think it\u2019s impossible to eradicate syphilis and congenital syphilis unless we are simultaneously addressing the meth-use and IV-use epidemic,\u201d Kennedy said.
\nSyphilis rates are setting records nationally. They jumped by 73 percent overall and 156 percent for women from 2013 to 2017. The highest rates were reported in Nevada, California and Louisiana.
\nSyphilis \u2014 which had been nearly eradicated before its resurgence in recent years \u2014 is treatable with antibiotics, but if left untreated it can lead to organ damage and even death. Congenital syphilis, which occurs when a mother passes the disease to her unborn baby, can lead to premature birth and newborn deaths. <\/p>\n
The study\u2019s authors analyzed syphilis cases from 2013 to 2017 and determined which patients had also reported using drugs. They discovered methamphetamine was the biggest problem: More than one-third of women and one-quarter of heterosexual men with syphilis reported using methamphetamine within the previous year.
\nSubstance use among both populations was highest in 13 Western states and lowest in the Northeast. In California, methamphetamine use by people with syphilis nearly doubled for women and heterosexual men from 2013 to 2017, according to the California Department of Public Health. <\/p>\n
‘OPPORTUNITY LOST’<\/strong> <\/p>\n The intersecting epidemics of sexually transmitted infections and substance abuse make it harder to identify and treat people with syphilis because drug use makes people less likely to go to the doctor and to report their sexual partners, Kidd said. Drug use is an \u201cincredibly huge contributing factor\u201d to somebody getting an STD and transmitting it, said Jennifer Howell, sexual health program coordinator for the health district in Washoe County, Nev. The city of Long Beach sends a mobile clinic to drug treatment facilities, where it provides HIV testing, said Dr. Anissa Davis, the city\u2019s health officer. She said Long Beach hopes to expand services to include screening for other sexually transmitted infections. Fighting the rising rates of syphilis will also require more resources, said Dr. Jeffrey Klausner, a professor of medicine and public health at UCLA. SOURCE: ANNA GORMAN, KAISER HEALTH NEWS 15TH FEB2019 <\/em><\/p>\n","protected":false},"excerpt":{"rendered":" Two major public health issues are colliding,’ CDC official warns Public health officials grappling with record-high syphilis rates around the nation have pinpointed what appears to be a major risk factor: drug use. \u201cTwo major public health issues are colliding,\u201d said Dr. Sarah Kidd, a medical officer at the Centers for Disease Control and Prevention […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[68,11,64,14,19],"tags":[],"class_list":["post-15547","post","type-post","status-publish","format-standard","hentry","category-drug-use-various-effects","category-effects-of-drugs","category-health","category-social-affairs","category-usa"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/15547","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=15547"}],"version-history":[{"count":0,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/15547\/revisions"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=15547"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=15547"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=15547"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nPregnant women also may be reluctant to seek prenatal care and get syphilis testing and treatment because of concerns their doctor will report the drug use.
\nTo stem the transmission of syphilis, the CDC urges more collaboration between programs that address STDs and programs that treat substances abuse. <\/p>\n
\n\u201cEverybody needs to see that we are dealing with a lot of the same clients,\u201d she said.
\nFresno County has the highest rate of congenital syphilis in California. Its health department analyzed 25 cases of congenital syphilis in 2017 and determined that more than two-thirds of the mothers were using drugs, said Joe Prado, the county\u2019s community health division manager.
\nThe county has started offering STD testing for people entering inpatient drug treatment facilities, Prado said. \u201cThat\u2019s our opportunity to get them screened,\u201d he said.
\nThose who return for the results are offered incentives such as gift cards. The county also gives people in drug treatment a care package that contains condoms and education materials about sexually transmitted infections, Prado said. <\/p>\n
\nAlthough increased collaboration between drug treatment providers and STD clinics is essential, it\u2019s not always easy because they traditionally have not worked together, said Kissinger of Tulane.
\n\u201cThe STI people are hyper-focused on STIs and the substance abuse people are focused on substance abuse,\u201d she said. It is an \u201copportunity lost\u201d if people in drug treatment aren\u2019t screened for syphilis and other sexually transmitted infections, she added. <\/p>\n
\n\u201cThe STD workforce has almost entirely disappeared,\u201d he said. \u201cWhile policies could be put in place that require syphilis testing, those policies also have to come with resources.\u201d <\/p>\n