2020 National Survey on Drug Use and Health NSDUH Releases
We used 2011 and 2010 census data, respectively, to determine the number of PWID for the HIV diagnosis rates and rates of living with diagnosed HIV infection (Table S1). Two trained reviewers screened abstracts from each of the 2,695 unduplicated references for specific criteria. We also excluded school-based samples (including university students) as these may under-estimate the PWID population proportion. We screened conference abstracts and dissertations but did not include them, as they provided too few details.
- However, those data on past-year PWID are not directly comparable to our rates which were based on lifetime PWID.
- A report by Perez and colleagues [22] from a household survey conducted during 2005–2008 indicated that 1.5% of adults aged 21–64 years in Puerto Rico had ever injected drugs (no standard error reported).
- In the context of these strategies, a current PWID population size estimate can both inform resource allocation and program planning for intervention scale-up and help to monitor effectiveness of such programs through assessment of change in the risk-specific burden of these infectious diseases.
- NSDUH is representative of persons aged 12 and older in the civilian noninstitutionalized population of the United States and in each state and the District of Columbia.
Supplementary Data
The 2021 NSDUH national report includes selected estimates by race, ethnicity, and age group. It is the most comprehensive report on substance use and mental health indicators that SAMHSA has released to date. Despite these limitations, our method offers an approach to provide more robust and routine estimation of PWID population size as additional and improved data become available. Improvements in surveillance of injection-involved overdose deaths will enhance use of this method. NVSS death records do not currently include route of administration for overdose deaths, but improvements in death scene investigations being implemented through CDC’s State Unintentional Drug Overdose Reporting System will lead to better estimation of the number of injection-involved overdose deaths [39]. Additionally, many of the data sources used for inputs (eg, NVSS mortality data, TEDS-A data) can be stratified by PWID characteristics and substance type, but the ratio of nonfatal to fatal overdose across different substances could not be varied based on existing data.
Persons Who Inject Drugs (PWID)
All of the tables can be downloaded in a zip file which contains both an html and PDF file containing every table. Alternatively, users can open the clickable Table of Contents to go to a particular section. Click on “PE” to get to a population estimate or percentage table, and “SE” to get a standard error table.
Essential for impact: health interventions
- “We’re also mindful that this is a respite from the street and at times it might be difficult for people to leave the only situation that feels vaguely safe for them in a day.”
- For each recall period (ever, past year) we first multiplied each survey estimate by a weight inversely proportionate to its variance, summed the weighted estimates across studies, and then divided by the sum of the weights.
- In some cases, a “quintile” could have more or fewer states than desired because two (or more) states had the same estimate (to two decimal places).
- In this new consolidated guidelines document on HIV prevention, diagnosis, treatment and care for key populations, the World Health Organization brings…
- The estimate of the number of PWID in the U.S. and resulting rates are important additions to cost effectiveness and other data used to make critical decisions about resources for prevention of HIV and HCV infections.
- UNAIDS is working with countries to develop a Spectrum model that matches the estimates of people living with HIV if estimates other than those produced through Spectrum are used.On estimating the number of children who know their status in countries with modelled estimates based on household survey data.
Global coverage of harm reduction interventions is extremely low – less than 1% of people who inject drugs live in settings with sufficient, combined and high-coverage services. The National Survey on Drug Use and Health (NSDUH) Small Area Estimates displays the prevalence of mental health or substance use issues within a geographic area. Use this tool to compare between areas, look at how the outcome has changed over time, or compare the data to related issues. Find key substance use, mental health, and treatment indicators among adults aged 60 or older in the United States, by gender.
We divided the number of nonfatal overdose events by the proportion of PWID that reported a nonfatal overdose in the past year to estimate the number of PWID within each stratum. We collapsed across strata to estimate the number of PWID overall iv drug use and by each single stratification. Using population denominators from the 2018 NCHS Bridged-Race Population Estimates, we estimated the percent of adults 18+ years of age that injected drugs in 2018 overall and by demographic groups [38].
We multiplied this ratio by the number of injection-involved overdose deaths from step 1 to estimate the number of nonfatal overdose events within each stratum for 2018 (step 3). The front page of DrugAbuseStatistics.org features the most noteworthy drug abuse data, including overdose deaths, demographics, mental health, drug abuse treatment programs, and the cost of the War on Drugs. The estimate of the number of PWID (lifetime and past year) in the U.S. and quantifying the burden of disease and disparities among PWID can be particularly important for planning and evaluating programs serving disproportionately affected populations and addressing health inequities at the national level. The estimate of the number of PWID in the U.S. and resulting rates are important additions to cost effectiveness and other data used to make critical decisions about resources for prevention of HIV and HCV infections. The estimation method presented here (meta-analysis results of ongoing, national survey data) represents one method, as our expert consultants recognized, for estimating the size of the PWID population in the United States.
- Skin and soft-tissue infections and complications of bacteraemia remain common, but outbreaks of rare infections do occur, so it is essential to remain alert for severe or unusual presentations.
- Injection drug use provides an efficient mechanism for transmitting bloodborne viruses, including human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV).
- Injection drug use provides an efficient mechanism for transmitting bloodborne viruses, including human immunodeficiency virus (HIV) and hepatitis C virus (HCV).
- Addressing the nation’s mental health crisis and drug overdose epidemic are core pillars of the Biden-Harris Administration’s Unity Agenda.
- The estimates of the number of PWID and rates of HIV and HCV infection among PWID are needed to effectively plan, implement at an appropriate scale, and evaluate programs that serve PWID with or at risk for bloodborne infections such as HIV, HBV, or HCV.
- Our rate of adults and adolescents living with a diagnosis of HIV infection among PWID in Puerto Rico (14%) is higher than that published by Perez and colleagues (2.8% [CI 0.6%–12.4%]) [22].
HIV and hepatitis B and C
The tables are based on the NSDUH survey, which interviews people ages 12 or older in the civilian, noninstitutionalized population. In the tables, indicators are broken out by a variety of demographic, geographic, and economic variables. For Sharon Larson, a longtime public health researcher who recently reviewed the evidence on supervised injection and assessed their potential impact for the city of Philadelphia, questions still remain. Early on, they considered setting up the gold standard for a study — a randomized trial — but that would mean separating a sample of drug users into two groups, one that gets access to Insight, and one that doesn’t. After years of drug-user-led activism, the government approved it as a pilot, creating a place with wrap-around addiction services under the same roof, and mandated scientific evaluations on the impact from the start.
NSDUH Annual National Report
In a study published in Lancet, Milloy and other researchers found that the fatal overdose rate sharply decreased in and around the immediate area of the site. Estimating the population proportion of PWID allowed calculation of rates of HIV and HCV infection, which quantifies the disproportionate impact among PWID nationally. Trends from population-based surveys will be monitored as part of CDC’s behavioral surveillance analyses and the meta-analysis can be updated as new data emerge. For HIV infection, rates can be calculated on an annual basis with the most recent surveillance data. Other disease metrics can be used to calculate rates, such as HIV incidence [1] or national HIV prevalence estimates [2], which include persons with undiagnosed HIV infection.
The 2022 Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health… The Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response… Key populations (men who have sex with men, people who inject drugs, sex workers, trans and gender diverse people and people in prisons) are at increased… The color of each state on the U.S. maps indicates how the state ranks relative to other states for each measure. Because 51 states were ranked for each measure, the middle quintile was assigned to 11 states, and the remaining quintiles were assigned 10 states each.
Our HCV infection prevalence rate among PWID aged 40–65 years was 43,126 per 100,000 population, reflecting the substantial impact of injection drug use on acquiring HCV infection. The HCV infection prevalence we found (43.1%) was similar to a previous NHANES estimate of 48% [4]; the higher NHANES prevalence may be due to the inclusion of PWID in a broader age range than our estimate. The prevalence estimate points to the importance of national efforts to raise awareness of HCV testing among persons who have injected drugs [25]. In an era of improved treatment, it is also important that those who are infected are linked to appropriate care [11]. CDC recommends integrated prevention services for PWID, which address risk for HIV and HCV infections and are expected to result in increased access to services, improved timeliness of service delivery, and increased effectiveness of prevention efforts [26].