Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder.

BACKGROUND: The rise in injection drug use in the USA has led to an increase in injection site infections. We performed a national survey of people who use drugs to evaluate common drug use preparation, harm reduction practices, and experiences with injection site infections. METHODS: A survey was disseminated to members of the Survey of Key Informants' Patients Program from 2021 to 2022 and distributed to patients 18 years or older newly entering one of 68 substance use disorder treatment programs across the USA with a primary diagnosis of an opioid use disorder. Participants were surveyed about practices when preparing and using drugs, along with self-reported infections and drug use complications. RESULTS: 1289 participants responded to the survey. Sexually transmitted infections were common, with 37.6% reporting ever having had any sexually transmitted infection. Injection-associated infections had affected 63.4% of participants who had ever used injection drugs. Many respondents reported not seeking professional medical assistance for infection management, including 29% draining abscesses without seeking medical care and 22.8% obtaining antibiotics through non-healthcare sources. Non-sterile injection practices included sharing needles with others who were febrile or ill (18%), using needles previously used to drain wounds/abscesses (9.9%) for subsequent injection drug use, and licking needles (21.2%). CONCLUSION: Patients entering treatment for opioid use disorder reported a high burden of infectious diseases. A number of easily-modifiable high risk behaviors for developing injection-related infections were identified. Efforts are needed to disseminate targeted harm reduction education to PWID on how to reduce their risks for injection-related infections.

Caracterização dos pacientes e procedimentos executados no serviço de atendimento a pacientes com necessidades especiais da Faculdade de Odontologia de Araraquara - UNESP / Characterization of patients and procedures performed in the service to patients with special needs of Araraquara School of Dentistry - UNESP

Objetivo: Caracterizar os pacientes atendidos e os procedimentos realizados no Serviço de Atendimento a Pacientes com Necessidades Especiais da Faculdade de Odontologia de Araraquara (FOAr) - UNESP. Metodologia: A partir dos prontuários odontológicos dos pacientes atendidos em nível ambulatorial entre 2007 e 2013, foram obtidas informações em relação a idade no início do tratamento, tipo de deficiência, medicamentos usados, número de sessões de atendimento e número e tipo de procedimentos odontológicos realizados. Resultado: Dos 232 prontuários analisados, observou-se que mais da metade dos pacientes (56,0%) apresentava deficiência mental, paralisia cerebral ou anomalias congênitas determinadas por agentes infecciosos, com deficiência mental associada. Entre as anomalias congênitas, a mais prevalente foi a Síndrome de Down (9,9%). Apenas 20% dos pacientes iniciaram o tratamento antes dos dez anos de idade e 62,0% faziam uso de anticonvulsivantes, antipsicóticos, ansiolíticos, antiepilépticos e antidepressivos. Foram realizados 4.506 procedimentos odontológicos, sendo 37,6% preventivos e 62,4% curativos (Restauradores, 28,0%; Periodontais, 13,9%; Endodônticos, 9,7%; Cirúrgicos, 9,1%; Protéticos, 1,7%). Observou-se também que, para a maior parte dos pacientes (63%), foram necessárias até dez sessões para a realização do tratamento. Conclusão: Os pacientes que procuraram tratamento odontológico no Serviço de Atendimento a Pacientes com Necessidades Especiais da FOAr apresentavam, na sua maioria, deficiências com envolvimento neurológico. Apesar de esse serviço priorizar os procedimentos preventivos, a maior parte dos procedimentos executados foi curativa, o que está diretamente relacionado com a procura tardia pelo tratamento odontológico.

Objective: To characterize the patients and dental procedures performed in Service to Patients with Special Needs of Araraquara School of Dentistry (FOAr) - UNESP. Methodology: From the dental records of patients treated at outpatient basis between 2007 and 2013, information regarding age at the beginning of treatment, type of disability, controlled medications used, number of dental sessions, and number and type of dental procedures performed was obtained. Result: Of the 232 records analyzed, more than half of the patients (56.0%) had mental retardation, cerebral palsy or congenital abnormalities caused by infectious agents associated with mental retardation. Among the congenital abnormalities, the most prevalent was the Down syndrome (9.9%). Only 20% of patients started treatment before the age of ten and 62.0% used anticonvulsants, antipsychotics, anxiolytics, antidepressants and antiepileptics. A total of 4,506 dental procedures were performed, 37.6% were preventive procedures and 62.4% curative procedures (restorative, 28.0%; periodontal, 13.9%; endodontic, 9.7%; surgical, 9.1%, and prosthetic 1.7%). Also was observed that for most patients (63%) up to 10 sessions were required for the completion of treatment. Conclusion: Most patients with special needs who sought dental treatment at FOAr presented neurological involvement. Despite this service prioritize preventive procedures; most of the procedures carried out were curative, fact directly linked to late search for the dental treatment.