Becker's Clinical Quality & Infection Control

29 SPOTLIGHT ON THE OPIOID EPIDEMIC Hepatitis C Infections Skyrocket; CDC Report Blames Opioid Epidemic By Heather Punke H epatitis C infection rate nearly tripled in the U.S. from 2010 to 2015, and the opioid epidemic is largely to blame, according to data released by the CDC May 12 during Hepatitis Awareness Month. The 294 percent spike in hepatitis C infections from 2010 to 2015 is "largely attributed to injection drug use," like the increased use of hero- in, according to the researchers. State lawmakers could have the power to reverse this trend, the researchers wrote. "To promote HCV prevention, state laws can facilitate access to clean injection equipment and other ser- vices for persons who inject drugs, and thereby be an effective tool to reduce the risk for transmission and stop the increasing incidence of HCV infection in communities, particularly those most affected by the nation's current opioid epidemic," according to the report. For instance, the three states with the most comprehensive laws relat- ed to HCV prevention (Massachu- setts, New Mexico and Washington) allowed for syringe exchange, did not classify syringes and needles as drug paraphernalia and also al- lowed for the retail sale of syringes to drug users. Additionally, a change in Medicaid policies could limit the spread of hepatitis C. Some states' Medicaid policies have strict sobriety require- ments, which can limit access to the treatment that can cure the infec- tion. n CDC: Hospitalizations for Heroin-Related Infections on the Rise in North Carolina By Heather Punke A s the opioid epidemic wors- ens, hospitals in North Caro- lina have seen an increase in patients being hospitalized for en- docarditis, a bacterial complication of injection drug use, according to a report in the CDC's June 9 Morbidi- ty and Mortality Report. Researchers analyzed data from the North Carolina Hospital Dis- charge database to examine trends in hospitalizations for endocarditis with drug dependence from 2010 through 2015. They found the incidence of hospi- tal discharges for drug dependence with endocarditis increased more than twelvefold in the six-year span — from 0.2 per 100,000 discharges in 2010 to 2.7 per 100,000 discharg- es in 2015. Additionally, hospital costs for treating these types of patients in- creased from $1.1 million in 2010 to $22.2 million in 2015 — an eighteen- fold increase. "As the U.S. opioid epidemic con- tinues to grow, hospitalizations for infectious complications associated with injection drug use are likely to increase," the CDC report reads. The authors recommend imple- menting syringe service programs, harm reduction strategies and other public health interventions to "reduce disease burden and save healthcare costs." They also urge collaboration be- tween healthcare systems, public health and policymakers to "reduce the risks associated with injection drug use." n Study: Prolonged Opioid Use is the Most Common Postsurgical Complication By Brian Zimmerman A significant portion of surgical patients continue using opioid painkillers more than three months aer surgery. is pattern of prolonged use does not differ among major and minor surgical patients, suggesting pain related to surgery is not the lone driver of extended opioid use, according to a study published in JAMA Surgery in April. With millions of Americans undergoing surgery every year, and postoperative opioid painkiller prescribing practices varying widely across the nation, researchers sought to assess the relationship between first-time opioid ex- posure postsurgery and long-term opioid use. For the study, researchers examined ad- ministrative health claims compiled in the Clinformatics Data Mart from January 2012 through June 2015 on minor and major surgical procedures performed on more than 36,000 adults ages 18 to 64 who had not used opioids in the year prior to surgery. Research- ers defined persistent opioid use as filling an opioid prescription between 90 and 180 days aer surgery. Analysis revealed comparable rates of long- term opioid use between patients who un- derwent major surgical procedures and those who had minor surgery. e rate of persistent opioid use among major surgical patients was 6.5 percent, while the rate and for minor surgical patients was 5.9 percent. "In a cohort of previously opioid-naive pa- tients, approximately 6 percent continued to use opioids more than three months aer their surgery, and as such, prolonged opioid use can be deemed the most common postsurgical complication," concluded the study's authors. "New persistent opioid use is not different among patients who underwent minor and major surgical procedures, thereby suggesting that prolonged opioid use is not entirely due to surgical pain." n

• Cover