Evidence-Based Prevention Interventions for People Who Use Illicit Drugs

The World Drug Report of 2012 [1] reports that, globally, illicit drug use is a common occurrence and is a growing health problem in some regions. Global reporting estimates indicate that approximately 230 million people or 5% of the global adult population have used illicit drugs. While somewhat stable use is ongoing in developed countries, resource-limited settings are seeing the growth and emergency of an illicit drug use as a new and significant national health issue. Heroin, cocaine, and other commonly used illicit drugs are particularly destructive to individual livelihoods, families, and neighborhoods with high social impact and increased morbidity and mortality related to the adverse health consequences of their use [2]. These adverse health consequences include addiction, overdose, violence, mental health disorders, suicide, and infectious complications such as HIV, tuberculosis, and hepatitis C [2–4]. To address the adverse health consequences of illicit drug use, the World Health Organization (WHO) and the United Nations Office of Drugs and Crime (UNODC) have developed a comprehensive package of interventions for the prevention and care of HIV among people who inject drugs [5]. There are nine component interventions comprised in this package and they are syringe service programs; medication-assisted treatment and other evidence-based drug dependence treatment; HIV testing and counseling; antiretroviral therapy; prevention and treatment of sexually transmitted infections; condom programs for people who inject drugs and their sexual partners; targeted information, education, and communication for people who inject drugs and their sexual partners; prevention, vaccination, diagnosis, and treatment of viral hepatitis; and prevention, diagnosis, and treatment of tuberculosis. The articles of this special issue address the importance of the prevention of the adverse health consequences of illicit drug use. This issue provides a framework for health policy and model programs across the globe as well as outcomes of the implementation of evidence-based interventions for people who use drugs, particularly in less resource health care systems. T. F. Kresina et al. present the importance of a continuum of response as a framework for implementation of evidence-based prevention, care, and treatment interventions as part of a national strategic plan to address HIV/AIDS and the comorbidities associated with injection illicit drug use. This framework is developed by stakeholders who plan, develop, pilot, and provide a full range of services that address the various prevention, care/support, and treatment needs of individuals, families, and communities. S. Pinkham et al. provide an overview of the need for multifaceted …