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. 2023 Jan 6;76(1):96-102.
doi: 10.1093/cid/ciac543.

Estimated Number of People Who Inject Drugs in the United States

Heather Bradley  1 , Eric W Hall  2 , Alice Asher  3 , Nathan W Furukawa  3 , Christopher M Jones  4 , Jalissa Shealey  1 , Kate Buchacz  3 , Senad Handanagic  3 , Nicole Crepaz  3 , Eli S Rosenberg  5   6
Affiliations

Estimated Number of People Who Inject Drugs in the United States

Heather Bradley et al. Clin Infect Dis. .

Abstract

Background: Public health data signal increases in the number of people who inject drugs (PWID) in the United States during the past decade. An updated PWID population size estimate is critical for informing interventions and policies aiming to reduce injection-associated infections and overdose, as well as to provide a baseline for assessments of pandemic-related changes in injection drug use.

Methods: We used a modified multiplier approach to estimate the number of adults who injected drugs in the United States in 2018. We deduced the estimated number of nonfatal overdose events among PWID from 2 of our previously published estimates: the number of injection-involved overdose deaths and the meta-analyzed ratio of nonfatal to fatal overdose. The number of nonfatal overdose events was divided by prevalence of nonfatal overdose among current PWID for a population size estimate.

Results: There were an estimated 3 694 500 (95% confidence interval [CI], 1 872 700-7 273 300) PWID in the United States in 2018, representing 1.46% (95% CI, .74-2.87) of the adult population. The estimated prevalence of injection drug use was highest among males (2.1%; 95% CI, 1.1-4.2), non-Hispanic Whites (1.8%; 95% CI, .9-3.6), and adults aged 18-39 years (1.8%; 95% CI, .9-3.6).

Conclusions: Using transparent, replicable methods and largely publicly available data, we provide the first update to the number of people who inject drugs in the United States in nearly 10 years. Findings suggest the population size of PWID has substantially grown in the past decade and that prevention services for PWID should be proportionally increased.

Keywords: HIV; drug overdose; hepatitis C virus; injection drug use; people who inject drugs.

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Conflict of interest statement

Potential conflicts of interest. K. B. reports salary as an employee at the US Centers for Disease Control and Prevention. E. H. reports consulting fees from Merck & Co. for work unrelated to this paper. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Data steps and sources for estimating the number of adult persons who inject drugs (PWID), United States, 2018.
See this image and copyright information in PMC

References

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