Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 22;10:749033.
doi: 10.3389/fpubh.2022.749033. eCollection 2022.

Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews

Svetlana Puzhko  1 , Mark J Eisenberg  2   3   4 , Kristian B Filion  2   3   5 , Sarah B Windle  3 , Andréa Hébert-Losier  2 , Genevieve Gore  6 , Elena Paraskevopoulos  7 , Marc O Martel  8   9 , Irina Kudrina  1   8
Affiliations
Free PMC article

Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews

Svetlana Puzhko et al. Front Public Health. .
Free PMC article

Abstract

Background: The North American opioid crisis is marked by high opioid-related mortality and morbidity, including opioid use-associated infections (OUAIs). Users of pharmaceutical and non-pharmaceutical opioids are at an increased risk of acquiring hepatitis C (HCV), human immunodeficiency virus (HIV), and other infections. No high-level evidence, however, has been synthesized regarding effectiveness of interventions to prevent OUAIs in legal, and illegal/mixed opioid users. The aim of the study is to synthesize available systematic review (SR)-level evidence on the scope and effectiveness of interventions to prevent OUAIs among opioid users.

Methods: A SR of SRs approach was applied. We searched PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Epistemonikos and Google Scholar from inception to September 2020. Data selection and extraction were performed independently by three researchers. Risk of bias and quality of evidence were assessed using the AMSTAR2 tool. Results were narratively synthesized. Strength of evidence for each category was reported.

Results: Eleven of twelve identified SRs included interventions to prevent HCV/HIV transmission in persons who inject drugs (PWID), including opioids. One SR evaluated interventions to prevent recurrent infectious endocarditis. There was sufficient and tentative SR of SRs-level evidence for the effectiveness of opioid substitution therapy (OST) in preventing HIV and HCV, respectively. We found tentative evidence to support effectiveness of needle/syringe exchange programs (NSP) in HIV prevention, and sufficient evidence to support effectiveness of the combined OST and NSP in HCV prevention. There was insufficient SR-level evidence to support or discount effectiveness of other interventions to prevent OUAIs. No SR focused on non-PWID populations.

Conclusion: SR-level evidence supports the use of OST, NSP, and combined interventions for the reduction of HCV and HIV transmission in PWID. More research on prevention of other OUAIs and on prevention of OUAIs in non-PWID populations is urgently needed.

Systematic review registration: Registered in PROSPERO on July 30, 2020. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195929, identifier: #195929.

Keywords: effectiveness; infection; intervention; opioid; prevention; systematic review.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Selection of papers, PRISMA flow diagram.
Figure 2
Figure 2
Typology of interventions with reported effectiveness in prevention of common infections in opioid users.
Figure 3
Figure 3
Effectiveness of interventions to prevent infections in opioid users: existing evidence and knowledge gaps.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Aronson ID, Bennett A, Marsch LA, Bania TC. Mobile technology to increase HIV/HCV testing and overdose prevention/response among people who inject drugs. Front Public Health. (2017) 5:217. 10.3389/fpubh.2017.00217 - DOI - PMC - PubMed
    1. Friedman SR, Krawczyk N, Perlman DC, Mateu-Gelabert P, Ompad DC, Hamilton L, et al. . The opioid/overdose crisis as a dialectics of pain, despair, and one-sided struggle. Front Public Health. (2020) 8:540423. 10.3389/fpubh.2020.540423 - DOI - PMC - PubMed
    1. Lisa B, Jessica H. Evidence synthesis-The opioid crisis in Canada: a national perspective. Health Promot Chronic Dis Prev Can. (2018) 38:224. 10.24095/hpcdp.38.6.02 - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention . Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018. (2020). Available online at: https://www.cdc.gov/mmwr/volumes/69/wr/mm6911a4.htm 10.15585/mmwr.mm6911a4 - DOI
    1. Government of Canada . Opioid-related harms in Canada. (2020). Available online at: https://health-infobase.canada.ca/substance-related-harms/opioids

Publication types

MeSH terms

Substances