United States

National HIV Behavioral Surveillance Data On People Who Inject Drugs

"This report describes data from 11,437 PWID who participated in NHBS in 2018, of whom 69% identified as male, 30% female, and 1% transgender; 39% were white, 33% were black, and 21% were Hispanic or Latino; 36% were aged ≥50 years (Table 1). Among all participants, 26% had no health insurance, 21% had not visited a health care provider, and the household income of 75% of participants was at or below the federal poverty level.

HIV Diagnoses Associated With Injection Drug Use by Region and Race/Ethnicity

"In 2018 in the United States and 6 dependent areas, 2,492 diagnosed HIV infections were among PWID. Of these, the largest number of HIV infection diagnoses were in the South (976), followed by the Northeast (595) (Figure 19). In all regions, the largest percentage of diagnosed HIV infections among PWID was among whites. In the South, whites accounted for 436 diagnosed HIV infections among PWID (45%), blacks/African Americans accounted for 359 (37%), and Hispanics/Latinos accounted for 143 (15%) (Table 6b).

HIV Diagnoses Attributed to Injection Drug Use by Race and Ethnicity

"From 2014 through 2018 in the United States and 6 dependent areas, the percentage of diagnoses of HIV infection attributed to injection drug use increased. In 2018, among 1,434 male adult and adolescent PWID with diagnosed HIV infection, approximately 41% were white, 30% were black/African American, and 24% were Hispanic/Latino (Figure 18). Among 1,058 female adult and adolescent PWID with diagnosed HIV infection, 50% were white, 30% black/African American, and 15% Hispanic/Latino.

Drug Overdose Deaths In the US Involving Cocaine 2009 Through 2018

"• Throughout the study period, the rates of drug overdose deaths involving cocaine were highest for the non-Hispanic black population, followed by non-Hispanic white and the Hispanic population (Figure 3).

"• In 2018, the rate of drug overdose deaths involving cocaine in the non-Hispanic black population (9.0 per 100,000) was nearly twice that of the non-Hispanic white population (4.6) and three times that of the Hispanic population (3.0).

Drug Overdose Deaths Involving Cocaine in the US 2009 Through 2018

"• In 2018, there were 14,666 drug overdose deaths involving cocaine in the United States for an age-adjusted rate of 4.5 per 100,000 standard population (Figure 1)."

"• The age-adjusted rate of drug overdose deaths involving cocaine remained stable from 2009 through 2013 ranging from 1.3 to 1.6 per 100,000, then increased on average by 27% per year from 2013 through 2018.

Rates Of Alcohol-Induced Deaths In The US Increased From 2008 To 2018

"• Age-adjusted rates of alcohol-induced deaths among all persons aged 25 and over were stable from 2000 to 2006 at about 10.7 per 100,000, then increased 43% to 15.3 in 2018 (Figure 1).

"• For males aged 25 and over, rates were stable from 2000 to 2005, then increased 34% from 2005 through 2018, from 16.9 to 22.6.

"• For females aged 25 and over, rates increased 76% from 2000 through 2018, from 4.9 to 8.6.

"• For each year, rates of alcohol-induced deaths for males aged 25 and over were higher than for females."

Successful Operation of an Unsanctioned Supervised Consumption Site in the US

"In total, there were 10,514 injections and 33 opioid-involved overdoses over 5 years, all of which were reversed by naloxone administered by trained staff (Table 1). No person who overdosed was transferred to an outside medical institution, and there were no deaths. The number of overdoses increased over the years of operation, due partially to the number of injections increasing over the same period of time (Fig. S1 in the Supplementary Appendix).

Juvenile Injustice: Trauma and Risk of Abuse

"Once incarcerated, children are at risk of physical and psychological abuse, sexual assault, suicide and other harms, including inadequate educational instruction. The use of solitary confinement further deprives them of social interaction, mental stimulation and key services during a critical time of adolescent brain development. Risks are heightened for children in the adult criminal justice system, which is focused on punishment rather than rehabilitation and treatment.