The Dogwood Center, Princeton, NJ, USA

Disease and death associated with injecting drug use each year in the United States

	16,000 new HIV cases and 7,000 AIDS deaths⁽¹⁾
	24,000 new hepatitis C cases and 5,000 hepatitis C deaths⁽²⁾
	Some unknown fraction of new hepatitis B cases and hepatitis B deaths
	Drug overdose deaths⁽³⁾
	500,000 soft tissue infections ⁽⁴⁾

Footnotes

(1)	The estimate of 16,000 new HIV cases every year is based on: The estimate by the Centers for Disease Control and Prevention of 40,000 new cases a year for all exposure groups. See Morbidity and Mortality Weekly Report. 1999. “Guidelines for National Human Immunodeficiency Virus Case Surveillance, Including Monitoring for Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome,” vol. 48, no. RR-13. The estimate that 40 percent of all new HIV infections are injection-related is based on the percent of new AIDS cases in 2000 involving 3 exposure groups: "injecting drug use," "men who have sex with men and inject drugs" and "heterosexual partners of injecting drug users." Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report. U.S. HIV and AIDS cases reported through December 2000, Vol. 12, No. 2, Tables 22 and 23. The estimate of 7,000 AIDS deaths in 1999 is taken from Centers for Disease Control and Prevention. 2000. HIV/AIDS surveillance report. U.S. HIV and AIDS cases reported through June 2000. Vol. 12, No. 1, Table 28.
(2)	The estimate of 24,000 new hepatitis C cases attributable to hepatitis C annually is based on: The estimate by the Centers for Disease Control and Prevention of 40,000 new hepatitis C cases in 1998. See Morbidity and Mortality Weekly Report. 2001. "National Hepatitis Awareness Month -- May 2001" May 18, vol. 50. no. 19. page 399. The estimate that 60 percent of all new hepatitis C cases are related to injection drug use. See National Institute on Drug Abuse, 2000, " Community Drug Alert Bulletin: Hepatitis C," May, 4 pages. The estimate of 5,000 deaths attributable to injecting drug use annually is based on information from National Institute on Drug Abuse, 2000, " Community Drug Alert Bulletin: Hepatitis C," May, 4 pages.
(3)	J. Michael McGinnis and William H. Foege. 1999. "Mortality and morbidity attributable to use of addictive substances in the United States." Proceedings of the Association of American Physicians. vol. 111. no. 2 . pages 109-118. Charles E. Cherubin and Joseph D. Sapira.1993. "The medical complications of drug addiction and the latermedical assessment of the intravenous drug user: 25 years later." Annals of Internal Medicine. vol. 119. pages 1017-1028.
(4)	The estimate of 500,000 soft tissue infections per year based on: The assumption that a third of all injecting drug users have a soft tissue infection in the course of a year. The assumption is based on a 1997 study of injecting drug users in a San Francisco neighborhood found that a third had had a soft tissue infection. Morbidity and Mortality Weekly Report. 2001. "Soft tissue injuries among injection drug users -- San Francisco, California, 1996-2000. May 18. vol. 50. no.19. pages 381-384. Holmberg's estimate that there are 1.5 million injecting drug users in the U.S. Scott D. Holmberg. 1996. "The estimated prevalence and incidence of HIV in 96 large U.S. metropolitan areas." American Journal of Public Health, vol. 86, no. 5, May, pp. 642-54.

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