Integrated Care and Treatment for Severe Infectious Diseases and Substance Use Disorders (SUD) among Hospitalized Patients

The National Academies of Sciences, Engineering and Medicine (NASEM) refer to opioid use disorder (OUD) and infectious diseases as “inextricably linked.” The OUD epidemic has contributed not only to recent outbreaks of HIV and hepatitis C virus infections across the U.S., but also -- primarily through injecting drugs -- to an increase in severe bacterial and fungal infections such as Staphylococcus aureus bacteremia, infective endocarditis, skin and soft tissue infections, bone and joint infections, and fungemia. This project will study a comprehensive, integrated hospital-based intervention to address concurrent treatment and follow-up support for people who inject drugs with infectious complications. A combined (pharmacologic/behavioral/harm reduction/low barrier communication) intervention approach will be tested to 1) initiate integrated medications for SUD in the hospital concurrently with treatment for infectious complications (e.g., treatment for bacterial, fungal and viral infections including COVID-19) and 2) rapidly transfer and retain patients in (less costly) integrated post-discharge follow-up and outpatient care.