A new report from Centers for Disease Control and Prevention in Atlanta revealed that one out of five Americans with tuberculosis also abuse alcohol and/or illicit drugs. The report further disclosed that those who reported such practice were also found to be more contagious and their conditions more difficult to treat.
These results were derived from the analysis of the data of around 153,268 patients aged 15 years and above and who have had TB any time from 1999 to 2006. From this data, the researchers found that a larger percentage of the patients reported substance abuse than any other established risk factor of tuberculosis. More than 18% of reported to have abused drugs or alcohol compared with recent immigration (12.9%), HIV infection (9.5%), residence in group setting (6.6%), homelessness (6.3%), and having a high-risk occupation (4.3%).
The report further revealed that among patients negative for HIV, those who reported abuse of any substance were more likely to be suffering from a more contagious type of tuberculosis. Treatment failure was also observed to be 2.4 times more likely to happen to females who reported substance abuse than all the other females under treatment.
According to the authors of the report, these findings show that substance abuse is easily the most reported modifiable behavior that hinders the total eradication of the disease from the United States.
“The relation between substance abuse and increased transmission of Mycobacterium tuberculosis can be explained in several ways, some of which are indirect and revolve around delayed diagnosis and difficulties identifying at-risk contacts, screening them for TB and treating patients with positive findings,” they said. They added that substance abusers also have less access top primary medical care, which leads to delayed diagnosis, making their condition possibly more contagious.
Furthermore, TB patients who use drugs and alcohol have less potential for being screened for TB or for beginning and completing treatment because substance abuse makes their immune system weaker and damages their liver, which is mainly responsible for metabolizing anti-tuberculosis medicine.
In conclusion, the authors recommend that substance abuse and tuberculosis control programs should work together to be able to treat TB and addiction simultaneously.
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