ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Estimated Number of People Who Inject Drugs in the United States.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
102 citing papers in PubMed, 4 syntheses or guidelines pooled it, 153 citations in OpenAlex.
- Willingness to switch to long-acting regimens among people with HIV: a systematic review and meta-analysis.AIDS (London, England) · 2026Pooled it
- Tissue-retained needles in people who inject drugs: A systematic review of case reports and series on clinical presentations, complications and management.Addiction (Abingdon, England) · 2026Pooled it
- Assessing coronavirus disease 2019 pandemic impacts on the health of people who inject drugs using a novel data sharing model.AIDS (London, England) · 2025Pooled it
- Determining Herd Immunity Thresholds for Hepatitis A Virus Transmission to Inform Vaccination Strategies Among People Who Inject Drugs in 16 US States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Pooled it
- Preliminary Efficacy of a Theory-Informed Intervention to Increase COVID-19 Testing Uptake Among People Who Inject Drugs in San Diego County: Findings From a Pilot Randomized Controlled Trial.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2023Trial
- Review
- Comparison of persons who died of drug overdoses with and without evidence of hepatitis C, United States, 2019-2024.Drug and alcohol dependence · 2026Article
- Reproductive health considerations for HIV prevention integrated care models for women who inject drugs: Qualitative perspective of participants and providers in HIV Prevention Trials Network 094.Drug and alcohol dependence · 2026Article
- Informing the Equitable Implementation of Hepatitis C Interventions: Cost-Effectiveness Modeling in Rural Populations of People Who Inject Drugs.PharmacoEconomics · 2026Article
- County by county estimation of possible deaths averted, infections averted, and cost savings of overdose prevention centers in the United States from July 2019-June 2025.The International journal on drug policy · 2026Article
- Gender Differences in Adverse Childhood Experiences, Psychological Distress, and Substance Use Disorder Among Persons who Inject Drugs in Northeast Georgia, USA: A Moderated Mediation Analysis.Journal of child & adolescent trauma · 2026Article
- Correlates of Syringe Acquisition at Syringe Services Program and Pharmacies among Persons Who Inject Drugs: National HIV Behavioral Surveillance, United States, 2022.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Interactions between long-acting antiretrovirals and opioids: a call for clinical awareness.Clinical microbiology reviews · 2026Review
- Projected Outcomes of Reducing Federal Funding for Syringe Service Programs via Executive Order.JAMA network open · 2026Article
- Hooked before the first injection: The role of prescription opioids in early injection drug use initiation in San Francisco.Addictive behaviors reports · 2026Article
- Comorbidities Associated With Chronic Hepatitis C Among Medicaid Beneficiaries, 2016-2020.American journal of preventive medicine · 2026Article
- Failure to Treat Opioid Use Disorder and Opioid Withdrawal Associated with Patient-Directed Discharge in People with Injection-Related Infections.Journal of general internal medicine · 2026Article
- The Impact of MOUD Initiation in Patients With Injection Drug Use-Associated Infective Endocarditis.Open forum infectious diseases · 2026Article
- County by county estimation of possible deaths averted, infections averted, and cost savings of overdose prevention centers in the United States from July 2019-June 2025.medRxiv : the preprint server for health sciences · 2026Article
- When delay costs a limb: Severe chronic osteomyelitis in a patient with intravenous drug use.Trauma case reports · 2026Article
42 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundPublic health data signal increases in the number of people who inject drugs (PWID) in the United States during the past decade. An updated PWID population size estimate is critical for informing interventions and policies aiming to reduce injection-associated infections and overdose, as well as to provide a baseline for assessments of pandemic-related changes in injection drug use.
methodsWe used a modified multiplier approach to estimate the number of adults who injected drugs in the United States in 2018. We deduced the estimated number of nonfatal overdose events among PWID from 2 of our previously published estimates: the number of injection-involved overdose deaths and the meta-analyzed ratio of nonfatal to fatal overdose. The number of nonfatal overdose events was divided by prevalence of nonfatal overdose among current PWID for a population size estimate.
resultsThere were an estimated 3 694 500 (95% confidence interval [CI], 1 872 700-7 273 300) PWID in the United States in 2018, representing 1.46% (95% CI, .74-2.87) of the adult population. The estimated prevalence of injection drug use was highest among males (2.1%; 95% CI, 1.1-4.2), non-Hispanic Whites (1.8%; 95% CI, .9-3.6), and adults aged 18-39 years (1.8%; 95% CI, .9-3.6).
conclusionsUsing transparent, replicable methods and largely publicly available data, we provide the first update to the number of people who inject drugs in the United States in nearly 10 years. Findings suggest the population size of PWID has substantially grown in the past decade and that prevention services for PWID should be proportionally increased.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.