TUBERCULOSIS IN DRUG-USERS

The rise in tuberculosis (TB) has disproportionately affected specific populations. Historically, many patients with TB became iatrogenic op iate addicts through therapeutic use of these drugs for symptom contro l. Demographic trends reshaped the relationship between drug use and T B into one in which drug use became a risk factor for tuberculosis as a result of the overlap of epidemiological and social factors associat ed with both drug use and TB. The spread of human immunodeficiency vir us infection has amplified the spread of TB among drug users. We revie w the epidemiology of TB in drug users as well as the factors relevant to screening and compliance in drug-using populations. Drug users con stitute a high-risk group for whom screening, prevention of infection, diagnosis, and treatment pose particular challenges. The development of TB services capable of engaging drug users (those both in and out o f drug treatment programs) has potential for disrupting a significant chain of rapid TB transmission.