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Gregory L. Armstrong, MD

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In reply

I thank Pieper and colleagues for sharing their insights on the problem with CVD among injection drug users and for reminding readers that the medical, social, and psychiatric consequences of IDU extend beyond the realm of infectious diseases.

I also concur with Newman about the unfortunate exclusion of prisoners from the sampling frame of the National Household Survey on Drug Abuse. Regretfully, with a retrospective study based on public use, archived data offers no opportunity to address such an issue.

The US Department of Justice data allow a crude estimation of the number of prisoners with a history of ever having used injection drugs ("IDU-ever"). Applying the prevalence of IDU-ever among federal prisoners in 1997¹ to the federal prison population in 2005² and applying the IDU-ever prevalence among state prisoners in 1997¹ to all other prison and jail populations in 2005² (Table) . . . [Full Text of this Article]

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