The best available data must be used to guide decision-making for disease prevention. The estimate of the number of PWID (lifetime and past year) in the U.S. and quantifying the burden of disease and disparities among PWID can be particularly important for planning and evaluating programs serving disproportionately affected populations and addressing health inequities at the national level. The estimate of the number of PWID in the U.S. and resulting rates are important additions to cost effectiveness and other data used to make critical decisions about resources for prevention of HIV and HCV infections.