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In Recognition of World Hepatitis Day

   If we continue to box people in because of their medical conditions, to stigmatize individuals because of their health, and treat diseases as discrete conditions, we will never reach our common goals of health and wellbeing.
Michael Botticelli, Director of National Drug Control Policy 
Today, as we observe World Hepatitis Day, it is important to consider the relationship between infectious disease and substance use disorders.  Both viral hepatitis and HIV can be transmitted by injection drug use; in fact, injection drug use is the major driver of hepatitis C virus (HCV) infections.  A recent outbreak of HIV infection in Scott County, Indiana attributed in large to injection drug use behaviors, and increases in HCV infections nationally from 2010 to 2013 underscore the adverse health outcomes of substance use. 
These outcomes are not inevitable: infectious diseases and substance use disorders are both preventable and treatable.  Evidence-based strategies, such as the provision of medication-assisted treatment and integrated screening and treatment service, are needed to better and more comprehensively address the intersection of substance use disorders and viral hepatitis infections to help reduce drug use, bend the curve in HCV infections, and avoid more HIV outbreaks like that in Scott County.  
HCV infection causes inflammation of the liver and is a major cause of liver disease and cancer.  It affects an estimated 3.2 million Americans and studies indicate a high prevalence of HCV among people who inject drugs. HCV can be transmitted by sharing syringes and other equipment used to inject drugs. 
A number of important advances provide an unprecedented opportunity to address HCV among persons with substance use disorders. These include:
  • Enhanced access to HCV testing based on the availability of rapid point-of-care tests and US Preventive Services Task Force recommendations for HCV screening among individuals at high risk for infection; 
  • Improved access to health coverage based on provisions of the Affordable Care Act and Federal parity protections; and,
  • New HCV therapies that are effective in curing HCV in the majority of people who complete treatment.  
The Action Plan for the Prevention, Care, & Treatment of Viral Hepatitis from the Department of Health and Human Services (HHS) calls for ensuring that persons who inject drugs have access to viral hepatitis prevention, care, and treatment services through the integration of behavioral health and viral hepatitis services.  These efforts to prevent and treat HCV infection must be coupled with initiatives that help people who inject drugs get treatment for their substance use disorders, reduce risk of disease transmission from sharing syringes and other injection equipment, and prevent drug use initiation.  
ONDCP and HHS are committed to reducing the rising rates of HCV infection in the United States.  Access to prevention services and treatment should be evidence-based and available to all individuals.  An individual’s substance use status should not affect his/her ability to get treatment for HCV infection.  Only by ensuring equality and the highest standards of care to all individuals can we be successful in making concrete strides against viral hepatitis. 
Click here for more information on Hepatitis C prevention and treatment methods.