Hepatitis C and Opioid Abuse: What's the Connection?
Hepatitis C infections and the opioid crisis are undeniably linked. Many people who become addicted to opioids inject these drugs into their bodies, and injected drug use is a major risk factor for contracting the hepatitis C virus (HCV). In fact, injected drug use is the most common path of transmission of hep C, because the virus spreads through infected blood. In most cases, if you contract the hep C virus, you’ll go on to develop chronic hepatitis C. Experts estimate at least 1.5 million people who inject drugs have hepatitis C, and if you’ve ever shared a needle with one of them, it’s possible you’ve got the virus in your blood, too.
If untreated, hepatitis C can become a dangerous chronic condition, severely damaging your liver and other organs–but it doesn’t always show symptoms. That’s why people at higher risk of the virus, including those who inject drugs like opioids, should be aware of the signs and understand the connection.
Understanding the Risks
Do you know who’s most at risk for contracting hepatitis C? For many years, public health experts recommended HCV screening for people deemed to be at elevated risk for contracting hepatitis C. This group includes:
People born between 1945 and 1965
Babies born to mothers who had HCV
People who received blood transfusions before 1992 or clotting factor concentrate before 1987
People who had undergone hemodialysis for a long time
People with HIV
Healthcare professionals who’ve been exposed to infected blood
People who inject or have ever injected illicit drugs
Recently, public health experts documented a sobering trend in the U.S. Now, young people are the fastest growing group of people to join the list. The Centers for Disease Control and Prevention (CDC) hepatitis surveillance program and the Substance Abuse and Mental Health Services’ national database of admissions to substance use disorder treatment facilities collected the numbers. Researchers found the rate of injected drug use and hep C among people 18 to 39 years old skyrocketed between 2004 and 2014.
In fact, there was a 400% increase in acute hepatitis C infections among people ages 18 to 29 and an 817% increase in admissions to substance use programs for injection of prescription opioids, plus a 600% increase in admissions for heroin injection. The 30 to 39 age category experienced a 325% increase in acute hepatitis C infections, a 169% increase in admissions due to prescription opioid injections, and a 77% increase in admissions related to heroin injection.
These staggering numbers in younger adults, as with all American adults, are likely a result of the increased rates of prescribed opioids over the last three decades. Opioids are effective pain relievers, typically reserved for short periods of recovery after surgery or injury, or for people with cancer pain. But the body can quickly become dependent on these drugs and develop a tolerance, requiring higher doses for the same level of relief over time. Opioids are also mood enhancers and many people unwittingly become addicted to the “high” feeling they provide. Once the opioid prescription runs out, people who seek further pain relief or mood boosts can turn to the illicit version of opioid pain relievers: injected heroin. In fact, in a 2013 study, about 80% of participating heroin users reported they began with prescription opioids.
Another study revealed the age group with the highest rate of opioid abuse is young adults aged 18 to 25, even though opioids are most likely to be prescribed to people older than 26. This suggests young adults are seeking out their parents’ prescription pills or acquiring the drugs elsewhere, engaging in risky activity due to their still-developing brains and decision-making skills.
Acknowledging the Risks
Now we know the connection between opioid abuse and hepatitis C widened during that window of time between 2004 and 2014. But what does that mean?
It means that you shouldn’t wait to get screened for hep C if you fall into a high-risk category, including that group of younger people who have used opioids. With the current medical therapies available, your hep C can very likely be cured. But avoiding screening and treatment could potentially be very harmful. Chronic hepatitis C that’s left untreated can lead to serious complications like scarring of the liver called cirrhosis, liver cancer, and liver failure. Some people even need a liver transplant if the damage to their liver is severe enough.
Better Treatment Options Now Available
If you have chronic hepatitis C and a history of injected drug use, there’s some good news about treatment options. Treatment is wide open to people who have used drugs in the past or continue to struggle with opioids. We now have antiviral medications that, when taken appropriately, can usually cure chronic hepatitis C without the challenging side effects that made treatment hard to take in the past. Current recommendations for these direct-access antivirals do include people with an opioid use disorder. With the exception of a few groups of people with disqualifying health issues, anyone can undergo treatment.
The bottom line: don’t make any assumptions about your health if you’ve ever used illicit drugs or struggled with an opioid use disorder. It’s important to know your status, so you can seek out treatment–because you can be treated.