What Is the Link Between Hepatitis C and Addiction?
Hepatitis C is a chronic liver disease a person can get from sharing infected needles and having unprotected sex. 1 The condition can lead to serious conditions, including liver cancer and cirrhosis, a type of liver scarring. The condition is a serious one with no cure. Hepatitis C and addiction can be so pervasive that an estimated 70 to 96 percent of people who inject drugs long-term are exposed to the virus. 3 Even if a person doesn’t inject drugs, they can still experience the link between hepatitis C and addiction. People may engage in risky behaviors, such as having unprotected sex, that can put them at higher risk for contracting the virus. Also, if a person is infected with the virus, they’re at risk for transmitting it to others. According to the National Institute on Drug Abuse (NIDA), for everyone one intravenous drug user who has viral hepatitis will typically infect 20 other people, usually within the first three years they have the disease.1 For this reason, early detection, treatment to minimize serious effects, and prevention from transmitting the virus is also important.
What Is Hepatitis C?
The term hepatitis refers to a viral condition that causes liver inflammation. There are four main hepatitis types: A, B, C, and D. Hepatitis A is a short-term viral infection from eating infected foods or drinking infected water. Hepatitis B and C are those that are transmitted from sexual contact and intravenous drug use. Hepatitis D can only occur if a person has hepatitis B. When a person is first infected with hepatitis C, they will usually experience a short-term infection. This can cause symptoms that are similar to that of the flu. In an estimated 20 percent of people, a person’s body clears the virus and they no longer have hepatitis C.2 This will usually occur within six weeks of exposure to the virus. However, most people don’t clear the virus. As a result, the virus will continue to multiply in a person’s body, which can lead to scarring and liver inflammation. Often, a person doesn’t experience chronic hepatitis C symptoms until the condition is more advanced. At that time, medications can undo the damage that’s already been done to the liver. Symptoms of advanced hepatitis C include:
Yellowed skin and eyes
Unfortunately, alcohol abuse can accelerate the effects of hepatitis C on the body. 3 If a person has a polysubstance addiction to both drugs and alcohol and has hepatitis C, this can create health problems at a much younger age. According to the journal Addiction Science and Clinical Practice, drinking alcohol and having hepatitis C is like “pouring gasoline on a fire”. If a person experiences these symptoms, they should seek immediate medical treatment.
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Hepatitis C and Injecting Drug Use
Hepatitis C can spread via infected syringes and surfaces. According to the Centers for Disease Control and Prevention (CDC), hepatitis C can live on infected surfaces for up to six weeks. 2 Some of the ways that hepatitis C can spread via intravenous drug use include:
Using infected needles:
Sharing or using needles that a person with hepatitis C has used can transmit the virus. According to the CDC, detachable needles are more likely to spread the virus because they tend to retain more blood than fixed needles.
Equipment used to prep drugs:
Many people may try to use clean needles, but take for granted that hepatitis is also transmitted via contaminated surfaces. For example, cookers, alcohol swabs, cotton balls, water, or tourniquets/ties can also become contaminated with the virus, increasing the risks a person can get hepatitis C. A person’s fingers may become contaminated with blood that can get on these preparation materials, and another person comes in contact with them, getting the virus.
Surfaces can also become contaminated by hepatitis C. This includes countertops or other areas where a person may prepare equipment for injection. As a result, it is unfortunately easy to spread hepatitis C when a person uses needles for injection. Also, a person who snorts cocaine can get the virus by sharing straws or tubing with another person as using cocaine can frequently cause nosebleeds that may expose a person to the virus.
Hepatitis C Diagnosis
Hepatitis C doesn’t always cause symptoms until the condition has advanced. This means a lot of people, including those suffering from substance abuse, have the condition but don’t know it. A person should talk to their doctor about if they should get a test for hepatitis C. 1 The test involves a simple blood test for hepatitis C antibodies. If a person has a positive test, a doctor will usually recommend other testing to determine how much of the virus is present in a person’s blood or if the active viral form is present at all. This means a positive test doesn’t necessarily mean a person does have active hepatitis C.2 A doctor may also make other recommendations to determine how much the virus has affected a person’s liver. As a general rule, if a person has used intravenous drugs, they should get tested for hepatitis B and hepatitis C. 1
Hepatitis C and Co-Occurring Disorders
If a person has hepatitis C, they are also at risk to have other medical conditions as well. Examples include HIV/AIDS, which is also transmitted via sharing infected needles and via unprotected sex. A person with hepatitis C is also more likely to have depression, anxiety, or other mental health disorders that require treatment, according to the NIDA. Often, a person may see multiple healthcare professionals to help them treat these conditions. This can include not only a family physician or nurse, but also a therapist or psychiatrist.
Hepatitis C Transmission Prevention
Ideally, a person who injects drugs can get help to stop using. However, regardless of circumstance, it’s important that steps are taken to prevent the spread of hepatitis C. Examples of these steps include: 2
Refraining from sharing equipment, including needles, and injecting drugs with another person
Using all-new equipment every time a person injects drugs. This includes new syringes, needles, cookers, water, tourniquets, and alcohol swabs
Refraining from dividing and using a drug solution someone else has used
Washing hands with soap and water before and after injecting drugs
Cleansing an injection site with soap and water before injecting
Only handling one’s own injection equipment
Boiling, burning, or other types of cleaning methods can’t kill enough of the hepatitis C virus to safely say a person can’t get the virus. Sometimes, syringes can be soaked in one part bleach to 10 parts water for at least two minutes. However, this approach usually only works on syringes and not other equipment types. Using new equipment every time is a much safer approach. It’s important to be aware that people who have hepatitis B are at greater risk to get hepatitis C and vice-versa. However, there is a vaccine for hepatitis B. If a person injects drugs, they should get this vaccine.
Hepatitis C Treatment
Doctors will commonly prescribe medications known as antiretrovirals to patients with hepatitis C. These medications help to reduce the rate at which the virus multiplies and have shown great promise in treating the virus. For an estimated 90 percent of people, taking antiretrovirals for 8 to 12 weeks can help them clear the virus and cure their hepatitis C, according to the NIDA. 1 However, there is no cure for other viral illnesses, such as HIV and hepatitis B. Also, even if a person has been treated for hepatitis C, they can get the virus again. There are different viral strains.2 Researchers have conducted several studies on whether or not people undergoing treatment for hepatitis C and still using drugs or who are on methadone maintenance therapies can take medications to treat hepatitis C.3 With few exceptions, most people can take the antiretroviral medications to treat their hepatitis C, even if they’re still using. Also, studies haven’t shown that there is a difference in treatment success from those who have hepatitis C from injecting drugs and those who have hepatitis C from other causes. Both can clear the viruses at nearly equal rates.
Conclusions on Hepatitis C and Addiction
Hepatitis C and addiction can be co-occurring conditions. An estimated 2.7 million Americans have chronic hepatitis C infections, and injecting drug users make up a majority of hepatitis C cases.3 According to the journal Addiction Science & Clinical Practice, only 5 percent of people who inject drugs receive treatment for their hepatitis C.4There are opportunities for prevention and treatment to keep a person from experiencing this chronic and potentially deadly disease. Help is available for both for hepatitis C and addiction, and both can be overcome.