Substance Abuse and the Risk of Hepatitis C

Hepatitis C is a virus that causes chronic inflammation of the liver. It is transmitted by the blood of another infected person. It generally starts as an acute infection and progresses to a chronic condition that leads to scarring and cirrhosis of the liver. The Centers for Disease Control and Prevention estimates 3.2 million Americans have chronic hepatitis C. Due to being primarily asymptomatic, as many as 75 percent don’t even know they are infected, notes the CDC.

Who Is in Danger of Infection?

danger of infectionThere are certainly different people who are more at risk for contracting the hepatitis C virus (HCV) than others, and drug users may be the biggest demographic. Specifically, injection drug users carry a much higher risk of contracting HCV due to sharing needles and not having clean injection practices. A Current Drug Abuse Reviews publication states that 60-90 percent of all injection drug users have the disease. The Harm Reduction Coalition states that up to 55 percent of individuals with HCV contracted it from injecting drugs.

Exchange programs have given drug users a new option. Addicts can drop off their used needles to be sterilized and get clean needles in return. Some nations have even set up injection clinics where drug users can inject drugs in a supervised setting at clinics with no threat of legal action. While these facilities are a point of contention for many who disagree with their practices, they have proved purposeful in reducing both overdose rates and the contraction of infectious diseases.

Drug abuse also has the ability to heavily sway your judgment, and addicts are known for being more likely to engage in unprotected sex, often with other drug users. This further increases the chance of getting hepatitis C from someone else. Although the risk of this is somewhat lower, it is higher for those with current HIV infections — another disease that is all too common among injection drug users. The Los Angeles Office of AIDS Programs and Policy’s HIV L.A. Directory states 25-30 percent of all Americans who are infected with HIV also have hepatitis C.

Other demographics are plausible but seem to play a smaller role. A Psychiatric Services study notes that males in one study were nearly twice as likely to have hepatitis C as women. Approximately 20 percent of all individuals who are exposed to HCV are fortunate enough to fight it off and clear the infection on their own, Healthline reports.

Mental health plays a large part in the lives of many addicts, not just those with a disease or those who are injecting. Helpguide reports around 53 percent of drug addicts and 37 percent of alcoholics have serious mental health disorders. That being said, there is room for more research on the correlation between mental illness and HCV. Another Psychiatric Services study sought to examine the relationship between substance abuse and hepatitis C transmission in the severely mentally ill population, noting that among the 668 substance abusers studied with a severe mental health disorder, 18 percent had HCV, and over 20 percent had reported lifetime injection drug use, with 14 percent admitting to lifetime needle sharing.

Limiting the Risks

The most obvious measure that can be taken to decrease the chance of ending up with a hepatitis C diagnosis is avoiding the use of a shared needle or a contaminated supply. Sometimes the disease is spread via the very equipment that was used to prepare a drug for injection. So even with separate or sterilized needles, you could still become infected. Taking advantage of syringe exchange programs can drastically cut down your chances of contracting an infectious disease like HCV.

Reduced HCV infections will come through spreading awareness of the disease and urging drug users to get tested. Too many go untreated because they aren’t aware of their illness. The symptoms of HCV often seem flu-like in nature and can make it easy to overlook them. They include:

  • Fatigue
  • Muscle aches
  • Joint pain
  • Fever
  • Nausea
  • Loss of appetite
  • Itchiness
  • Darkened urine
  • Jaundice
  • Stomach pain

Alcohol is a game changer when dealing with any hepatitis infection, but especially hepatitis C. Reuters reported on a study’s comparison of 8,767 people without HCV to 218 who had it, noting only 11 percent of those without the virus died during the study’s 14-year lifespan while 19 percent of those with it had died. Additionally, those with the virus who consumed three or more alcoholic beverages a day were at a fivefold increased risk of fatality.

WebMD reported on another study on HCV-infected individuals in which the risk of liver disease increased with every level of alcohol consumption — even among those who drank fewer than two drinks daily. Alcohol use should be significantly limited, if not removed altogether, in patients with HCV. A Hepatology review concluded that 20 percent of individuals with a chronic HCV infection end up with cirrhosis of the liver within 20 years’ time.

Early treatment is the best choice any infected person can make. Injection drug users should be tested for infectious diseases on a regular basis. Of course, those who are infected should refrain from passing the virus on to anyone else.


Hepatitis C can be treated with therapies that can clear the infection in most patients, and those who remain free of it for at least six months are considered to be cured from the infection. Generally, interferons are used in conjunction with ribavirin and a protease inhibitor drug. A typical treatment period lasts six months to a year. Antiviral therapy has been shown to decrease liver-related deaths and cirrhosis that stem from HCV infections. The World Health Organization touts a 50-90 percent success rate for antiviral treatments.

Telaprevir and boceprevir are protease inhibitors often added to the treatment regimen. This addition can boost success rates by 25 percent, per Hepatitis Central. The Center for Advancing Health claims fewer than five percent of people with HCV are treated successfully. New advancements in technology and research have made way for other treatment protocols. Medical News Today recently reported on a study of 380 patients with cirrhosis of the liver, noting that an interferon-free drug therapy cured more than 90 percent of them over a period 12 weeks.

Mental illness often complicates matters when treating hepatitis C, because certain disorders are actually more common in those who are infected. Hepatitis Central notes major depressive disorder is present in 24-70 percent of individuals with HCV, whereas only 6-10 percent of the general population struggle with the disorder. It can be tricky to navigate the waters of hepatitis C and substance abuse treatment conjunctively, with or without a mental health problem added into the mix.

This virus can be managed alongside addiction during treatment, as well as any other ailments or disorders you may be determined to be suffering from. A study carried out by the Department of Anthropology at the University of California, Santa Barbara on 239 veteran patients with HCV showed 93 percent of them had a current or previous mental health disorder, with 73 percent having more than one disorder and 58 percent having a substance use disorder. It’s common for HCV to co-occur with other physical or psychological issues.

Support groups can also be a fantastic resource for individuals struggling with hepatitis C. Whether you’ve just received the diagnosis or you’ve been dealing with it for a long time, you can find comfort and solace in knowing there are others who have been in your shoes and went on to live healthy, productive lives. Treatment for substance abuse habits and physical and/or mental health issues are only a phone call away. Take a leap of faith, and reach out to us at La Paloma now.