Hepatitis C (commonly referred to as hep C) is a virus that attacks the liver, potentially causing a host of health problems.
The human body is a complex and vastly clever organism. The liver is the largest organ in the body and responsible for filtering blood. Hepatic lobules, located in the liver, work to remove harmful substances, such as bacteria, from the blood.
When a person contracts the hep C virus, the virus invades the liver and makes copies of itself (which in turn can lead to new strains of the virus being created). The body responds by sending immune cells to the liver to attack the hep C virus and the liver cells that have become infected. As a result, the liver cells become inflamed and die, which leads to scar tissue forming. As scar tissue hardens, the liver shrinks, and it can no longer optimally function. This condition is known as cirrhosis. A person may also develop liver cancer.
At present, there is no effective vaccine to prevent hep C and no cure.
When a person contracts hep C, the body may successfully attack it within six months. If not, the person will be said to have chronic hep C.
If hep C worsens, then the virus is considered to be acute. According to the World Health Organization:
- Of all individuals who contract hep C, an estimated 15-45 percent will get better within a six-month period.
- An estimated 55-85 percent of people with hep C will progress to a chronic state.
- In 2009, there were 16,000 reports of acute hep C in the US.
- There are about 3.2 million Americans with chronic hep C.
- Worldwide, there are about 130-150 million people with hep C.
- Approximately 50-90 percent of individuals who are treated for hep C will show improvement.
In order to understand how hep C and drug addiction are related, it is necessary to first consider how hep C is communicated. This information can help a person to prevent spreading the virus or being infected by it. It is well established that drug abuse alters perception and can cause a person to take risks that they would avoid in a drug-free state. The hope, however, is that knowing the facts on hep C can help a person reduce their risk of infection and transmission despite being in the grip of addiction.
Addiction as a Risk Factor for Hep C
Individuals who use injection drugs face a heightened risk of becoming infecting with or transmitting hep C. In fact, intravenous drug use is the most common way that hep C is spread in the US. According to the Centers for Disease Control (CDC), the hep C virus can survive outside of a human host for three weeks. This means that an infected surface can remain contaminated for up to three weeks. When it comes to intravenous drug use, the CDC advises that the following are the most common ways the virus gets transmitted:
Through shared syringes and needles: There is a general advisement never to share syringes and needles and to only use new, sterile syringes needles with each use of an injection drug. Syringes with needles that can be removed can retain more blood than syringes with fixed needles, making them particularly risky to share.
- Contact with contaminated surfaces: When one person infects a surface with blood or bodily fluids (e.g., semen, saliva), another person who uses that infected area can become infected. A person who prepares injection drug equipment on an infected surface can unknowingly self-infect. The same holds true for using a discarded syringe and needle, or one passed down through fellow injection drug users. This means that face-to-face contact with the hep C host is not even necessary, which may come as a surprise.
- Infected fingers: For example, if there is any hep C infected blood or bodily fluids on a person’s fingers and those fingers are used to prep an injection site on the skin, the virus can be transmitted. The same holds true if infected fingers are used to prepare the common instruments and accessories used to inject drugs.
- Infection of preparation instruments: Individuals who use injection drugs commonly use the following things in the preparation stage: a cooker, a spoon, a heat source (e.g., a lighter), swabs, cotton balls, and belts or ties. Any of these items can become infected with hep C and then serve as a conduit to transmit the virus from one person to other people.
As Healthline discusses, hep C can be transmitted via sexual activities, but it is rare. In fact, according to one study, only one in every 190,000 people typically become infected with hep C through sexual conduct. When hep C is communicated this way, it is through saliva, semen, or blood (i.e., rough sexual activities that can cause an open wound on the body, including in the genital area). Some individuals face a heightened risk of getting hep C through sexual contact, including but not limited to those who:
- Have multiple sexual partners
- Currently have a sexually transmitted disease or infection (STD/STI)
- Are HIV positive (Research shows that 50-90 percent of individuals who use intravenous drugs and have HIV also have hep C.)
- Have unprotected sex
It is important to note that a person does not need to engage in any of the above behaviors directly in order to be at risk. Having a sexual partner who has a lifestyle or health status that is listed above presents a serious risk of transmission. The best practice is to always use protection during sexual activities, and if the partner’s blood, saliva, or semen is on a surface, to properly and safely disinfect it. In addition, if the partner is receiving treatment for hep C, it is a good practice to encourage the partner to maintain the necessary treatment regimen.
This discussion has expressly stated some of the ways that hep C can be communicated, but it’s also important to note how hep C is not communicated. There is no evidence that hep C is transmitted via kissing, hugging, contact that does not involve blood contact, sharing food, using the same utensils or beverage glasses, sneezing, or coughing.
How Drug Treatment Can Help Individuals with Hep C
There are numerous advisements on the steps individuals can take to avoid transmitting or being infected by hep C. It is critical to note that in the case of individuals with a substance use disorder, taking risks and not fully appreciating the potential outcomes are general mental health-related side effects of drug abuse. Since substance abuse can impair one’s ability to safely use drugs, the need to is particularly pressing. A rehab center can treat the addiction and often coordinate care with a doctor’s office or clinic to treat the hep C and any other viruses, infections, or diseases.
It is critical to receive treatment for hep C. According to the National Institute on Drug Abuse, if hep C is not treated, it can cause cirrhosis of the liver to develop and liver cancer (hepatocellular carcinoma). In real numbers, in 2013, it was expected that 22,000 Americans would die from liver cancer (reflecting hep B and hep C infections). This number exceeds that of deaths resulting from HIV/AIDS. It is projected that over the next 40-50 years, about 1 million individuals who have chronic hep C and do not get treatment will likely die from related complications.
A paper published by Addiction Science and Clinical Practice advises that drug rehab centers and the addiction professionals on staff are best positioned to help individuals who abuse drugs and have hep C. Rehabs can potentially:
- Help recovering clients to create and maintain a stable lifestyle
- Educate clients on the nuts and bolts of hep C, such as how to prevent transmission or follow treatment plans (Note: A person can have hep C, become clear, and then experience a re-infection)
- Promote testing and educate clients on how to access treatment.
- Monitor any hep C treatment plan that is in effect
- Continually provide encouragement to help the client follow a hep C treatment plan
As these points suggest, a rehab center can serve as an ally and advocate while a recovering person is getting hep C treatment. Since a rehab stay and the treatment duration for hep C will likely overlap, a recovering person is not alone while going through either process. In this way, recovering individuals have an opportunity to overcome addiction and possibly rid hep C from their bodies. A person is considered to be cured of hep C if, after six months of it being cleared, it does not re-emerge. Again, it is possible to become re-infected, making lasting abstinence all the more necessary.
For a person with hep C and co-occurring substance abuse, the need for treatment is particularly evident.