Hepatitis and Addiction

Hepatitis is often linked with drug and alcohol addiction because substance abuse is the most common way through which forms of Hepatitis are spread and developed. Hepatitis comes in many forms: viral, bacterial, chemical, and metabolic. It is a chronic condition that causes liver inflammation and, without treatment, can be fatal.

Development of Hepatitis

People who abuse drugs and alcohol are at a higher risk of contracting viral hepatitis. Due to the risky behaviors that many people who suffer from addiction engage in, hepatitis can easily spread from one person to the next. For example, intravenous drug users may share needles or other injection preparation equipment. When doing so, they may be exposed to bodily fluids from others who are infected. In addition, substance abuse can impair judgment causing individuals to engage in unsafe behaviors, such as unprotected sex, through which viral hepatitis can spread. Lastly, exposure to toxic chemicals in drugs or excess alcohol can cause metabolic hepatitis to develop.

When hepatitis is contracted, the liver tissue becomes more and more inflamed. If left untreated, it can lead to cirrhosis or hepatocellular carcinoma, a form of liver cancer. Although some individuals may not show any symptoms, common symptoms of hepatitis include:_[1]

Flu-like symptoms
Fatigue
Pale stool
Dark urine
Abdominal pain
Loss of appetite
Weight loss
Enlarged liver and pancreas
Jaundice (yellow skin and eyes)

Unfortunately, many people don’t know that they are infected until they have already sustained serious liver damage.

The National Institute on Drug Abuse reports that every person who is infected with viral hepatitis and is also an active IV drug user will infect nearly 20 other people within 3 years._[2] Due to the rapid transmission capabilities of hepatitis, there is a dire need for early detection as well as safe injection sites to prevent the spread of the disease.

Viral Hepatitis

Viral hepatitis is most commonly associated with drug and alcohol abuse. There are three forms of viral hepatitis that are often seen in individuals who suffer from addiction: Hepatitis B, C, and D.

Hepatitis B

Hepatitis B, or HBV, can be spread by contact with bodily fluids, particularly through the sharing of needles and sexual contact. The majority of cases of HBV do not require treatment, but some patients who have other medical conditions will benefit from it. The risk for chronic infection of HBV is substantially higher among newborns and children, but most adults experience acute symptoms that will resolve on their own.

Hepatitis C

Hepatitis C (HCV) is one of the most common bloodborne infections in the nation and it can be fatal. Like HBV, it is spread through contact with bodily fluids. Between 70%-85% of people who get infected with HCV will suffer from long term, chronic symptoms. While there is no vaccine to prevent HCV, it can be prevented by practicing safe sex and using clean injection techniques. Fortunately, modern medicine is able to cure HCV if it is detected in time and treated properly._[3]

Hepatitis D

Hepatitis D, or HDV, can only spread in individuals who have already been infected with HBV or HCV. It is a rare form of hepatitis that affects very few people. However, when HBV and HDV coexist, it is the most severe form of hepatitis and it progresses rapidly. The success rate of treatment for HDV-HBV co-infections is extremely low and the condition can be fatal._[4]

Metabolic Hepatitis

Metabolic hepatitis can also develop as a result of drug or alcohol toxicity rather than person-to-person transmission.

Toxic or Drug-Induced Hepatitis

It is often difficult to determine what toxic chemicals are contained in drugs of abuse. As a result, many of these chemicals can cause drug-induced metabolic hepatitis when abused long-term. This includes illicit and prescription drugs. If drug-induced hepatitis isn’t detected early and the substances continue to be taken, a liver transplant may become necessary.

Alcoholic Hepatitis

Prolonged heavy drinking is the primary cause of alcoholic hepatitis. It is the most common cause of Cirrhosis. It is estimated that up to 35% of chronic drinkers will develop alcoholic hepatitis and up to 40% of patients who develop alcoholic hepatitis die within 6 months after symptoms begin._[5]

Hepatitis Prevention

Many forms of hepatitis can be fatal or cause long-term, severe health complications. However, there are prevention measures that can be taken to prevent becoming infected. For HBV, the best prevention method is to get vaccinated. However, not all strains of viral hepatitis can be prevented through vaccination. Instead, practicing safe sex, safe injection techniques, and getting regular bloodwork done can prevent hepatitis and enable people to catch it in its early stages.

While it is unrealistic to simply tell people not to inject drugs, since addiction drives people to engage in risky behaviors, it is important to expand public access to needle exchange programs and safe injection sites. At needle exchange programs (NEPs), which are also known as syringe exchange programs (SEPs), facilities will dispose of used syringes and needles and provide access to sterile injection supplies. Utilizing these safe injection sites can help reduce the spread of viral hepatitis among people who inject drugs. In addition, the availability of these sites is crucial to those suffering from addiction as they have the potential to refer participants to addiction specialists and treatment resources. Studies have proven that NEPs have a high success rates of facilitate people with access to comprehensive addiction treatment centers_[6]

To help raise awareness and prevent the transmission of hepatitis, the National Institute on Drug Abuse has examined comprehensive addiction treatment models that integrate hepatitis-related specialty care with addiction and mental health treatment._[2] These types of treatment modalities allow patients to receive treatment for their addiction, mental health, and physical health-related conditions. It is paramount for healthcare providers and staff to increase their knowledge about hepatitis contraction among those with substance use disorders, as it can help catch the condition before it spreads further.

In the end, only abstaining from drugs and alcohol and practicing safe sex can prevent many with substance use disorders from contracting hepatitis. However, expanding access to safe injection sites and raising awareness among healthcare providers is proven to decrease hepatitis illnesses among those who suffer from addiction.

If you or a loved one is suffering from addiction, the following resources provide directories to find needle exchange programs near you:

https://www.nasen.org/map/

https://www.detoxlocal.com/needle-exchanges/

References:

Hepatitis and Addiction

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