Drug Use and Hepatitis C: Part One

This article is part one of a new series examining the intersections of drug use and hepatitis C.

The history of hepatitis C treatment and the obstacles drug users faced

When diagnosed with hepatitis C, I found myself limited in my treatment options. The direct-acting antivirals (DAA) commonly used today were not available; Interferon and Ribavirin were the current methods of treatment at that time. Not only that, but there were stringent requirements to be met before treatment. I was told I would have to maintain at least 6 months of abstinence from all substances before treatment would even be considered.

Setting unreachable goals for drug users

For persons living on the streets pre-DAA medication, maintaining 6 to 12 months of abstinence was intangible. When your main focus is where you are going to sleep or get food, abstaining from drug use is a low priority. To a person living on the streets, drug use may be the only comfort they have. Treatment and clearing hepatitis C becomes unimportant when the conditions of treatment are unrealistic and unreachable.

DAA pave the way

In the current hepatitis C landscape, things are much different now. Treatment does not come with the risks of hair loss, weight loss, chronic pain, and fatigue. Many people do not even feel any side effects from the new DAA medication. Better yet, stipulations have relaxed for persons who use drugs. In many situations, no longer is abstinence a requirement for HCV treatment.

The future is here!

Many communities are starting to provide harm reduction resources for drug user safety: needle access and disposals, safe using sites, and even safe supply. Providing clean needles and safe disposal locations for drug users is paramount in reducing HCV infection and reinfection. These actions combined with HCV treatment accessibility has begun to change the hepatitis C landscape for the better. For many folks, the prospect of harm reduction is frightening. Beliefs that drug use will run rampant in communities if safe supply and harm reduction are accessible is one of the main points of dissent.  We cannot change everyone’s mind about these topics. All we can do is further educate people and work to ensure better health outcomes for persons living with hepatitis C who use drugs.