The Dangers of Restricting Access to Hep C Treatment
Barring people from treatment based on substance use is, in my opinion, wrong. A bold statement? Not really, if our true goal is to reach viral hepatitis elimination and improve health outcomes (not to mention a range of other reasons). Is it a punishment, or seen by those who support this approach as being a useful tool to curtail drug use or a path to recovery? I think it is a mix of both and is based in the belief that people who use drugs are not worthy of the same care as others in society... Wrong again, and I think it is not only stigmatizing, but plainly discriminatory practice - and immoral.
What about alcohol and cigarettes?
Do we restrict healthcare for people who drink alcohol or smoke cigarettes, and should we? Is it down to a question of whether a substance is legal? Sure, we do stigmatize people who drink what we see as too much, but that is subjective, and is that in itself helpful if we don’t make any effort to support them in a positive way? Smokers are demonized, and generally the practice is frowned upon, but should we punish people because of an addiction. No, we have managed to reduce smoking over decades through awareness and education so that people understand the risks, so they can make informed decisions based on science and the statistical data.
Thinking about medical marijuana
With cannabis legal now in many US states and in all of Canada, how much sense does it make to deny hep C treatment based on consumption of a legal, or illegal, substances? Most states now allow medicinal use of marijuana products with few that have outright bans. We are a long way off making many drugs legal, but why should that stop us from treating hep C now?
Substance use should not be a reason to block hep C treatment
I am not suggesting that anyone take up the use of drugs, legal or not, pharmaceutical or otherwise. In this context, I am simply suggesting that substance use should not be a reason for denying care or treatment. The same is true for any substance/drug use, legal or not. It is foolish to think that we can help people deal with addiction or achieve targets of hep C elimination without removing these sorts of restrictive criteria. Do we honestly think as a society, that making it harder for people to deal with an infectious disease is any kind of rational or compassionate way to help people?
Punishment such as withdrawing medical care has never proven itself to me as an effective way to effect any positive change, if that is the goal, and there are a number of ethical questions. I think these sorts of restrictions have their basis in beliefs that are proven wrong in the science and have little to do with best practices or the ethical delivery of healthcare, not to mention the outcomes for people.
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