Harm Reduction Options for Hepatitis C Prevention

There are many different ways to get hepatitis C. Although everyone's experience with hepatitis C is different, today, injection drug use remains the leading risk factor for contracting hep C. To reduce the spread of hepatitis C and keep their communities safe, some cities (and states!) use programs focused on "harm reduction", rather than stigmatizing and criminalizing these high-risk behaviors. To better understand harm reduction efforts for hepatitis C prevention, we asked our HepatitisC.net advocates to share their perspectives.

From Connie

"Hepatitis C harm reduction means practicing ways to avoid contracting hepatitis C and avoid what harms the liver. It also means being proactive with testing and treatment. Proactive harm reduction efforts for all states and countries should be testing everyone for hepatitis C and making hepatitis C information widely available especially through doctor’s offices, clinic’s and hospitals. Also, making more treatment help available, as well as increased clinical trials for a vaccine."

From Daniel

"The primary means of hep C transmission today is through shared needles or spoons/bottle caps used to cook drugs before injection. With the growing opioid crisis, many younger people are now injecting drugs and are at high risk for transmission. Harm reduction is pretty clear, don’t share needle or cookers, provide clean needles and paraphernalia so the need to share is eliminated, create safe injection sites that provide clean resources, and provide outreach to those infected who can be seen by a physician and hopefully treated.

For the most part this is a state issue, as they can create safe sites and sanction needle exchanges. However they could be better supported by the public and the federal government, which keep a distance since it’s politically controversial. Some governors and mayors have stepped up, despite threats from the federal government. Most of the exchange programs were set up to combat the transmission of AIDS, but many of those continue today, as in Seattle where I live. While AIDS is still a concern, hep C prevention is now an equal focus of this form of harm mitigation. The cost of treatment is also problematic, since many can’t afford treatment leading to health decline or death, costly emergency room visits, and increased spread."

From Daryl

"Harm reduction in the context of hep C is mostly defined as prevention of exposure and subsequent chronic illness. In the population that use substances as a result of so-called recreational use, or addiction, this means safe supply of any delivery equipment such as needles for IV use, crack pipes, and straws for nasal inhaling. It expands beyond these devices to include Naloxone to prevent fatal overdose, and in some, more enlightened jurisdictions it means safe consumption sites where people can access safe equipment and staff who can intervene if there is an overdose or other. These places can also be a place of connection to services that can benefit the visitors in healthcare access and other necessary supports. Data has shown that these facilities are positive and benefit a much maligned and vulnerable population who are mostly ignored and forgotten. They save lives, and when coupled with good policies that can help and not hurt by criminalizing people, they improve health outcomes."

From Emma

"There are multiple forms of harm reduction: drug harm reduction, safe sex harm reduction, behavioral harm reduction.The most impactful forms of harm reduction in the HCV community are usually drug harm reduction and safe sex harm reduction. This comes in the form of safe injection and inhalation kits for persons who use drugs, and free condoms and lubrications for persons who want to have safe sex. Harm reduction has always been a passion of mine. I do not agree with many countries laws that prohibit access to safe drug supply and harm reduction materials. It is no secret that persons who use drugs, especially persons who inject drugs, are at a much higher risk of contracting the virus. I believe these laws and prohibitions come from a distorted belief that the only option for persons who use drugs is abstinence.

Canada has approximately 8 million persons who could be classified as having a substance use disorder. I do not believe it is a reasonable belief that all of those persons would be willing, or able to sustain long term recovery from substance use. Health Canada defines substance use disorder and alcoholism as a disease, or more appropriately, a mental illness. Criminalizing mental illness is counterproductive to the goal of helping persons access recovery. Accessible, safe harm reduction in all of its forms is the best first step to helping our communities and the persons who use drugs or alcohol in these communities feel supported, safe and reduces risk of transmission of dozens of diseases."

From Jessica

"When thinking about hepatitis C and harm reduction, it means meeting people where they are at, regardless of what point of their journey they are on. Meeting people with compassion creates an opportunity for change. A safe supply of substances, free access to harm reduction supplies, safe consumption sites, decriminalization, and the dismantling of stigma are all measure save the lives of people who use drugs."

From Karen

"Helping people get tested, access to treatment, counseling, and sobriety are all important parts of any harm reduction efforts. I am personally reaching into communities to create a safe place for people to talk about harm reduction and how it affects their personal lives. Whether they are on the road to sobriety are right in the middle of the addiction process, what’s important is that they understand how important liver health is. They need to see that they are valuable human beings who deserve to be hepatitis C free. I would love to see increased access to treatment, no matter where a person is in the addiction cycle. More awareness and ongoing education and support can make this possible."

From Kim

"Hepatitis C and harm reduction has now joined as we are in the midst of an opioid drug crisis with our younger generations. Therefore, now we see more in the twenties having contracted hep C and HIV. I feel strongly on getting out on the frontlines and helping those with needle exchanges and safe place to get help. We are not going to stop this all we can do is bring awareness and get more help on the front lines of this crisis. I think more needs to be funded to help bring awareness of hep C to the harm reduction places- funding to give free testing and provide the needle exchanges. Offer counseling to those with addiction and use those who beat addiction and hep C the opportunity to work on the front lines with their experience."

From Sue

"Harm reduction is policy and programs that are used to help patients mitigate the effect of harms that increase transmission of the virus and increase the harms that may be done to patients. Examples of harm reduction efforts would be things like needle exchange programs so people don’t share, making sure people know how to clean their works, and how to know when a person has overdosed and what to do about it."