Hepatitis C, commonly referred to as Hep C, is a serious liver disease caused by the hepatitis C virus (HCV), which is transmitted through blood. This infection can remain asymptomatic for many years, gradually causing significant liver damage and leading to severe health complications if left untreated.

Testing for Hep C and seeking effective treatment are crucial, especially for individuals involved in high-risk behaviors that increase their chances of infection. Those who inject drugs are particularly vulnerable, as sharing needles with someone who carries HCV poses a significant risk of transmission.

The opioid crisis is an urgent public health issue marked by a notable surge in opioid addiction rates. This encompasses individuals misusing both prescription opioids and illegal substances such as heroin, which is often injected.

Data from 2019 revealed that 10.1 million Americans misused prescribed opioids within a single year, while 1.6 million battled an opioid use disorder, and 745,000 had used heroin. The misuse of opioids has led to a tragic loss of life, with 48,006 fatalities linked to synthetic opioids and 14,480 to heroin that same year. In response, the U.S. designated the opioid epidemic a public health emergency in 2017.

The opioid epidemic has significant public health implications beyond addiction and mortality—namely, a disturbing rise in Hep C cases. Hep C is transmitted primarily through blood-to-blood contact, and many individuals who misuse opioids often resort to injection methods.

Shared needles and injection paraphernalia are potent vectors for HCV transmission. Research indicates that HCV can remain viable on surfaces and objects for several weeks, enhancing the likelihood of spreading the virus among those who share equipment:

• Needles and syringes
• Preparation tools
• Hands and fingertips
• Surfaces tainted with blood

Between 2009 and 2018, Hep C infection rates in the U.S. tripled, with 72% of reported cases in 2018 linked to individuals who use injection drugs. The most affected demographic comprises individuals in their 20s and 30s, primarily in regions with elevated opioid abuse. Alarmingly, the incidence of Hep C among pregnant women surged fivefold from 2000 to 2015, with about 68% of these women also battling an opioid use disorder. While rare, there remains a risk of mother-to-child transmission during childbirth.

Untreated Hep C can lead to severe liver complications, including cirrhosis, liver cancer, or liver failure. Since 2013, the number of deaths attributed to Hep C in the U.S. has outpaced those from 60 other infectious diseases combined, including HIV. Fortunately, treatments are available that can effectively cure a substantial percentage of infections.

Prompt discussion with a healthcare provider about treatment options is advisable upon diagnosis. As symptoms can often go unnoticed, regular testing is essential. The Centers for Disease Control and Prevention (CDC) recommends that all adults aged 18 and older undergo routine Hep C screening, particularly for those who inject drugs or are pregnant.

Hep C treatment typically involves antiviral medications, and adherence to the prescribed treatment plan is critical. Although Hep C treatment is not available during pregnancy, healthcare providers can monitor both the parent and child carefully. It's important to note that individuals can contract Hep C more than once, so preventive measures are crucial:

• Avoiding contact with blood
• Seeking support for injection drug use to facilitate quitting
• Utilizing new injection equipment for each use
• Refraining from sharing any injection gear
• Sanitizing hands and the injection site with alcohol and water before and after use
• Applying a bandage to the site of injection to control bleeding

Local resources may be available to assist with access to sterile injection supplies, testing, and financial support for treatment.

The intersection between injection drug use and Hepatitis C is well-established. If you engage in injection drug use, regular Hep C testing is crucial. Keep in mind that it is possible to contract Hep C more than once; therefore, practicing safe injection techniques is essential to reduce your risk of future infections. Pregnant individuals should also be screened to mitigate the risk of transmitting Hep C to their newborns. Effective treatments are available that not only cure a significant percentage of cases but also prevent further liver damage.