Hepatitis C: Treating Heroin Addiction as a Public Health Problem, Not a Moral One

Tragically, Massachusetts is having a hepatitis C outbreak, and it's entirely due to surging heroin use:

The spike in hepatitis C, an illness most often spread by drug needles tainted with the virus, emerges during a period of epidemic heroin use in Massachusetts.

That is almost certainly no coincidence, said John Auerbach , the state's public health commissioner. "I suspect there is a direct correlation between the increase in hepatitis C among younger people and the increase in injection drug use and heroin use, in particular," Auerbach said. "It is terribly tragic, but it is very consistent with the pattern of risk that goes along with injection-drug use."

Sadly, the epidemic is hitting 15-17 year olds the hardest: inexperienced drug users who are unaware of the risks of sharing needles, particularly when it comes to hepatitis C, and who are also unaware of Massachusetts' needle exchange programs. Thankfully, the state is starting an education program to reach these at-risk people. Rather than demonizing them, it's treating this as a health problem.

Unfortunately, the federal response by the CDC is not sufficient:

A March report from the CDC found that rates of acute, symptomatic hepatitis C were declining in all age groups. But acute cases are a small fraction of all hepatitis C infections; in 2005, for instance, the number of newly acute patients was just 671 nationally.

The Massachusetts data, unlike the CDC's, includes everyone who tested positive for the disease, even those without symptoms.

Dr. John Ward , director of CDC's Division of Viral Hepatitis, said the agency does not have the money to do a better job of tracking hepatitis. Improving surveillance is important "both so we can actually see how many cases there are but also for patients' own care," he said.

The good news is that we have a chance to dramatically lower hepatitis C since the primary infected population are people between 40 - 60 who used heroin and shared needles before those risks were understood and publicized (i.e., 20-40 years ago). However, we have to give the states and the federal government the money to do this. We're talking about a cost equal to that of only a few hours in Iraq...