Drug Users and Access to Hep C Treatment

by Nirah Johnson Patient Expert

There are some medical providers and health insurance plans that do not provide hepatitis C treatment for people who use drugs. This is unfortunate because in progressive healthcare settings, and in numerous research studies, it has been clearly demonstrated that people who use drugs can be treated and cured successfully.

The key to being cured of hepatitis C is adherence to the medication. As long as medications are taken daily as prescribed, a cure is almost definite. Drug users are often accused of poor adherence, but this is not always the case. In fact, drug users often understand the need to take medication at regular intervals quite well, and know how to plan ahead to avoid disruptions.

**Challenges for drug users**

However, lack of day-to-day stability that sometimes comes along with active drug use can get in the way of treatment. For example, homelessness, lack of food, active psychosis, legal issues, and heavy alcohol use can make it difficult to attend medical visits and take medication every day. However, with adequate support, such as patient navigation services, substance use treatment, housing and social services, harm reduction services, and mental health treatment, most patients can be treated successfully. Treatment adherence tools such as directly observed therapy, medication pillboxes or blister packs, daily text message reminders and calls can also help. Family, friends or a treatment buddy can be the key to success.

**How treating drug users can help stop the spread of hep C**

Sometimes drug users are denied Hep C treatment because of the risk of reinfection. Hep C can be prevented by using new or sterile drug use equipment, and never sharing with others. Being in a health care system for treatment opens up an opportunity to provide harm reduction interventions to establish healthier practices, and to substitute drug use with safer treatments such as buprenorphine or methadone.

For active drug using networks, treatment is prevention. Being cured of hep C means you can't pass it along to others. The fewer people with Hep C, the less chances of the infection spreading.

All people deserve equal access to health care, including people who use drugs. If you are being denied quality care, continue to seek progressive medical providers who will offer support and treatment.


Recommendations for the Management of Hepatitis C Virus Infection Among People who Inject Drugs. International Network on Hepatitis Care in Substance Users.

Nirah is a clinical social worker and public health professional who has been raising awareness about hepatitis C and liver health in NYC since 2007. She organizes the Hep Free NYC network in NYC. @HepFreeNYC

Nirah Johnson
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Nirah Johnson

Nirah Johnson, LCSW, Director of Program Implementation & Capacity Building NYC Health Department, Viral Hepatitis Program serves as the lead organizer of the NYC Hep B Coalition and Hep C Task Force since 2007.