Hepatitis C Cases Surge in Wake of Opioid Crisis

By Paul Fuhr 08/30/17

States with the highest overdose rates are experiencing a surge of the blood-born virus. 

a gloved hand holding a positive hepatitis C vial.

As the nation’s opioid epidemic continues to ravage American towns, yet another devastating crisis is emerging in its wake. According to the Huffington Post, cases of hepatitis C are skyrocketing among “young, white injection drug users”—a disconcerting trend that’s something of a double-whammy for communities already routed by opioids.

The opioid crisis certainly cuts a wide, unpredictable swath across the U.S., with one list of 15 “most affected cities” in states as far-flung as Texas, North Carolina, and Arkansas. Still, the HuffPost article notes that cases of the liver disease are popping up “in the same Appalachian, Midwestern and New England states that are seeing the steepest overdose death rates.”

In fact, the jagged trajectory of new hepatitis C cases almost exactly mimics the rate of opioid overdoses, with HuffPost citing new CDC info: “After declining for two decades, new hepatitis C cases shot to an estimated 34,000 in 2015, nearly triple the number in 2010.” (Michigan also reported a shocking 473% increase in hepatitis C infections among 18- to 29-year-olds.)

Given the prevalence of needle sharing, the trend is as alarming as it is expected—but the solution is even thornier than one might expect. “We have two public health problems that are related—it's called a syndemic—and we can't address one without addressing the other," said one expert.

With nearly 4 million Americans affected by hepatitis C at a cost of nearly $30,000 per person, treating everyone before curbing the opioid epidemic “would exceed $100 billion.” It’s an eye-popping price tag that’s as hard to swallow as it is to conceive when it comes to human health care. 

Still, to attack the syndemic, experts argue, we need to start somewhere. “States need to provide clean syringes for injection drug users who otherwise have no other contact with the health care system than emergency departments and jails,” the HuffPost story said.

Critics believe that the number of clean-needle programs necessary ventures into sci-fi territory, though that’s because it immediately recalls the unsuccessful efforts to combat the AIDS epidemic of the 1980s. By contrast, opioids affect people "who live in far-flung small cities and rural communities with few public health resources and scant political will to provide sterile needles to illicit drug users.”

The story finds rare hope in a “new wave of syringe exchange laws” that have given some momentum toward the much-needed syringe programs—especially in states that long opposed them. Thirteen states, including Florida, Kentucky, New Hampshire, and Ohio have all enacted syringe exchange laws since 2015.

"But it's a bit of a race against the clock," one policy director cautions. “Can we stand up enough new programs in time to blunt the rise in hepatitis C?”

Regardless, as needle laws and programs rise, hepatitis C cases could conceivably (and dramatically) fall, allowing medical experts to more acutely combat the opioid problem alone—and on its own battlefield. 

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Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at paulfuhr.com. You can also find Paul on Linkedin and Twitter.