Drug Abuse and Hepatitis
Hepatitis is a medical term used to describe swelling and inflammation in the liver. Doctors and researchers also use the term to refer to five separate forms of viral infection that can result in that inflammation. Specific forms of hepatitis common in the United States include hepatitis A, hepatitis B and hepatitis C. People who abuse drugs have seriously elevated risks for developing viral hepatitis. The clearest risks appear in people who use intravenous (IV) drugs, who have increased risks for both hepatitis B and hepatitis C. However, drug abusers who smoke or nasally inhale a variety of substances also have elevated risks for hepatitis C.
Hepatitis is a major health concern because the presence of swelling and inflammation in the liver can lead to the onset of serious liver damage, as well as outright liver failure or liver cancer. Generally speaking, symptoms of the condition commonly include a low-grade fever, pain or swelling in the abdomen, unexplained weight loss, unexplained appetite loss, a yellowing of the eyes and/or skin known as jaundice, itchiness that appears in various parts of the body, nausea, vomiting, fatigue, unusually dark urine, unusually light-colored stool, and abnormal breast growth in men. In many cases, people who have either hepatitis B or hepatitis C develop none of these symptoms during the initials stages of their illness.
Each one of the five viral diseases that cause hepatitis comes from infection with a specific virus species that also serves as the name for the disease. Hepatitis A comes from the hepatitis A virus (HAV), hepatitis B comes from the hepatitis B virus (HBV), and so on down through hepatitis E. Each of the five forms of viral hepatitis is also typically transmitted in a certain way. Hepatitis A infections come mainly from accidental ingestion of HAV-containing fecal matter. Hepatitis B infections come mainly from IV drug injection, some form of unprotected sex, or being born to an HBV-infected mother. Hepatitis C infections come mainly from IV drug use or blood transfusions, while hepatitis D infections typically occur when HDV-infected blood reaches the mucous membranes or breaks in the skin. Hepatitis E infections come mainly from accidental ingestion of HEV-containing fecal matter.
IV Drug Abuse
IV drug abuse acts as a pathway for hepatitis because people who share needles can easily inject a hepatitis virus into their bloodstreams during drug use. According to the National Institute on Drug Abuse, a minimum of 60 percent of all people in the US with hepatitis C get the disorder by abusing an intravenous drug. In turn, 80 percent or more of all IV drug abusers have hepatitis C, and 50 to 80 percent of those abusers get infected with HCV within the first half a year to 12 months of drug use. Government figures compiled in 2012 indicate that as many as 11 percent of all IV drug abusers develop cases of hepatitis B.
In addition to developing hepatitis more frequently than the general population, IV drug abusers have increased risks for unusually severe hepatitis-related health outcomes, researchers from the Substance Abuse and Mental Health Services Administration report. Reasons for these more severe outcomes include the likelihood that IV drug abusers have other health problems that worsen their hepatitis symptoms, lack of access to the health services required to effectively treat hepatitis, and (in some cases) a reluctance on the part of IV drug abusers to take advantage of available health services. In addition, IV drug abusers often engage in risky behaviors that increase their chances of simultaneously contracting more than one type of hepatitis virus or contracting HIV, the virus responsible for AIDS.
Non-IV Drug Abuse
Several different intravenous drugs-including cocaine, methamphetamine and heroin – are frequently smoked or nasally inhaled rather that administered by IV injection. According to an extensive study review published in 2007 in the journal Drug and Alcohol Dependence, non-IV use/abuse of these drugs still produces an increased risk for the development of hepatitis C. The authors of the review noted that there were greatly varying outcomes among the 28 studies they examined. For instance, some studies calculated a rate of hepatitis C infection among these drug abusers as high as 35 percent, while others calculated a rate as low as 2.3 percent. Explanations for these variations include the differences in the specific methods used in certain studies and the narrowness of the focus in some of the studies. Despite these problems, the authors concluded that non-IV drug abusers clearly do have heightened hepatitis C risks.