Opinion

It’s Time for Congress to Get Serious About Hepatitis and the Opioid Epidemic

It has been almost a year since the United States opioid crisis was declared a nationwide public health emergency, and too many American households are now familiar with its devastating effects. Unfortunately, one of its most serious consequences has been overlooked.

What we are actually facing is a dual epidemic, as the rise in opioid use has also led to a spike in the deadly hepatitis B and C viruses. Fortunately, there is common-sense action that Congress can take now to tackle opioid drug use and reduce rates of viral hepatitis infections.

Hepatitis C is currently the deadliest infectious disease in the United States. It is transmitted by contact with contaminated blood and disproportionately impacts baby boomers, those who use drugs, and recipients of blood transfusions.

At least 5 million individuals in the country are living with hepatitis B or C. Although curable and preventable, left untreated, hepatitis C leads to an increased risk of liver disease, liver cancer and even death. Because of the direct link between injectable opioid use and hepatitis B and C, any initiative to tackle the opioid crisis in America must include a robust effort to screen, vaccinate and treat people for these viruses.

As the rates of opioid drug injection use have climbed, so too have rates of hepatitis B and C diagnoses. Among Americans between the ages of 18 and 29, an 817 percent increase in admissions for prescription opioid injections and a 600 percent increase for heroin injection use have corresponded with a 400 percent increase in acute hepatitis C infections.

Although hepatitis C used to primarily impact older Americans, the opioid epidemic is now placing many younger lives at risk. Right now, 80 percent of new injection drug users will contract hepatitis C within a year. Reported cases of hepatitis B, which can also be transmitted via injection drug use, increased by over 20 percent in 2015.

Fortunately, there are now several effective medications on the market that can cure hepatitis C in a matter of months, meaning that more Americans have a chance to be treated. Across the country, there is a push to raise awareness of this potentially deadly disease and increase treatment for vulnerable populations, including prison inmates, expanding Medicaid coverage of treatment options and ensuring that all individuals living with hepatitis C have access to curative medications.

Last year, the National Viral Hepatitis Roundtable and the Harvard Law School Center for Health Law and Policy Innovation reviewed policies limiting access to hepatitis C treatments for Medicaid beneficiaries and found that the majority of U.S. states had imposed discriminatory restrictions on patients, such as imposing sobriety requirements, requiring patients to have severe liver disease before being eligible for treatment and mandating that medications be prescribed by a specialist. Since the publication of the report, 17 states have taken steps to increase access to curative hepatitis C medications, and additional states are exploring their options.

Right now, legislation that can help stop the spread of hepatitis and save tens of thousands of lives is waiting for action in the Senate. The Eliminating Opioid Related Infectious Diseases Act of 2018 is part of a comprehensive package of bills introduced to address some of the crucial underlying health issues fueling the opioid epidemic. The House has already taken a step in the right direction and passed this bipartisan legislation.

Among many other things, the bill will implement a surveillance system to help communities better handle infection outbreaks and respond more effectively to drive down the rates of new infections. It would also support efforts to identify more individuals living with hepatitis C so that they can be treated sooner and supply additional training to health care professionals responsible for providing care to hepatitis C patients.

Failing to treat hepatitis C cases as infection rates multiply has severe public health implications. Right now, the cost of hepatitis C in the United States is set to reach $13 billion every year, and the average cost over a lifetime for a young person diagnosed with the disease is over $92,000.

We know that hepatitis C elimination strategies that provide unrestricted access to treatment save money and patients’ lives and reduce new infections. The underfunding of surveillance and testing programs for hepatitis B and C has contributed in part to the explosion of these epidemics. Even a modest increase in funding would help communities hard-hit by the opioid crisis and suffering from high rates of hepatitis B and C.

Congress is closer than ever to acting on this dual threat, and patients and their families can’t afford to wait. On behalf of all Americans who have been impacted by opioid abuse and viral hepatitis, I urge Senate Majority Leader Mitch McConnell and the Senate to act now to pass bipartisan legislation to help end these national epidemics.

 

Tina Broder is the interim executive director of the National Viral Hepatitis Roundtable , a national coalition working to eliminate hepatitis B and C in the United States.

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