Hepatitis C on the Rise along with Opioid Injection

hepatitis c infectionsIt’s likely that you’ve heard of hepatitis. Did you know it is defined as inflammation of liver tissue? Did you know that hepatitis C is the most common type of the five, that there is no vaccine, and that it’s widely considered the most dangerous? Were you aware that hepatitis C is transmitted by blood, and that injecting drug users (known as IDUs) are most at risk? Is it among your knowledge that America is currently facing the worst opioid epidemic in history? Do you realize that heroin is the most widely abused opioid, and that the majority of users inject it? Do you also realize that lots of addicts inject prescription opioids? If it happens that you answered yes to all or most of these questions, then this shouldn’t shock you, but…

Acute hepatitis C infection rates have more than doubled since 2004.

As published just over a week ago in the American Journal of Public Health, a collaborative study shows how the “…behavioral risk factors associated with the increase in cases of acute HCV infection correspond to the populations and behaviors that characterize the nation’s opioid epidemic.” It makes perfect sense when you think about it. Before we delve into the study and its implications, let’s take closer glances at both intravenous drug use and hepatitis C itself.

Drugs by Injection

The effects of all drugs, legal and not, take place once the active chemicals in the drugs reach the brain. Intravenous drug use, (injecting drugs directly into the bloodstream through a vein), gets the drugs to the brain as quick as possible. Also, with intravenous drug use, the effects of whichever drug has been injected are experienced at maximum strength, having gone through virtually no bodily filters.

This is great news for legal intravenous drugs, such as doxorubicin for chemotherapy, or even morphine for cases of extreme pain. This is horrible news in the realm of the American opioid crisis, which kills about 100 people every day, the vast majority of them having fatally overdosed from an injection.

It’s not just heroin that can be abused by injection. Add cocaine, meth, amphetamines, and both opioid and non-opioid prescription drugs to the list. Users take the powder form of whichever drug they will inject, dissolve it into water, fill a syringe with the substance and inject it directly into a vein. It really sounds crazy when you spell it out like that and well, that’s because it is crazy.

The injection of recreational drugs has many slang terms. The five most common terms are “shooting up,” “jacking up,” “pinning,” “banging” and “slamming.” Heroin is also known as dope or smack, and comes in bags or bundles. Meth (think Breaking Bad) is also known as crank, ice, or glass.

The Sharing of Needles, the Sharing of Diseases

Hepatitis C, while a very serious and deadly disease, is by no means the only thing one has to worry about if and when a drug needle is shared. Hepatitis B, the HIV virus, and blood disorders such as cytomegalovirus or Epstein-Barr virus could also be contracted. Furthermore, inside of a used syringe, HIV can live for six weeks and Hepatitis C can live for up to eight weeks.

It’s not even just sharing needles that could land you a deadly virus. If you share the water used to clean a needle with someone, you could become infected. Another possible way to contract a deadly virus includes reusing “cookers,” the surfaces on which addicts dissolve the powder form of the drug in water, and/or cook the concoction. Yet another way, one more common than you might think, is the disposal of used drug needles.

Used drug needles are everywhere. It’s likely a rare occasion that IDUs properly dispose of their used needles after shooting up. Because of the vast numbers of American IDUs nowadays, used needles are turning up just about everywhere. It’s so bad that in July of last year, ABC News in San Francisco published an article titled It’s Raining Needles.

The article describes how all over the country, local officials are finding discarded needles in record numbers. Halfway through last year, officials in Portland, Maine discovered over 700 discarded needles. In 2016 the total number discovered in Portland was 900.  Halfway through last year, the number of needles found was 247 in Manchester, New Hampshire. In 2016 the total found in Manchester was 570. During just March of last year, an overwhelming 13,000 needles were found in San Francisco. Take Back Santa Cruz, based in California as well, is one of the country’s oldest drug needle tracking associations. Over the past five years, it has found over 15,000 needles in Santa Cruz County.

Where are officials finding the needles?

From the above-mentioned ABC News article: They hide in weeds along hiking trails and in playground grass. They wash into rivers and float downstream to land on beaches. They pepper baseball dugouts, sidewalks and streets. Syringes left by drug users amid the heroin crisis are turning up everywhere.”

There are cases virtually every day of everyday people stumbling across some used needle(s) and in some cases even being pricked by them. The risks of accidentally encountering a used drug needle are the same as using a dirty needle: HIV, Hepatitis, blood disorders, etc. In a best case scenario involving an accident with a used needle, the victim still must endure a slew of medical tests to make sure he or she is still healthy.

Some Scary Examples

Poughkeepsie, NY – August 2016

New York State Trooper Brian Weglinski and his wife Jessica have three kids together. Dylan, at this time, was less than a year old. Giuliana was 2 and Trevor was 3. The two older siblings were playing in the family front yard when Trevor found a used hypodermic needle. Being young and unaware, he poked his sister Giuliana with it.

According to Hudson Valley News Network, Jessica acted accordingly. “I immediately freaked out, and then we called the pediatrician and decided to take her to the ER to get her checked out,” she said. “I was, of course, in shock and just upset that someone could be that negligent and deliberately either walk down the road and throw it in our yard or drive down the road and throw it out their car window into our yard.”

Since the incident, the Weglinski family has notified all levels of their local government. A press release was issued by Poughkeepsie police shortly thereafter, warning all residents to beware of randomly discarded used needles. Trooper Brian Weglinski has made it a priority to crack down on this issue as part of his police work.

Greater Manchester, England – February 2013

This is one of those stories that makes people say that life can be stranger than fiction. On a chilly winter morning, an unnamed mother was shopping at her local Tesco store for sandwich ingredients, aiming to please her ten year old child. One of the things she purchased was a loaf of bread. Upon getting home and removing two slices, the mom noticed a blood-covered used drug needle stuck in the loaf.

Naturally, she handed the needle over to local police, who then used DNA to determine the last user of the needle.  It turns out 61-year-old David Rodgers, a grandfather, was the culprit. Rodgers stuck the needle into the loaf of bread after injecting so that his wife wouldn’t discover that he was using again.

At the time of the occurrence, he was facing charges including intent to cause public alarm, and the Daily Mail article states that Rodgers could have been looking at jail time.

Denver, CO – April 2017

The brief but powerful story of Randi Bartling’s findings is one of those ‘small’ stories that would have been in the bottom left corner of page 20 if it were in print. However, surely almost anyone living in a highly residential area, or really anywhere not extremely rural, can relate. Here’s what happened.

Just a few steps from her back door, Randi found a collection of used heroin needles. They were on the ground, mere inches away from a dumpster. Using a plastic bag, she disposed of the needles, telling her local paper how she was glad a child or an animal did not find them first.

“You’ll see them walking up in the alley zoned out a lot of times, so that’s not uncommon,” said Randi. But about finding needles in her backyard? “I don’t really know what to say. I am just at a loss. What do you say to an addict that is high? There are no words for it.”

Making matters much worse, Randi Bartling is a nanny who uses her home for her kids. There are children around all of the time. This is a sad state of affairs when Randi witnesses heroin use every day. “I drive along… and I can literally see them doing dope. What else is being done about it? Something needs to be done because it’s horrible.”

Back to the Crucial Point

To bring everything full circle, IDUs are leaving needles all over America, to the point where it’s become at least a little dangerous for children to be playing outside. IDUs (again, injecting drug users), are also more prominent than ever. The opioid crisis is at a peak of destruction, and with such vast numbers of IDUs comes vast numbers of diseases – especially hepatitis C.

Let’s get back to the crucial point: that as drug-associated needle use increases, so does disease.

Study from the American Journal of Public Health

Let’s take a closer look at the aforementioned study that showed how cases of hepatitis C are increasing in volume as does injectable drug use. For aesthetic purpose, hepatitis C will from now on be mentioned as HCV, which stands for hepatitis C virus. From 2004 to 2014, incidents of HCV more than doubled. This becomes rather interesting when you realize that during that same time span, opioid overdoses actually more than quadrupled.

The doctors behind the study do not see this as coincidence.

Essentially the study team looked for trends between “the annual incidence rate and demographic and risk characteristics of reported cases of acute HCV infection” and the percentage of substance abuse treatment admissions for IDUs. What they found is not shocking.

Not only did both the rate of HCV and the rate of IDUs increase, but they did so in a matching manner. For example, there are “significant increases among select demographic groups” when it comes to HCV infection. Injecting drug users rank as the single most at-risk group. In fact, over 80% of those studied who showed high risk for HCV had injected drugs.

In Conclusion

Goal number one is to simply not do drugs. That being said, if you or someone you know is an IDU, first and foremost please seek help. Opioid addiction ends about 100 American lives every day, and messes up plenty more. That being said, please do whatever you can to ensure that needles are never shared and are disposed of properly.

Every single time someone in America uses a needle for drug use, the potential for another Giuliana Weglinski, or another Randi Bartling, or another mom shopping for bread and finding a needle increases.