“Drug overdose is the leading cause of accidental death in the United States, federal statistics show, with more than 47,000 drug overdose deaths in 2014, about 19,000 linked to prescription pain pills and 10,600 ties to heroin,” according to an article. The opioid prescription epidemic is not new and many governing bodies including the Centers for Disease Control and Prevention have made recommendations to cut back on opioid prescriptions. These recommendations start with physicians, stating that opioids should not be prescribed for ongoing chronic pain. President Barack Obama even pledged $1.1 billion to fight the war against opioid addiction. In fact, a recent study has shown that prescription opioids have a high potential to lead users to illicit intravenous opioids such as heroin.
Intravenous opioids are much more dangerous than any other form of intravenous drugs, as they are one of the main causes of bloodborne illnesses. Hepatitis B, C and HIV are bloodborne diseases that can be lethal but can easily be avoided with appropriate and safe precautions. The Appalachian region in the United States has seen a huge increase in hepatitis B infections secondary to intravenous opioid drug use. The CDC reports a 114 percent increase in acute hepatitis B infection cases in Kentucky, Tennessee and West Virginia from 2006 to 2013, even though incidence in the U.S. overall remained stable. Injection drug use was reported as a risk factor in 75 percent of incidents in those states from 2010 to 2013.
The risks associated with hepatitis B
Hepatitis B can result in an acute viral infection, a chronic viral infection resulting in cirrhosis or hepatocellular carcinoma. Acute hepatitis B infection is characterized by jaundice and flu-like symptoms. Chronic hepatitis B can result in cirrhosis, which is characterized by shrinkage of the liver, resulting in decreased liver function and sometimes even requiring a liver transplant.
A vaccination series for hepatitis is required for the pediatric population and for health care workers, and is highly recommended to intravenous drug users and individuals with multiple sex partners. This is the only bloodborne virus that can be prevented through immunizations. Unfortunately, on a national level, hepatitis B vaccination coverage is low among adults and the opioid epidemic is high, leading to a messy recipe for developing hepatitis B and other bloodborne infections.
Programs that reduce harm
What if addicts cannot kick the habit? Needle exchange programs are an up-and-coming solution in harm-reduction approaches. In essence, harm reduction refers to policies and programs that aim to reduce the harms associated with drug use. A defining feature is preventing drug-related harm whether or not drug use can be stopped. There are many types of harm-reduction modalities including: drug replacement therapy such as methadone or buprenorphine (Suboxone), needle exchange programs, designated drivers, substituting abused drugs with “less harmful drugs,” testing illicit drugs for harmful additives, and behavior modification to control intake. Dirty syringes can cause HIV, hepatitis C and other bloodborne diseases.
These programs are becoming more prevalent and are an example of a harm-reduction modality. The core services provided by needle exchanges aim to increase the number of syringes in circulation, and encourage their return and safe disposal, so that each syringe is used fewer times, thereby reducing the chances of viral transmission. Louisville and Lexington, Kentucky, and many other cities and counties around the world have already initiated needle exchange programs. Hopefully these programs can help cut the hepatitis and viral bloodborne transmission rate.
Sovereign Health of California is a leading behavioral health care provider that treats people with addiction, mental health disorders and dual diagnosis. Our clinicians have experience treating opioid, heroin and many other types of addictions. For more information, please call our 24/7 helpline.
About the author
Kristen Fuller, M.D., is a senior staff writer at the Sovereign Health Group and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author, who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.