National Recovery Month: An Opportunity to Integrate Behavioral Health and Hepatitis C Prevention

Content From: Corinna Dan, R.N., M.P.H., Viral Hepatitis Policy Advisor, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services, and Michelle Moses-Eisenstein, M.P.H., Public Health Analyst, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human ServicesPublished: September 30, 20144 min read



Every year in September, we recognize National Recovery Month. Now in its 25th year, Recovery Month highlights how prevention and treatment of and recovery from mental and substance use disorders benefit individuals and our communities. This year’s theme is “Join the Voices for Recovery: Speak Up, Reach Out.”“Recovery Month reminds us that our year-round support of those in recovery, and the behavioral health providers working with them, can make a real difference in improving the health of individuals, families, and communities, including reducing the spread of viral hepatitis” remarked Dr. Ronald Valdiserri, Deputy Assistant Secretary for Health, Infectious Diseases. “Since recovery from substance abuse through effective addiction treatment can also reduce the risk for acquiring or transmitting viral hepatitis, individuals in recovery and behavioral health providers are important stakeholders in our national efforts to achieve the goals of the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis.”

We wanted to lend our voices to the observance this year by highlighting the high burden of hepatitis C virus (HCV) infection among persons who inject drugs (PWID) and the importance of HCV prevention and screening for people in recovery. Below we share information about some new resources for individuals in recovery and the substance abuse treatment staff who work with them.

HCV Infection among PWID

There has been a large increase in the use of opioid pain medications in the U.S. over the past decade, leading to an epidemic of opioid misuse. People who misuse prescription opioids are at increased risk for transitioning to injection drug use. PWID are at great risk for hepatitis C because blood-borne infections like hepatitis C can be transmitted when people share needles, as well as injection equipment like cotton and cookers. PWID are at particular risk for hepatitis C because the virus can survive on surfaces and remain infectious for up to 6 weeks.

In fact, recent studies show that approximately 70% of new hepatitis C cases in the U.S. are among PWID. These data underscore the vital importance of incorporating hepatitis C education and screening into behavioral health and substance abuse treatment services. Fortunately, there are new opportunities to expand the provision of HCV screening among PWID as a result of the U.S. Preventive Services Task Force’s recommendation for HCV screening in persons at high risk for infection. Learn more about preventive services for infectious diseases that, under the Affordable Care Act, are covered without charging a co-payment or co-insurance.

According to the Centers for Disease Control and Prevention (CDC), approximately half of people with hepatitis C are unaware of their infections and at risk for developing cirrhosis and liver cancer. Viral hepatitis is the leading cause of liver cancer and most common reason for liver transplantation in the United States. Additionally, alcohol use increases one’s risk of cirrhosis, and for people living with hepatitis C, alcohol use can make liver damage progress faster. Ensuring that people in recovery have access to preventive services to help them stay healthy and prevent transmission will benefit everyone.

Recognizing critical prevention opportunities for hepatitis C, the Action Plan for the Prevention, Care, & Treatment of Viral Hepatitis includes a Priority Area focused on reducing viral hepatitis associated with drug-use behaviors. Working with key stakeholders to mobilize communities, educate patients and providers, and prevent transmission are important components of the Action Plan.

Resources to Support Integrating Viral Hepatitis Services for People in Recovery

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The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed a new hepatitis C education resource for use by people in recovery. This free resource, Take Action Against Hepatitis C: For People in Recovery From Mental Illness or Addiction, is an easy-to-read, highly visual guide to preventing viral hepatitis infection and promoting access to screening and care for people with viral hepatitis. (See other SAMHSA resources on hepatitis C.)

A SAMHSA webinar, Screening for Viral Hepatitis within Behavioral Health Organizations, discusses psychosocial issues of viral hepatitis prevention, screening, and treatment. It features presentations by Maggie Chartier, PsyD, MPH, San Francisco VA Medical Center and University of California, San Francisco’s Department of Psychiatry, and Becky Goldberg, RN, ACRN, Ruth M. Rothstein CORE Center, with introductory remarks by Dr. Elinore McCance-Katz, SAMHSA’s Chief Medical Officer. The presentation, recording, and transcript from this webinar are all available through the SAMHSA-HRSA Center for Integrated Health Solutions.

“At SAMHSA, we believe that those with behavioral health disorders must receive care for all of their physical and mental health needs,” said Dr. McCance-Katz in the webinar. “Given the higher prevalence of hepatitis C virus infection in this population, we at SAMHSA urge providers to learn about this infection, to screen and test for it, and to refer those with infection to treatment.”

Continued efforts on the part of all stakeholders to expand and strengthen the provision of HCV prevention, screening, and, when necessary, linkage to hepatitis care and treatment services among those in recovery are vital to preventing viral hepatitis transmission and progression of disease, saving lives, and achieving the goals of the Viral Hepatitis Action Plan.