The Baby Boomers grew up at a time of dramatic social change. That change marked the generation with a strong cultural cleavage, between the proponents of change and the more conservative ideations. These individuals were able to experience, first-hand, historical events such as the first man walking on the moon, the Cold War and the Vietnam War, anti-war protests, social experimentation, Woodstock and numerous protests. Given the colorful past, between 1946- 1964, it may not surprise many that the CDC estimates that 1 in 30 baby boomers has Hepatitis. However, it is more surprising that many of them are unaware that they even suffer from this lethal inflammation of the liver caused by a virus, given all of the advancements in medicine over the last several decades. The most common hepatitis viruses are HAV, HBV, HCV, and HEV (commonly referred to as types A, B, C and E). Together, HBV and HCV are the most common cause of liver cirrhosis and cancer.
Currently, there are over 20 million people in the United States who are both active and former addicts. According to the Centers for Disease Control and Prevention (CDC), from 2000 to 2015, more than half a million individuals died from drug overdoses. 91 Americans die every day from an opioid overdose. In 2017, the number of opiate overdose deaths has jumped to 144 per day. Addiction plays a multi-faceted role in how it affects society. Not only is it detrimental for the abuser’s overall health and risk of developing disease, it affects incarceration rates, vehicle accidents, employment and the overall financial burden placed on the government and health insurers. The National Institute on Drug Abuse has estimated that the annual financial burden to be in excess of $78.5 billion, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.
One may ask how this pertains to substance abuse, detoxification, and one’s overall recovery? Another often overlooked and underappreciated fact is that Hepatitis is a common disease among intravenous drug users because of the chronic incidence of unsafe needle use. It is important to note that the Hepatitis C Virus is highly infectious and can easily spread when an individual comes into contact with surfaces, equipment, or objects that are contaminated with infected blood. This still applies for amounts of blood that are so minute that the eye cannot see it.
Furthermore, this virus can survive on dry surfaces for up to 6 weeks. Injection drug abusers increase their risk of contracting Hepatitis C through the sharing or reusing of needles and syringes. Syringes with detachable needles also have a greater risk of contracting Hepatitis C due to the fact that they are able to retain more blood than fixed needles, thus increasing the risk of infection. Preparation equipment such as cookers, cotton, water, ties and alcohol swabs are easily contaminable during the drug preparation process. Fingers can easily become contaminated with the Hepatitis C Virus and contaminate other surfaces and equipment with the virus as well. Many a patient is unaware of their current Hepatitis status, and if they are, they do not pay heed to the seriousness of the condition, as they should.
During traditional detoxification, much emphasis is given to treating the current Post Acute Withdrawal Symptoms the patient is experiencing as a result of discontinuing their substances of physical and chemical dependence. Due attention is given to the detoxification protocols to ensure that the patient does not develop any severe life- threatening withdrawals, and remains as comfortable as possible during their detoxification and stabilization.
Of course, ceasing to inject oneself with needles would be the ideal modality to employ when trying to prevent contraction of Hepatitis C. There are a number of different Substance Abuse treatment centers and substance abuse treatment programs which use substances such as Subutex/Suboxone or injections such as vivitrol or sublocade, making the necessity to inject not remain. If stopping injection is not feasible at the present time, there are a number of different measures that one can take to reduce the chances of being infected. These measures are recommended by the Centers for Disease Control:
• Do not share any equipment used to inject drugs with another person.
• Always use new, sterile needles, syringes and preparation equipment—cookers, cottons, water, ties, and alcohol swabs—for each injection.
• Set up a clean surface before placing down your injection equipment.
• Do not divide and share drug solution with equipment that has already been used.
• Avoid using syringes with detachable needles to reduce the amount of blood remaining in the syringe after injecting.
• Thoroughly wash hands with soap and water before and after injecting to remove blood or germs.
• Clean injection site with alcohol or soap and water prior to injecting.
• Apply pressure to injection site with a sterile pad to stop any bleeding after injecting.
• Only handle your own injection equipment. If you do inject with other people, separate your equipment from others to avoid accidental sharing.
Hepatitis, when detected early, can be treated with antiviral medications, maximizing the chances of the patient maintaining maximal liver function, and preventing one from developing severe chronic side effects, such as liver cirrhosis and cancer. At Detox of South Florida, a premier Florida drug and alcohol treatment center Hepatitis detection and treatment is a part of our treatment protocols, alongside other traditional detoxification protocols instituted. A high level of attention is given to educating our patients on the importance of treating this curable condition in its early stages. Detox of South Florida is very fortunate to have a resident Gastroenterologist Physician, Dr. Vikram Tarugu, who is an expert in Hepatitis, available 5 days a week to address the Gastrointestinal needs of our patients.
Dr. Tahir Naeem, MD is a board certified internist in Okeechobee, Florida. He is affiliated with Raulerson Hospital and Martin Health System.
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