Addiction Treatment Forum - Hepatitis C: Good News and Challenges

(Following the publication of a new hepatitis C guide by the federal Substance Abuse and Mental Health Services Administration (SAMHSA), the Addiction Treatment Forum has a new article on hepatitis C in opioid treatment programs that highlights VOCAL-NY’s Beyond Methadone report and advocacy campaigns.)

Copied below are excerpts from the Addiction Treatment Forum article (view the full article here).

Hepatitis C: Good News—and Challenges

Patients’ Views

Focus groups of OTP patients interviewed in Beyond Methadone (see Resources) called for at least one onsite OTP specialist for hepatitis C—but that’s a difficult goal for a small OTP, and trained staff can fill many roles. The survey noted that about one-fourth of OTP patients didn’t know their HCV status, and didn’t recall ever being offered a test. The survey also found that more than half who tested positive said they weren’t referred for follow-up tests or medical care, nor were they aware of any support groups or educational materials at their program. Based on these focus findings, OTPs can provide more HCV education, testing, support, and treatment, either onsite or by referral.

How OTP Staff Can Help

OTPs are being called upon to help patients deal with a deadly illness. According to the Centers for Disease Control and Prevention (CDC), more people in the U.S. now die each year from hepatitis C than from AIDS—almost 5 per 100,000 from hepatitis C, vs. about 4 per 100,000 from AIDS. Clearly, early diagnosis, treatment, and support services would save much suffering and many lives. This is a great opportunity for OTPs to make a difference in the lives of their patients.

VOCAL-NY and other patient advocacy groups have long urged OTPs to provide better intervention and care for patients with HCV.  Many OTPs—67 percent, according to the National Survey of Substance Abuse Treatment Services—already test patients for HCV infection, and that’s very encouraging, but it leaves a sizeable percentage untested, therefore untreated. Some OTPs that test haven’t the resources to provide follow-up care for patients who test positive—additional tests, education, counseling, and medical care. Those OTPs will need a strong referral system to send patients elsewhere, and to make sure they follow up.

Sometimes the side effects of HCV therapy may feel similar to withdrawal symptoms. Staff can encourage peers and patients in treatment to share experiences, support each other, and help each other access care and adhere to treatment.

Many OTPs offer testing only, but staff can still help immensely by being supportive of patients and providing information about HCV in a nonjudgmental, compassionate way, referring patients to outside sources, and making sure they follow up. VOCAL-NY recommends that OTPs with limited services “establish a concrete referral system for HCV patients, and enter into memoranda of understanding (MOUs) with medical providers for follow-up care.”

Among the many wonderful resources for OTP staff in Tip 53 are leads for patients seeking financial help. Treating hepatitis C is costly and can take many months. Yearly medical expenses can easily top $60,000—and that’s before a liver transplant, which can add $100,000 to $250,000 for the procedure alone.

View the full article here.

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