Addressing Viral Hepatitis in People with Substance Use Disorders: Treatment Improvement Protocol Series (Tip 53)

Introduction: An estimated 3.5-5.3 million people in the United States live with chronic viral hepatitis (Institute of Medicine [IOM], 2010). Viral hepatitis is often a silent disease whose symptoms and signs become evident only after the disease has caused severe liver damage. The symptoms of hepatitis can take decades to manifest, so many people who are infected with hepatitis are unaware that they have the disease and therefore do not seek treatment. As a result, between 2010 and 2020, an estimated 150,000 people in the United States could die of liver cancer or other hepatitis-related liver disease (IOM, 2010). For many of these people, substance use will be a major factor that contributes to or worsens their hepatitis-related outcomes. All people who use or have used illicit substances are at risk of contracting viral hepatitis. Injection drug use (IDU) is the primary way of contracting hepatitis C, and people who use substances are at risk for contracting other forms of viral hepatitis.