Relapse to Injecting Drug Use: A Hepatitis C Treatment Concern

Abstract

In light of current initiatives to increase hepatitis C treatment uptake amongst current and former injectors, this article aims to explore the barriers and facilitators to treatment uptake from the patient's perspective. Semistructured interviews were conducted with people living with hepatitis C in Auckland, New Zealand and Sydney, Australia in 2004 and 2006. This article explores in detail one significant issue that has not so far been addressed in the social research literature about decision making for hepatitis C treatment. This is the concern expressed by a quarter of the 34 ex-injecting participants regarding the potential for hepatitis C treatment to cause a relapse to injecting drug use. The connection between hepatitis C treatment and relapse to injecting drug use is supported by a substantial clinical literature. Thus the proposed expansion of hepatitis C treatment into alcohol and other drug settings needs to be undertaken with caution.

Keywords

Hepatitis C interferon injecting drug use

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References

Astone

Strauss

Hagan

, & Des Jarlais

D.C.

(2004). Outpatient drug treatment program directors' hepatitis C-related beliefs and their relationship to the provision of hepatitis C services. American Journal of Drug and Alcohol Abuse, 30, 783–797.

Backmund

Meyer

Zielonka

M. V.

, & Eichenlaub

(2001). Treatment of hepatitis C infection in injection drug users. Hepatology, 34(1), 188–193.

Berk

S. I.

Litwin

A. H.

Arnsten

J. H.

Soloway

, & Gourevitch

M. N.

(2007). Effects of pegylated interferon alfa-2b on the pharmacokinetic and pharmacodynamic properties of methadone: A prospective, nonrandomized, crossover study in patients co-infected with hepatitis C and HIV receiving methadone maintenance treatment. Clinical Therapeutics, 29(1), 131–138.

Childress

Ehrman

McLellan

MacRae

Natale

, & O'Brien

(1994). Can induced moods trigger drug-related responses in opiate abuse patients? Journal of Substance Abuse Treatment, 11(1), 17–23.

Crooks

Pell

Hill

, & Spina

(2007). Evaluating the hepatitis C community prescribing pilot P17. Journal of Gastroenterology & Hepatology, 22(S3), A283.

Crosbie

(2008). Marketing Manager, Roche Pharmaceuticals, New Zealand (personal communication, September 8, 2008).

Dalgard

Bjøro

Hellum

Myrvang

Skaug

Gutigard

(2002). Treatment of chronic hepatitis C in injecting drug users: 5 years' follow-up. European Addiction Research, 8(1), 45–49

Davis

G. L.

, & Rodrigue

J. R.

(2001). Treatment of chronic hepatitis C in active drug users. The New England Journal of Medicine, 345(3), 215–217.

Doab

Treloar

, & Dore

(2005). Knowledge and attitudes about treatment for hepatitis C virus infection and barriers to treatment among current injection drug users in Australia. Clinical Infectious Diseases, 40(S5), S313–S320.

10.

Dore

(2008). Head of Viral Hepatitis Clinical Research Program, National Centre in HIV Epidemiology and Clinical Research, Australia (personal communication, September 3, 2008).

11.

Edlin

B. R.

Kresina

T. F.

Raymond

D. B.

Carden

M. R.

Gourevitch

M. N.

Rich

J. D.

(2005). Overcoming barriers to prevention, care, and treatment of hepatitis C in illicit drug users. Clinical Infectious Diseases, 40(S5), S276–S285.

12.

Fireman

(2003). Hepatitis C treatment and substance use disorders. Psychiatric Annals, 33(6), 402.

13.

Fraenkel

McGraw

Wongcharatrawee

, & Garcia-Tsao

(2005). What do patients consider when making decisions about treatment for hepatitis C? American Journal of Medicine, 118(12), 1387–1391.

14.

Fraenkel

McGraw

Wongcharatrawee

, & Garcia-Tsao

(2006). Patients' experiences related to antiviral treatment for hepatitis C. Patient Education and Counseling, 62, 148–155.

15.

Geppert

C. M. A.

, & Arora

(2005). Ethical issues in the treatment of hepatitis C. Clinical Gastroenterology and Hepatology, 3(10), 937–944.

16.

Grebely

Genoway

K. A.

Raffa

J. D.

Dhadwal

Rajan

Showler

(2008). Barriers associated with the treatment of hepatitis C virus infection among illicit drug users. Drug and Alcohol Dependence, 93(1–2), 141–147.

17.

Hallinan

Byrne

Agho

, & Dore

G. J.

(2007). Referral for chronic hepatitis C treatment from a drug dependency treatment setting. Drug and Alcohol Dependence, 88(1), 49–53.

18.

Hepatitis C Virus Projections Working Group. (2006). Estimates and projections of the hepatitis C virus epidemic in Australia. Sydney: National Centre in HIV Epidemiology and Clinical Research, UNSW.

19.

Hoofnangle

, & Seeff

(2006). Peginteferon and ribavirin for chronic hepatitis C. The New England Journal of Medicine, 355(23), 2444–2451.

20.

Hopwood

(2003). New treatment for hepatitis C infection. Sydney: National Centre in HIV Social Research, The University of New South Wales.

21.

Hopwood

, & Treloar

(2005). The experience of interferon-based treatments for hepatitis C infection. Qualitative Health Research, 15(5), 635–646.

22.

Hyman

S. M.

Fox

Hong

K. I. A.

Doebrick

, & Sinha

(2007). Stress and drug-cue-induced craving in opioid-dependent individuals in naltrexone treatment. Experimental and Clinical Psychopharmacology, 15(2), 134–143.

23.

Matthews

A. M.

Fireman

Zucker

Sobel

, & Hauser

(2006). Relapse to opioid use after treatment of chronic hepatitis C with pegylated interferon and ribavirin. The American Journal of Psychiatry, 163(8), 1342.

24.

Matthews

Kronborg

I. J.

, & Dore

G. J.

(2005). Treatment for hepatitis C virus infection among current injection drug users in Australia. Clinical Infectious Diseases, 40, S325–S329.

25.

McNally

, & Temple-Smith

(2006). Now, later or never? Challenges associated with hepatitis C treatment. Australian and New Zealand Journal of Public Health, 30(5), 422–427.

26.

McNally

Temple-Smith

, & Pitts

(2004). Making decisions about hepatitis C treatment. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University.

27.

Munoz-Plaza

Strauss

Astone-Twerell

Des Jarlais

D. C.

, & Hagan

(2006). Staff perspectives on facilitating the implementation of hepatitis C services at drug treatment programs. Journal of Psychoactive Drugs, 38, 233–241.

28.

Munoz-Plaza

C. E.

Strauss

Astone-Twerell

Jarlais

D. D.

Gwadz

Hagan

(2008). Exploring drug users' attitudes and decisions regarding hepatitis C (HCV) treatment in the U.S. International Journal of Drug Policy, 19(1), 71–78.

29.

National Centre in HIV Epidemiology and Clinical Research. (2007a). Australian NSP Survey National Data Report 2002–2006. Sydney: National Centre in HIV Epidemiology and Clinical Research, UNSW.

30.

National Centre in HIV Epidemiology and Clinical Research. (2007b). HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2007. Sydney: National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales.

31.

Robaeys

Van Vlierberghe

Mathei

Van Ranst

Bruckers

, & Buntinx

(2006). Similar compliance and effect of treatment in chronic hepatitis C resulting from intravenous drug use in comparison with other infection causes. European Journal of Gastroenterology & Hepatology, 18(2), 159–166.

32.

Russo

M. W.

, & Fried

M. W.

(2003). Side effects of therapy for chronic hepatitis C. Gastroenterology, 124(6), 1711–1719.

33.

Sheerin

I. G.

Green

F. T.

, & Sellman

J. D.

(2004). What is the cost effectiveness of hepatitis C treatment for injecting drug users on methadone maintenance in New Zealand? Drug and Alcohol Review, 23(3), 261–272.

34.

Sheppard

, & Hubbert

(2006). The patient experience of treatment for hepatitis C. Gastroenterology Nursing, 29(4), 309–315.

35.

Sherman

J. E.

Zinser

M. C.

Sideroff

S. I.

, & Baker

T. B.

(1989). Subjective dimensions of heroin urges: Influence of heroin-related and affectively negative stimuli. Addictive Behaviors, 14(6), 611–623.

36.

Sievert

(2001). An overview of antiviral therapy for chronic hepatitis C infection. In Crofts

Dore

, & Locarnini

, (Eds.). Hepatitis C: An Australian Perspective. IP Communications: Melbourne.

37.

Stephenson

(2001). Former addicts face barriers to treatment for hepatitis C. The Journal of the American Medical Association, 285(8), 1003.

38.

Stoové

M. A.

Gifford

S. M.

, & Dore

G. J.

(2005). The impact of injecting drug use status on hepatitis C-related referral and treatment. Drug and Alcohol Dependence, 77(1), 81–86.

39.

Swan

, & Raymond

(2004). Hepatitis C virus (HCV) and HIV/HCV coinfection: A critical review of research and treatment. New York: Treatment Action Group.

40.

Sylvestre

D. L.

(2002). Treating hepatitis C in methadone maintenance patients: An interim analysis. Drug and Alcohol Dependence, 67(2), 117–123.

41.

Sylvestre

D. L.

(2003). Injection drug use and hepatitis C: From transmission to treatment. Psychiatric Annals, 33(6), 377.

42.

Sylvestre

D. L.

(2005). Treating hepatitis C virus infection in active substance users. Clinical Infectious Diseases, 40(S5), S321–S324.

43.

Sylvestre

D. L.

, & Clements

(2007). Adherence to hepatitis C treatment in recovering heroin users maintained on methadone. European Journal of Gastroenterology & Hepatology, 19(9), 741–747.

44.

Sylvestre

D. L.

Loftis

J. M.

Hauser

Genser

Cesari

Borek

(2004). Co-occurring hepatitis C, substance use, and psychiatric illness: Treatment issues and developing integrated models of care. Journal of Urban Health, 81(4), 719–734.

45.

Topp

(2007). 1 client, 2 needs: Improving access to hep C services. Of Substance, 5(2), 14–16.

46.

Treloar

, & Fraser

(in press). Hepatitis C treatment: Increasing treatment uptake needs a critical view [Commentary]. Drug and Alcohol Review.

47.

Van Thiel

Anatharaju

, & Creech

(2003). Response to treatment of hepatitis C in individuals with a recent history of intravenous drug abuse. The American Journal of Gastroenterology, 98(10), 2281–2288.

48.

Vassilev

Strauss

Astone

Friedmann

, & Des Jarlais

D. C.

, (2004). Provision of on-site medical care to patients with hepatitis C in drug treatment units. Journal of Health Care for the Poor and Underserved, 15, 663–671.

49.

Walter

Wiesbeck

G. A.

Bloch

Aeschbach

Olbrich

H. M.

Seifritz

(2008). Psychobiological responses to drug cues before and after methadone intake in heroin-dependent patients: A pilot study. European Neuropsychopharmacology, 18(5), 390–393.

50.

Weiss

(2005). Neurobiology of craving, conditioned reward and relapse. Current Opinion in Pharmacology, 5(1), 9–19.

51.

Winstock

Anderson

, & Sheridan

(2006). National survey of HIV and hepatitis testing and vaccination services provided by drug and alcohol agencies in Australia. Medical Journal of Australia, 184, 560–562.

52.

World Health Organization. (2002). Hepatitis C. Factsheet number 164. Retrieved April 14, 2007 from http://www.who.int/mediacentre/factsheets/fs164/en.

53.

Zickmund

Bryce

Blasiole

Shinkunas

LaBrecque

, & Arnold

(2006). Majority of patients with hepatitis C express physical, mental, and social difficulties with antiviral treatment. European Journal of Gastroenterology & Hepatology, 18(4), 381–388.