By Usha Lee McFarling Feb. 16, 2021 STAT
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Among the unrelenting death statistics flowing from the CDC last month, one grim non-Covid-19 statistic stood out: 81,003 deaths. That’s the number of people who died from drug overdoses in the 12-month period ending last June: a 20% increase and the highest number of fatal overdoses ever recorded in the U.S. in a single year.
The drug deaths started spiking last spring, as the coronavirus forced shutdowns, and more recent statistics from cities throughout the U.S. and Canada show the crisis has only deepened. In Colorado, overdose deaths were up 20% through the end of last year, and those involving fentanyl doubled; British Columbia officials reported nearly five overdose deaths per day in 2020, a 74% increase over the previous year; and a study released this month showed emergency room overdose visits increased up to 45% during the pandemic, even as total ER traffic slowed markedly.
The pandemic has ushered in stress, isolation, and economic upheaval — all known triggers for addiction and relapse — while robbing many people of treatment options and support systems. Addiction specialists across the country told STAT the overlapping health disasters — the historic Covid-19 pandemic colliding with a preexisting drug epidemic made deadlier by the potent synthetic opioid fentanyl — have been devastating for their patients. Many have simply disappeared; some have died; others have relapsed.
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“There’s all of these ways Covid-19 has hurt the folks we take care of,” said Stephen Taylor, a psychiatrist and addiction specialist in Birmingham, Ala., who serves as chief medical officer of the behavioral health division of Pathway Healthcare. “Efforts to get this under control have really been decimated by the pandemic.”
Taylor described a patient who spoke only Spanish and had been doing well in recovery from opioid addiction for several months. “He’d found this excellent all-Spanish AA meeting. But that group wasn’t able to go online,” Taylor said. “That guy was all of a sudden without his 12-step group, and he relapsed.”
The increase in opioid deaths is crushing to those who work in public health and addiction treatment, who were finally making headway, thanks to growing public attention and government funding. Overdose deaths had fallen in 2018 for the first time in years. But the spread of fentanyl began to erode those gains, and now the pandemic has severely undercut efforts to control the opioid epidemic; with public health officials focused so heavily on the coronavirus, suffering and death due to substance abuse has largely fallen off the radar.

TO CONTINUE READING: https://www.statnews.com/2021/02/16/as-pandemic-ushered-in-isolation-financial-hardship-overdose-deaths-reached-new-heights/?fbclid=IwAR0hf4_PgPriFjAp1kNcFjqaAmRgQw3onaXoJNqARRar50TpazTTokdjkGI

​In this HepVu Q&A, Frank Hood of The AIDS Institute explains the need for viral hepatitis elimination and the logistics behind budget negotiations.

Frank Hood is the Manager of Hepatitis Advocacy for The AIDS Institute.

Q: What brought you to Hepatitis C advocacy and can you describe your work at The AIDS Institute? How do viral hepatitis efforts fit in with AIDS Institute’s advocacy on HIV?
I’ve been fortunate enough to spend my career helping people access better healthcare, safer workplaces, and stronger communities. I started working in the implementation of the Affordable Care Act (ACA), which solidified my focus on public health and how it affects not only individuals, but also entire communities. As I advanced through my career and the opportunity with The AIDS Institute around Hepatitis C came up, I realized that we were just resources and dedicated personnel hours away from eliminating this infectious disease – and jumped right in.
Working in the progressive and LGBTQ community gave me experience with the impact of HIV, so working with an issue directly tied to HIV is another big reason I moved into the viral hepatitis space. We can’t talk about HIV health unless we also talk about viral hepatitis health. About a third of people living with HIV in the U.S. are also co-infected with viral hepatitis, either Hepatitis C or B. Persons with HIV and viral hepatitis have worse health outcomes than those persons who have viral hepatitis but are not infected with HIV.
At The AIDS Institute, we advocate a syndemic approach to viral hepatitis elimination by leveraging not only best practices, but also the existing public health infrastructure for HIV, STDs, and other infectious diseases. For example, if someone gets an HIV test, they should get tested for viral hepatitis at the same time.
In addition to screening, there are connections within HIV treatment programs, such as the Ryan White HIV/AIDS program, to provide viral hepatitis care for co-infected patients. Viral hepatitis advocates also keep updated on the U.S. Department of Health and Human Services (HHS)’ Ending the HIV Epidemic: A Plan for America (EHE) plan, because it provides an infrastructure framework that can also positively impact viral hepatitis in the country by expanding provider locations and scope of programs to attract people living with viral hepatitis. The AIDS Institute and various viral hepatitis organizations will participate in advocacy days with other infectious disease groups to work together, because these diseases are very much intertwined. There is a huge syndemic focus on these diseases, including injection drug use and lack of sterile injection equipment.
Q: What is the current landscape of viral hepatitis funding in the U.S.? How does it compare to other diseases, and has it been impacted by the COVID-19 pandemic?
The current funding landscape for viral hepatitis in the U.S. is abysmal – but improving. We have had some success generating additional funding from Congress over the last four or five fiscal years, but it is still dramatically less than what we need.
The Centers for Disease Control and Prevention’s Division of Viral Hepatitis received core prevention and surveillance funding of less than $40 million in fiscal year 2021. According to experts, the CDC needs nearly ten times that amount to put the U.S. on a path toward elimination. Viral hepatitis funding is significantly lower than dedicated funding for other infectious diseases, and that must be increased to effectively mount an elimination campaign. We urge Congress and the administration to do that in conjunction with funding to combat the opioid crisis, because the increasing incidence of Hepatitis C is directly tied to injection drug use and lack of sterile injection equipment.
We also urge Congress to bolster funding for the entire public health system, because a stronger system will help identify and contain viral hepatitis outbreaks, and to take a syndemic approach that allows state and local programs flexibility to address multiple infectious diseases at once. Many of the populations at increased risk for viral hepatitis are also at increased risk for HIV, STDs, and COVID-19.
The impact of COVID-19 on viral hepatitis funding is complex. State and local budgets have taken a hit in the last year, and we are concerned that there may be budget cuts that could set back viral hepatitis programs as a result. Many of those programs had to reduce their activities in 2020 because of COVID-19, and we expect to see an increase in unmet need in 2021. Congress did not allocate any hepatitis-specific funding as part of the COVID-19 stimulus packages in 2020, but we will be advocating for that this year. That said, COVID-19 has also really put a spotlight on the value of a strong public health system, and what happens when that system is neglected. We hope that will spur some members of Congress to champion increasing funding to fight infectious diseases, including viral hepatitis.

TO CONTINUE READING: https://hepvu.org/hepvu-qa-frank-hood-on-the-importance-of-funding-viral-hepatitis-elimination/

A report from Germany provides more evidence that SARS-CoV-2 can invade the liver and cause damage.
"Our study demonstrates once again that COVID-19 is a systemic disease and that SARS-CoV-2 damages the liver and results in vascular injury," Dr. Jan Schulte am Esch of the University Hospital of Bielefeld told Reuters Health by email.
He and his colleagues analyzed liver tissue obtained at autopsy from 60 patients who died of COVID-19 pneumonia in Hamburg between March and June, as well as a control of 13 patients who died of pneumonia but did not have SARS-CoV-2 infection.
Only five patients with COVID-19 and one control had a history of liver disease, the team reports in Clinical Gastroenterology and Hepatology.

"We show in this paper the essential elements of the liver pathology that result in the abnormal hepatic function, seen in severe forms of COVID-19. The changes manifest as thromboses of hepatic micro-vessels and sinusoids with aberrant hepatic regeneration responses, as has already been observed for other forms of viral hepatitis," Dr. Shulte am Esch told Reuters Health.

TO CONTINUE READING: https://www.mdlinx.com/news/more-evidence-that-sars-cov-2-damages-the-liver/6cbEeeJHlppaFTCg0Xx7rp?show_order=2&utm_campaign=All+SP+2%2F6%2F2021+M

BGU researchers and their collaborators at Harvard say they’ve adapted the Mediterranean diet to make it twice as effective in eliminating liver fat by tweaking the traditional regimen to include special greens.
“Over 20 years, our research team has shown through rigorous, randomized long-term trials that the Mediterranean diet, rich with wholegrains, fruit, vegetables, and nuts, is the healthiest,” says BGU’s Prof. Iris Shai.
“Now, we have found that specific changes to this diet can cause a big reduction in liver fat,” says Shai, an expert epidemiologist in BGU’s School of Public Health.

The study conducted by Shai, who is also an adjunct professor at the Harvard T.H. Chan School of Public Health, was recently published in the peer-reviewed journal Gut. Several Harvard scholars were involved in the study.
In an 18-month 294-participant study conducted in southern Israel, two-thirds of participants ate a Mediterranean diet and exercised regularly. They lost weight in similar amounts,
“Even though the Mediterranean diet and the green Mediterranean diet led to equal weight loss overall, fat loss in the liver was doubled among those who had the green diet,” Shai says.
“The liver is so important for general human health, and fatty liver disease has wide implications, but there’s a lack of drug treatments and a lack of dietary protocol beyond general weight loss, which makes this finding important.”

TO CONTINUE READING: https://www.mdlinx.com/news/green-mediterranean-diet-reduces-liver-fat/3aW6CGbJP9WLApGrtWoYq3?show_order=5&utm_campaign=All+SP+1%2F30%2F2021+Morning+Alert&utm_medium=email&utm_source=iPost&ipost_environment=m3usainc&iqs=9z2z90prmbgvpmjhlcvm8s9lt6pales36bdioqd7tg8

A person can be infected for years without having symptoms of hepatitis C. During that time, their liver is being damaged.
January 22, 2021 • By Connie M. Welch HEP

People can mistakenly think if they do not have risk factors then they do not have hepatitis C. Unfortunately, this is wrong. Many people without risk factors may never know how they got hepatitis C. The best proactive step you can take is to get tested and seek treatment and get cured.


The Danger of Not Knowing
A simple blood test is the only way to know if you have hepatitis C. Being proactive in avoiding what is harmful to your liver is vital to your liver health. The liver performs many vital functions for the body. You can not live without your liver. The liver can regenerate healthy liver tissue to a point, but once permanent scarring (cirrhosis) is done, liver function is compromised and can not be fully restored.


You can not fix what you do not know. Get tested and be proactive with seeking treatment.

​TO CONTINUE READING:https://www.hepmag.com/blog/importance-hepatitis-c-treatment

Judy George, Senior Staff Writer, MedPage Today December 17, 2020

​Is COVID-19 response to blame? Probably, Redfield suggests

The CDC issued a Health Alert Network advisory to medical and public health professionals and others Thursday, saying drug overdose deaths have soared to the highest number ever recorded in a 12-month period.
Approximately 81,230 drug overdose deaths occurred in the U.S. in the 12 months ending May 2020, with the largest spike after the COVID-19 public health emergency started, from March 2020 to May 2020.
Drug overdose deaths were rising before March, but the findings suggest they accelerated during COVID-19, the agency said.

"The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard," said CDC Director Robert Redfield, MD, in a statement. "As we continue the fight to end this pandemic, it's important to not lose sight of different groups being affected in other ways. We need to take care of people suffering from unintended consequences."
The number of deaths increased 18.2% from the 12-month period ending in June 2019 to the 12-month period ending in May 2020 and appeared to be driven largely by deaths involving synthetic opioids like illicitly manufactured fentanyl, according to the CDC.
Of 38 jurisdictions with available synthetic opioid data in the CDC's analysis, 37 reported increases in synthetic opioid overdose deaths. Eighteen reported increases greater than 50%. Ten western states reported more than a 98% increase in synthetic opioid-involved deaths.
Cocaine-related overdose deaths also increased by 26.5% in the 12-month period; these were likely connected to using cocaine together with illicitly manufactured fentanyl or heroin, the CDC noted.

TO CONTINUE READING: https://www.medpagetoday.com/publichealthpolicy/opioids/90304

The people directly affected by conditions like substance use disorder should be involved at the state and federal levels in developing policies.
​
Ryan Hampton, Opinion contributor, USA TODAY Published December 31st, 2020

Connections, whether with friends and family, support groups or other types of programs, are critical to recovery. The coronavirus pandemic has interrupted support and services, amplified stress and anxiety, and added physical distancing requirements to people already feeling isolated. Those factors have made it even harder for people to take the first step toward remission from substance use disorder.
As a result, experts have called for more resources and heightened intervention to reduce substance use disorders since early in the pandemic. With little action from federal and state governments over the past 10 months, however, we are starting to see alarming trends.
This month, the American Medical Association noted that more than 40 states have reported increases in opioid-related deaths. In my home state of Nevada, we saw a 50% increase in opioid and fentanyl-involved drug overdose deaths in the first six months of the year. A Centers for Disease Control and Prevention report published in August found respondents were more likely to start or increase substance use to cope with COVID-19 stress and emotions, including 24.7% of essential workers.
This much is clear: To prevent further loss of life, COVID-19 recovery efforts must include mental health treatment and substance use recovery — and advocates from the recovery community need a seat at the table.
There’s a rallying cry in the recovery community: “Nothing about us, without us.” This means that the people directly affected by conditions like substance use disorder should be involved at the state and federal levels in developing policies.
We may not all have doctorates, but we’re certainly experts in our conditions. To that end, President-elect Biden must ensure that people in recovery are represented in his administration, ensuring that any policy solutions around drug use and addiction are informed by the experiences of people who have lived with that reality.
Support peer recovery effortsIn the recent COVID relief package, a late revision by the Senate wiped out a critical component from the original proposal — $75 million for peer recovery support services. These essential services provide a lifeline to Americans who fall through gaps in addiction treatment.
Peer recovery support provides non-clinical services that educate and support individuals as they make changes necessary for recovery from substance use disorder. This is a striking example of why voices with personal experience must have substantial weight in decision-making within this new administration: to avoid catastrophic policy blind spots that could lead to increased overdoses.
Lost in the flurry of Biden’s recent high-level nominations are key roles that will guide the nation’s response to our worsening addiction and mental health crisis. The Assistant Secretary for Mental Health and Substance Use and directors at the Substance Abuse and Mental Health Services Administration will have a strong influence on how treatment is provided.

​TO CONTINUE READING: https://www.usatoday.com/story/opinion/2020/12/31/how-joe-biden-can-reduce-surge-drug-overdoses-column/4084961001/

December 22, 2020
Rachel Lutz     HCP Live

​The investigators measured a 3.5-month period before and after a policy was implemented to preserve hospital resources.

Preserving hospital resources in the face of the novel coronavirus (COVID-19) pandemic has led to gaps in routine coverage, including screening and identifying patients with hepatitis C, according to a paper published in the Journal of Primary Care & Community Health.
A research team from Boston Medical Center said that the COVID-19 pandemic has led to modifications to their health care system, which were designed to preserve resources and decrease ambulatory in-person visits beginning March 16, 2020. The study authors also noted that telemedicine was incorporated into clinical workflows but preventative care, including hepatitis C testing, was not routinely performed.
Thus, the investigators wanted to determine what impact their COVID-19 restructuring response had on hepatitis C testing as well as identification hospital-wide and in ambulatory settings. To do so, they compared unique patient data tests for a period of 3.5 months before and after March 16.
Boston Medical Center described their testing process as utilizing reflex confirmatory testing for hepatitis C, and when a sample is Ab positive, it is automatically sent for RNA and genotype testing. They routinely screen for hepatitis C in the emergency department and their ambulatory clinics, aligned with the United States Preventive Services Task Force (USPSTF) guidelines released in March and the US Centers for Disease Control and Prevention (CDC) guidelines released in April.
Hepatitis C Ab testing and new hepatitis C RNA identification decreased hospital-wide and in the ambulatory clinics alone after the preservation of resources restructuring took affect on March 16.
TO CONTINUE READING:​https://www.hcplive.com/view/flu-vaccine-could-reduce-severity-covid-19

DEC 15, 2020 Tanya Albert Henry Contributing News Writer AMA

​
A few countries in Europe in the 1980s tried something new to reduce the harms associated with the use of illicit drugs: A supervised, hygienic facility where people could consume pre-obtained drugs, be monitored for overdoses, have access to counseling, and get referrals to health care and social services, including drug treatment.

Today, about 120 legally sanctioned supervised consumption sites operate in 11 countries globally, including Canada, Germany and Switzerland. Now there’s a proposal for the first supervised consumption site to open in the United States, but the federal government filed a lawsuit to block it from opening in Philadelphia. They argue it violates a section of the Controlled Substances Act that was aimed at making it easier for police to arrest individuals who opened and used buildings to produce, sell, or use crack cocaine.

Medical experts disagree.

​In an amicus brief, the Litigation Center of the American Medical Association and State Medical Societies joined the Pennsylvania Medical Society, Philadelphia County Medical Society and about a dozen other organizations to provide information to the U.S. Court of Appeals for the 3rd Circuit that years of evidence show that these facilities provide evidenced-based medical and health interventions that help save lives, offer access to necessary services, and provide support to people who use drugs.

TO CONTINUE READING: https://www.ama-assn.org/delivering-care/opioids/will-us-get-its-first-supervised-drug-consumption-site

By Elizabeth Elizalde     December 18, 2020 | 6:16pm | Updated NEW YORK POST

Drug overdose deaths have substantially increased in the U.S., and set a new record for fatalities in the year ending in May, the Centers for Disease Control and Prevention announced.
The CDC’s Health Alert Network released a report Thursday saying 81,230 drug overdose deaths occurred during that time starting in June 2019.
“This represents a worsening of the drug overdose epidemic in the United States and is the largest number of drug overdoses for a 12-month period ever recorded,” the agency said.
The CDC noted that “after declining 4.1% from 2017 to 2018, the number of overdose deaths increased 18.2% from the 12-months ending in June 2019.”
Drug overdose fatalities were already on the rise before the start of 2020, but accelerated once the COVID-19 pandemic stuck, the CDC says.


Synthetic opioids have been the primary source of the increases in overdose deaths, the agency continued, and that, “The 12-month count of synthetic opioid deaths increased 38.4% from the 12-months ending in June 2019 compared with the 12-months ending in May 2020.”
The CDC recommends expanding the use of naloxone, a medication that treats overdoses during emergencies, and that people should take overdose prevention classes.

TO CONTINUE READING: https://nypost.com/2020/12/18/us-drug-overdoses-skyrocketing-cdc/?fbclid=IwAR19tSp2iA77WieBv-elmY4eoiAIpXnKElTzrf7zuLUtS3rlJyPc1Q2xU2o