by Manisha Krishnan, Vice News
A growing number of academics are openly discussing their past and present drug use in an attempt to reduce stigma and help overcome addiction.
When drug policy researcher Jean-Sébastien Fallu saw a recent op-ed in the Atlantic argue that destigmatizing drug use has been “a profound mistake,” he was furious.
The piece said “cultural disapproval of harmful behavior can be a potent force for protecting public health and safety” and that we need “more consistent rejection of drug use, not less.”
Fallu, 50, an associate professor at Université de Montréal’s school of psychoeducation, believes the opposite is true. Stigma, he said, is leading to worse health inequities and excluding people from society. It’s a feeling he’s familiar with, as an academic who for years hid the fact that he uses drugs. But now he’s “come out” about the fact that he enjoys using LSD, MDMA, 2C-B (a stimulant and hallucinogenic), weed, and alcohol, and that he thinks they’ve made him a better, more confident person. He believes his honesty, coupled with the respect he’s garnered through his career, is “destroying people’s perception that if you use drugs you’re a bad person and you cannot achieve anything good.”
“I refuse to be dehumanized,” he said.
TO CONTINUE READING: https://www.vice.com/en/article/y3w4nb/these-academics-went-public-about-using-drugs
EEN INTERLANDIJENEEN INTERLANDIEN INTERLANDI
By Jeneen Interlandi Photographs by Damon Winter
Ms. Interlandi is a member of the editorial board. Mr. Winter is a staff photographer on assignment in Opinion Dec. 13, 2023 NY Times
Humanize Drug Users
Raina Mcmahan, a 42-year-old recovery coach, spent roughly half her life seeking treatment for her own opioid use disorder.
She tried detoxing multiple times at different inpatient facilities, but those programs usually discharged her after a week or two without any follow-up care.
She paid one doctor $500 to treat her with buprenorphine, a medication that helps reduce opioid cravings, but he administered that medication improperly. When she got sick, he told her she was allergic — a falsehood she believed for years.
She tried methadone, another medication used to treat opioid addiction, but the hurdles proved insurmountable. The only clinic that had space for her was two hours away by subway, required her to report in person every day and stopped serving patients at 10 a.m. sharp. “If you got there at 10:01, they would shut the window in your face,” she told me recently. When that happened, she would have to either go without medication for the day and wind up in withdrawal or use street drugs and risk a positive urine test (which could get her expelled from the program) or an accidental overdose (which could kill her).
TO CONTINUE READING: https://www.nytimes.com/2023/12/13/opinion/addiction-policy-treatment-opioid.html?campaign_id=2&emc=edit_th_20231217&instance_id=110412&nl
Thousands die from hepatitis C every year, even though we have a nearly foolproof cure. A new plan would change that.
By Jonathan Cohn Nov 26, 2023, 08:00 AM EST |Updated Nov 26, 2023 HUFF POST
Dying from hepatitis C is a notoriously miserable way to go.
The virus attacks your liver ― in many cases, destroying its ability to make proteins and filter blood. You might not notice at first, because it can inflict damage gradually and “silently” until finally you start to feel symptoms that could include fatigue, jaundice, mental disorientation, severe itching and joint pain. Your belly could fill up with so much fluid that doctors have to drain it, while gastrointestinal difficulties might have you vomiting up blood.
This could go on for months or years, and eventually your liver could fail completely. A transplant might save you, but only if you can get one, and only if it works.
Hepatitis C kills thousands of Americans every year, making it the nation’s deadliest bloodborne infectious disease. And it doesn’t have to be this way.
There’s a cure for hepatitis C that works in almost all cases ― an antiviral medication that’s been around for a decade, needs to be taken for just two or three months, and has relatively mild side effects. But lots of Americans diagnosed with the disease aren’t getting the drug because it’s too expensive, or they’re getting it only after the virus has already done severe damage. Takeup is worst among low-income groups and uninsured people, according to the U.S. Centers for Disease Control and Prevention, although even among the privately insured, only about one-third have initiated treatment within a year of testing positive.
TO CONTINUE READING: https://www.huffpost.com/entry/biden-plan-eliminate-hepatitis-c_n_655e1590e4b0c0333bee58ac
November 11, 2023 HC P LIVE
Abigail Brooks, MA Conference|American Association for the Study of Liver Diseases
Tatyana Kushner, MD, MSCE, sat down with HCPLive to discuss the White House hepatitis C elimination plan.
In an interview with HCPLive during The Liver Meeting 2023 from the American Association for the Study of Liver Diseases (AASLD) in Boston this weekend, Tatyana Kushner, MD, MSCE, associate professor of medicine in the division of liver diseases at the Icahn School of Medicine at Mount Sinai, discussed the White House hepatitis C elimination plan, clinicians’ role in addressing this issue, and disparities in patients affected by HCV.
“The goal is to have a national plan to work towards hepatitis C elimination, and within that proposed plan, there are specific aspects to address,” Kushner explained.
Components of the goal include providing easier access to medications, improving the process from testing to treatment, and emphasizing the need for research, especially as it pertains to the development of a hepatitis C vaccine. Beyond those elements, Kushner also described the role clinicians must play in eliminating HCV and emphasized the need for screening.
“If you're seeing a patient, whether it's in primary care or any other healthcare setting, you need to screen them for hepatitis C. And that is really, really important. Even if you're not someone who sees many hepatitis C patients, it is an important part of your healthcare maintenance that you need to screen,” Kushner said
TO CONTINUE: https://www.hcplive.com/view/tatyana-kushner-md-msce-hcv-screening-treatment-and-elimination
Hepatitis C: Britons getting tattoos and cosmetic procedures abroad may be at risk – here’s how to avoid it
Published: September 28, 2023 11.52am EDT, The Conversation
A growing number of people living in the UK are going abroad to have tattoos, piercings and cosmetic surgeries. Any procedure, no matter where it’s performed, can carry the risk of injury and infection.
But people heading abroad for cosmetic procedures may want to be extra cautious – with recent reports suggesting thousands of UK residents may have unknowingly contracted hepatitis C this way.
Over 170 million people worldwide are estimated to have hepatitis C. There are approximately one million new infections each year. In England, more than 70,000 people had hepatitis C in 2022. But many more could unknowingly be infected, as hepatitis C symptoms can take years to show up.
Hepatitis C can develop into severe and fatal liver disease if undiagnosed. But when caught early, treatment is over 95% effective – highlighting just how important timely testing is.
TO CONTINUE READING: https://theconversation.com/hepatitis-c-britons-getting-tattoos-and-cosmetic-procedures-abroad-may-be-at-risk-heres-how-to-avoid-it-212645
News/Press SEPTEMBER 26, 2023
Bill Text (PDF)
Washington (September 26, 2023) – Senator Edward J. Markey (D-Mass.), chair of the Senate Health, Education, Labor, and Pensions (HELP) Subcommittee on Primary Health and Retirement Security and a member of the U.S. Commission on Combating Synthetic Opioid Trafficking, along with Senators Todd Young (R-Ind.) and Tammy Baldwin (D-Wis.), today announced the reintroduction of the Eliminating Opioid-Related Infectious Diseases Act, bipartisan legislation that would reauthorize the Centers for Disease Control and Prevention’s (CDC) ongoing initiative to eliminate the risk of infectious disease caused by substance use disorder to continue through 2028. In 2018, Senators Markey, Young, and Baldwin secured the passage of legislation to expand the CDC’s initiative to collaborate with states to improve education, surveillance, and treatment of opioid use-related infectious diseases such as human immunodeficiency virus (HIV) and hepatitis C.
The connection between HIV, hepatitis C, and injection drug-use is well-documented. This follows the CDC reporting an increasing number of hepatitis C infections over the past decade, most of which is due to injection drug-use. The high rates of transmission, especially among young people, highlights the continued need for these targeted programs to stop the spread of preventable diseases.
“The opioid epidemic is a public health crisis, and infectious diseases compound the health challenges faced by Americans suffering from substance use disorder,” said Senator Markey. “Our federal government has a duty to empower providers serving on the frontlines so they can treat every impact of this epidemic, including the spread of infectious diseases. The Eliminating Opioid-Related Infectious Disease Act gives Americans access to life-saving treatment through commonsense programs based on science. We need to lead with care that is compassionate to end this opioid and overdose crisis once and for all.”
“The fentanyl and opioid epidemic has far-reaching and deadly public health impacts, including spreading infectious diseases like hepatitis and HIV,” said Senator Baldwin. “While I am fighting to stop these drugs from coming into our communities and boost treatment and recovery efforts, Washington also needs to step up to help states curb the spread of diseases related to this crisis. Our bipartisan bill will give communities the tools they need to help save lives and fight this public health crisis on all fronts.”
TO CONTINUE READING: https://www.markey.senate.gov/news/press-releases/markey-young-baldwin-announce-bipartisan-legislation-to-combat-opioid-related-infectious-diseases
The American Association for the Study of Liver Diseases and the Infectious Diseases Society of America recently released updated guidance on testing, treating, and managing hepatitis C.
The updated guidance, published online in Clinical Infectious Disease on July 23, 2023, is focused on recommendations for addressing nonadherence; treatment options for children as young as 3 years old; hepatitis C virus (HCV)–positive organ donation; eligibility changes for a simplified treatment approach; and therapy in vulnerable populations, including incarcerated persons.
Treatment nonadherenceHCV can be treated with direct acting antivirals (DAA). Though the course of therapy is considered to be complete at 8 or 12 weeks, the guidance specifies that up to 40% of patients do not adhere to their treatment regimen.
To address this, the guidance panel developed a new treatment algorithm for patients that considers the timing and duration of nonadherence. The algorithm is broken down into two categories: interruptions prior to receiving 28 days of DAA therapy and interruptions after receiving 28 or more days of DAA therapy.
For all patients who are first nonadherent to their DAA therapy before 28 days, the panel recommends immediately restarting the course of treatment. If a patient misses 7 or fewer days, no other action is needed. If a patient misses 8 or more days, they should immediately receive an HCV RNA test after restarting therapy. If the test returns a negative reading, the patient should complete the medication for the full duration. If positive, the treatment should be extended by 4 weeks.
For patients whose nonadherence occurs after 28 days of treatment and who miss 7 or fewer days, they can immediately restart DAA and continue for the full duration. If a patient misses 8 to 20 consecutive days, they should immediately restart therapy and receive an HCV RNA test.
A negative test indicates that a patient should complete the full duration of therapy, which can be extended in certain circumstances. A positive test indicates stopping treatment and instead following a separate set of recommendations that is laid out in the retreatment section of the guidance document. Patients who miss 21 consecutive days of therapy or more should follow the same steps as a patient with a positive HCV RNA test.
TO CONTINUE READING: https://pharmacist.com/Publications/Pharmacy-Today/Article/national-infectious-disease-organizations-update-guidance-on-hepatitis-c
Tuesday, September 26, 2023
Designation, new research program and update to NIH mission are actions to ensure inclusion of people with disabilities.
Today, Eliseo J. Pérez-Stable, M.D., director of the National Institute on Minority Health and Health Disparities (NIMHD), designated people with disabilities as a population with health disparities for research supported by the National Institutes of Health. The decision was made in consultation with Robert Otto Valdez, Ph.D., the director of the Agency for Healthcare Research and Quality, after careful consideration of a report delivered by an NIMHD advisory council, input from the disability community and a review of the science and evidence. A report issued in December 2022 by the Advisory Committee to the (NIH) Director (ACD), informed by the work of the Subgroup on Individuals with Disabilities, explored similar issues faced by people with disabilities. The designation is one of several steps NIH is taking to address health disparities faced by people with disabilities and ensure their representation in NIH research.
"This designation recognizes the importance and need for research advances to improve our understanding of the complexities leading to disparate health outcomes and multilevel interventions,” said Dr. Pérez-Stable. “Toward this effort, NIMHD and other NIH institutes launched a new research program to better understand the health disparities faced by people with disabilities who are also part of other populations designated as having health disparities.”
NIMHD is the lead NIH institute on monitoring minority health and health disparities research. Designated populations experience significant disparities in their rates of illness, morbidity, mortality and survival, driven by social disadvantage, compared to the health status of the general population. A health disparity designation helps to encourage research specific to the health issues and unmet health needs of these populations. Other NIH-designated populations with health disparities include racial and ethnic minority groups, people with lower socioeconomic status, underserved rural communities and sexual and gender minority groups.
TO CONTINUE READING:https://www.nih.gov/news-events/news-releases/nih-designates-people-disabilities-population-health-disparities
by Elana Gotkine, August 22, 2023
In a clinical practice guideline issued by the American College of Obstetricians and Gynecologists and published online Aug. 17 in Obstetrics & Gynecology, recommendations are presented for hepatitis B and C virus screening in pregnancy, for management of patients with infection, and for vaccination.
Brenna L. Hughes, M.D., from the American College of Obstetricians and Gynecologists, and colleagues developed guidelines for pregnant or postpartum women and individuals who screen positive for viral hepatitis infection.
The authors recommend early universal prenatal screening for hepatitis B surface antigen (HBsAg) of all pregnant patients, regardless of history of testing or vaccination status. Triple panel screening (HBsAg, anti-HBs, and total anti-HBc) is recommended for all pregnant patients who do not have a documented negative triple screen result after age 18 years, those who did not complete vaccination, or those with ongoing risks for hepatitis B infection, regardless of vaccination status or testing history. In each pregnancy, all patients should be screened for hepatitis C virus antibodies. Prepregnancy screening for hepatitis C virus infection and treatment is recommended before pregnancy when possible. Women with hepatitis B or C virus infection should have prepregnancy counseling, including the effects of pregnancy on maternal disease and risks to the fetus and neonate. Recommended groups should undergo vaccination for hepatitis A virus, hepatitis B virus, or both during pregnancy.
July 26, 20232:33 PM ET By Bec Roldan
How do viruses do their job of infecting humans? Some of them are experts at evading the immune system so that it won't knock them out.
Take hepatitis C, a sneaky and potentially deadly viral infection of the liver that is transmitted by contact with human blood – for example, through needles, sex and childbirth.
Scientists have known for a long time that hep C can hide from our immune system. While the immune system might attack the invading virus at first, leading to mild symptoms like fever or fatigue, the virus eventually hides so the immune system gives up the chase. Which is why most patients with hep C never show symptoms.
That gives hep C plenty of time to replicate and spread throughout healthy liver cells, leading to a chronic case of hepatitis C.
"We have this constant battle going on with these viruses," says Jeppe Vinther, a professor of biology at the University of Copenhagen who studies hepatitis C. "We are trying to defeat them and they are trying to avoid being detected and defeated."
But scientists didn't know how hep C pulled off its hiding trick. A new study led by Vinther and published in the journal Nature offers an explanation.
The cap is the keySo how does hep C do it? The virus uses standard villain fare to evade detection: a mask.
Hepatitis C is an RNA virus – one of several viruses that rely on their RNA instead of their DNA to carry information needed to take over the body's healthy cells. Other RNA viruses include measles, mumps, influenza and SARS-CoV-2.
RNA molecules in our body have a protecting group of DNA building blocks at their end known as a cap. These caps have various functions, including sending a message to our immune system: Leave us alone! Do not destroy us!
Since RNA viruses lack caps, once they invade our body, says Vinther, the cell control alarm bells go off and the immune system is activated to kill the foreign RNA.
This new study shows that when your body is infected with hep C, the virus attracts a cap for its RNA – like the protective cap on the body's own RNA. The researchers don't know exactly how the hep C virus does this — one of the many mysteries about viruses.
TO CONTINUE READING: https://www.npr.org/sections/goatsandsoda/2023/07/26/1187040969/hep-c-has-a-secret-strategy-to-evade-the-immune-system-and-now-we-know-what-it-i