By Alan Mozes Updated on July 21, 2023

Key Takeaways
Cases of hepatitis C, a liver infection spread by blood contact, have skyrocketed during the U.S. opioid epidemic

​The upshot: Cases of the disease are rising exponentially among pregnant women.

HCV drives up the risk for poor fetal development and preterm birth

PregnancyInfectious Disease

Hepatitis C Rates Soar Among Pregnant WomenBy Alan Mozes,Updated on July 21, 2023

Key Takeaways

Cases of hepatitis C, a liver infection spread by blood contact, have skyrocketed during the U.S. opioid epidemic

The upshot: Cases of the disease are rising exponentially among pregnant women

HCV drives up the risk for poor fetal development and preterm birth

FRIDAY, July 21, 2023 (HealthDay News) – In the two decades since the opioid epidemic took off, the addiction crisis has claimed the lives of hundreds of thousands of Americans.

Now, new research points to another grim outgrowth of the crisis on American health: a skyrocketing risk in pregnant women for hepatitis infection (HCV).

That's because the main risk factor for contracting hepatitis C — a liver infection spread by blood contact -- is injection drug use.

Between 1998 and 2018, prevalence of HCV among pregnant women shot up 16-fold, researchers found, driving up the risk for poor fetal development and fetal distress, as well as preterm birth.

And that's just the broad picture among pregnant women of all ages. Among those between 21 and 30, hepatitis C risk shot up more than 3000%.

"We do think the increase in HCV infections among pregnant women in our data is concerning," noted lead author Dr. Po-Hung (Victor) Chen, an assistant professor of medicine Johns Hopkins University School of Medicine's Comprehensive Transplant Center in Baltimore.

TO CONTINUE READING:
​https://consumer.healthday.com/hepatitis-c-and-pregnancy-2662303676.html

Written by Lindsay Kalter    WebMD Health News

May 17, 2023 – Jose Martinez spent several years unhoused, jobless, and trapped in a cycle of addiction to synthetic marijuana – a lab-created drug that affected his mind and behavior and is dangerous and sometimes deadly.
His life changed when the Bronx, NY, resident began recovery in 2017, which he credits in large part to what is now an overdose prevention site in New York City’s Harlem neighborhood – one of two official so-called safe injection sites in the United States, where people can use illicit drugs under supervision of trained staff to prevent death and illness. 
The other is in the city’s Washington Heights neighborhood. At the time, both locations were needle exchanges, which merged and added supervised injection to create OnPoint NYC in 2021.
Though Martinez did not inject drugs, he took advantage of the other resources there, including laundry facilities and showers.
“People can access safer supplies, but also mental health services, and I used those,” said Martinez, 35. “Before that, I tried rehab and detox, and they didn’t work for me. The [site] helped me get there when I was ready.” 
I tried rehab and detox, and they didn’t work for me. The [site] helped me get there when I was ready.
Former addict Jose MartinezHe added, “We were a community, like a family.”
The federal government will, for the first time, bankroll a study of how well overdose prevention sites work, according to an announcement on May 8.
A grant of more than $5 million over 4 years will go to New York University and Brown University in Providence, RI, to study 1,000 people at New York’s two sites, along with one set to open in Providence next year.  
The announcement comes as deadly overdoses continue to claim lives across the country. There were more than 106,000 overdose deaths in 2021.
The approach is controversial, with critics claiming it enables illegal drug use and brings crime into surrounding areas. But overdose prevention sites already operate in 14 countries, including Canada. There are efforts to open these facilities in Colorado, New Mexico, and Nevada.
TO CONTINUE READING:  https://www.webmd.com/mental-health/addiction/news/20230517/us-will-fund-study-of-safe-injection-sites-despite-pushback

Eliminating viral hepatitis by 2030 requires support and funding from organizations large and small.
May 22, 2023 • By Laura Schmidt,  hep magazine

In an opinion piece, author and global health advocate Chelsea Clinton emphasized the importance of education, vaccination and treatment for people living with viral hepatitis, which affects almost 400 million people worldwide and kills more than 1 million each year, according to the World Health Organization (WHO). The article was cowritten by Finn Jarle Rose, the executive director of The Hepatitis Fund.
Almost 90% of people living with hepatitis do not know their status. Clinton compared the testing rates for hepatitis C virus (HCV) with those for HIV during the early years of that epidemic. “But it doesn’t have to be this way,” she wrote.
The WHO’s goal of eliminating viral hepatitis by 2030 is achievable. In fact, Egypt, which once had one of the highest rates of hepatitis C virus in the world, recently succeeded in eliminating HCV in its entire population. It did so “through a partnership approach that engaged civil society, the private sector, and philanthropic organizations to mobilize the community and increase rates of screening, diagnosis, and treatment,” wrote Clinton.

​TO CONTINUE: https://www.hepmag.com/article/chelsea-clinton-weighs-viral-hepatitis-elimination-goal

MAY 18, 2023   THE WHITE HOUSE - BRIEFING ROOM- PRESiDENTIAL ACTIONS

Thousands of Americans die every year of viral hepatitis — infections of the liver that can be managed or cured if patients know they are infected and can get treatment.  On National Hepatitis Testing Day, we urge Americans to get tested and recommit to ensuring that those who are diagnosed can receive lifesaving care.     Viral hepatitis is a hidden epidemic.  For those with hepatitis C, which spreads through contact with infected blood and is the most common strain, it can be years between the time someone is infected and when they first present symptoms, leaving far too many unaware that they are sick.  This can further spread the virus, delay treatment, and lead to serious liver disease — including cirrhosis, liver failure, liver cancer, and even death.  Pregnant women with untreated hepatitis C can also pass the virus on to their newborns.  It disproportionately affects Black Americans and Native Americans, who too often cannot access quality health care, and it is more common among those experiencing homelessness and those who are incarcerated as more than a third of people in a jail or prison can be positive at a given time.  The good news is that we now have a cure for hepatitis C that is 95 percent effective — but its high cost, among other factors, has kept it from many of the more than 2 million Americans in need.
     My new Budget includes a bold plan to change that this decade — ending hepatitis C as a public health threat by expanding testing, slashing the high cost of treatment, and promoting awareness of the risks and the cure.  It draws on work that the Department of Veterans Affairs has done in treating more than 100,000 affected veterans since 2014.  My plan would make testing quicker and simpler with more point-of-care diagnostic tests so patients can be tested and treated in a single visit, rather than having to return several times before determining their infection status.  It would pioneer innovative approaches to treating hepatitis C, including a national antiviral subscription model, so more Americans can get affordable care and taxpayers can save billions of dollars through prevention and the reduced need for treatment of advanced liver diseases.  My plan would also support grassroots public health groups; train more health care professionals; and expand mobile, telehealth, and community sites focused on hepatitis testing and care.  And it would boost progress toward a hepatitis C vaccine.

​TOCONTINUE:https://www.whitehouse.gov/briefing-room/presidential-actions/2023/05/18/a-proclamation-on-national-hepatitis-testing-day-2023/​

1. 1. 1. BRIEFING ROOM
      2. PRESIDENTIAL ACTIONS
      BRIEFING ROOM
   2. PRESIDENTIAL ACTIONS
   BRIEFING ROOM
2. PRESIDENTIAL ACTIONS

Content From: HIV.gov•Published:May 03, 2023
Topics
Hepatitis A Hepatitis Awareness Month Hepatitis B Hepatitis CHepatitis Testing Day

May is Hepatitis Awareness Month, a time to raise awareness that viral hepatitis continues to be a major public health threat in the United States. While we bring attention to viral hepatitis this month, we also recognize that the epidemic of viral hepatitis does not occur in a vacuum, but interacts with other diseases like HIV, sexually transmitted infections (STIs), and substance use disorders, also known as a syndemic.

A syndemic is the clustering and interaction of two or more diseases, impacted by social and structural determinants of health (SDOH), that leads to excess burden of disease in a population. As an example, people with HIV have a higher risk for viral hepatitis and worse health outcomes than people without HIV. Therefore, those impacted by any part of the syndemic need to be made aware of and have access to the different prevention and treatment tools for viral hepatitis, including hepatitis A and hepatitis B vaccinations, hepatitis B and hepatitis C screening, and hepatitis B and hepatitis C treatment.

The Viral Hepatitis National Strategic Plan 2021-2025 (PDF, 1.68MB) and National HIV/AIDS Strategy 2022-2025 (PDF, 1.76MB) both recommend a syndemic approach that is, a no-wrong-door-approach to healthcare services for viral hepatitis and HIV. When people get tested for HIV, they should also be tested for hepatitis B, hepatitis C and STIs. When people are treated for substance use, they should be screened for HIV, viral hepatitis, STIs and connected to appropriate services.

Below is information about new viral hepatitis resources.
TO CONTINUE READING: https://www.hiv.gov/blog/hepatitis-awareness-month-recognizing-the-syndemic-of-viral-hepatitis-hiv-stis-and-substance-use-disorder/​

When Ju Park was studying epidemiology in graduate school, she volunteered with a harm reduction organization that trained local community members on how to prevent a drug overdose. She traveled around the state to demonstrate how the medication naloxone can be used to reverse an overdose from opioids if administered in a timely manner.
After one session, a mother whose daughter had a substance abuse disorder approached Park to share a heartbreaking story: The daughter, who had been in and out of rehabilitation centers, recently experienced a relapse. She locked herself into a bathroom alone, overdosed on drugs, and died. The mother expressed gratitude for the naloxone training and told Park that she was eager to do more to help other families dealing with addiction. Park couldn't bear to tell the woman what she was thinking: Training bystanders how to administer naloxone wouldn't have saved her daughter, because nobody had been present to help.
"It made me wonder: What are we doing to help people who are using drugs alone and in secret?" recalled Park, who is now an assistant professor of epidemiology (research) at Brown University's School of Public Health and an assistant professor of medicine (research) at Brown's Warren Alpert Medical School.

That question continued to preoccupy Park as she established the Harm Reduction Innovation Lab at Rhode Island Hospital with the mission to develop, implement and evaluate interventions to promote the health and well-being of people who use drugs.

TO CONTINUE READING:  https://www.mdlinx.com/news/when-naloxone-isn-t-enough-how-technology-can-save-lives-when-people-use-drugs-when-they-re-alone/5Eienzx2HxwHLrSHx33A1J?show_order=2&utm_campaign=reg_daily-alert_230509_daily-nl-am-v3_registered-users-a90&utm_source=iterable&utm_medium=email

SCIENCE, HEALTH & TECHNOLOGY Apr 25, 2019    |   
​For more information, contact Lou Corpuz-Bosshart
Zero-tolerance messaging tuned out by most teenagers

For many parents, talking to their children about substance use is like navigating a field of landmines. It’s difficult to know exactly what to say and how to say it.
But a new study from researchers at the University of British Columbia and University of Calgary is showing the way forward. Emily Jenkins, a UBC professor of nursing who studies youth substance use, and her colleagues interviewed 83 teenagers across B.C. Interestingly, they found that a harm reduction message resonated the most with teens, instead of the typical “don’t do drugs” talk.Emily Jenkins
“Teens told us that they generally tuned out abstinence-only or zero-tolerance messaging because it did not reflect the realities of their life,” said Jenkins. “Either they or their peers were already using substances, or substance use was happening in their own family circles.”
Harm reduction is a philosophy and set of practices that acknowledge that substance use – be it drugs, cigarettes or alcohol – is a part of life. It aims to reduce the harmful effects of substance use, rather than simply ignoring or condemning it.
“Youth were more receptive when their parents talked – in a non-judgmental way – about substance use or could point to resources or strategies to help minimize the harms of use. This approach seemed to work better in preserving family relationships and youth health,” said Jenkins.
Some teens who used substances despite their families’ zero-tolerance approach reported feeling disconnected from their families. One participant, who consumed alcohol occasionally, experienced difficulties with her mother, who never drank. “When she was a teenager she never did any of that…so to her, that’s like, I’m going to hell,” she said.
Another participant whose family took a zero-tolerance position found himself unable to help a friend who was struggling with cannabis use and whose family also shunned substance use of any kind. “I just can’t help him if his dad’s not going to say anything,” he told the researchers.
However, teens still valued setting limits, the study showed.
“An overly lenient approach to substance use did not work either,” said Jenkins. “One participant who drank alcohol frequently said she was ‘sick of it’ but did not know how to scale back her drinking as her parents ‘don’t really care about what I do. I could go home drunk and they won’t do anything.’”
The study, published this month in Harm Reduction, surveyed youth ages 13-18 in urban, suburban and rural areas in B.C.
“The numbers show that the greatest levels of substance use and related harms occur amongst young people, yet youth perspectives are often missing when we formulate parental approaches to substance use,” said Jenkins. “This study goes beyond the typical approach, which features adult perspectives, and brings youth knowledge and expertise, a critical missing element in substance use programming.”
TO CONTINUE READING:​ https://news.ubc.ca/2019/04/25/teens-prefer-harm-reduction-messaging-on-substance-use/

Officials said the formal designation was a sign of the grave danger posed by xylazine, which can cause horrific wounds and, when mixed with fentanyl, increase the likelihood of overdose.
​
By Jan Hoffman  April 12, 2023 New York Times

The White House on Wednesday designated a common animal tranquilizer that is increasingly mixed into street fentanyl as an “emerging drug threat,” a formal move that requires the administration to create strategies to enhance law enforcement efforts, health interventions and data collection to combat it.
This is the first time that the White House’s Office of National Drug Control Policy has ever identified a substance for that designation, a mark of the gravity of the danger that it considers to be posed by the drug, xylazine.
Xylazine was approved for veterinary procedures, primarily in cattle and horses, 50 years ago but has never been sanctioned for medical use in humans. Known popularly as tranq or tranq dope, it is a powerful and addictive sedative that slows breathing and heart rate, increases the risk of fatal overdose and often produces severe skin ulcers and abscesses that have led to amputations.
“Many communities are not even aware of the threat in their backyard,” Dr. Rahul Gupta, the head of the drug control office, who is often referred to as the national drug czar, said in a briefing with reporters.
TO CONTINUE READING:  ​https://www.nytimes.com/2023/04/12/health/tranq-dope-xylazine.html

Agency Continues to Take Critical Steps to Reduce Drug Overdose Deaths Being Driven Primarily by Illicit Opioids
For Immediate Release:  March 29, 2023 FDA  News Release

Today, the U.S. Food and Drug Administration approved Narcan, 4 milligram (mg) naloxone hydrochloride nasal spray for over-the-counter (OTC), nonprescription, use – the first naloxone product approved for use without a prescription. Naloxone is a medication that rapidly reverses the effects of opioid overdose and is the standard treatment for opioid overdose. Today’s action paves the way for the life-saving medication to reverse an opioid overdose to be sold directly to consumers in places like drug stores, convenience stores, grocery stores and gas stations, as well as online. 
The timeline for availability and price of this OTC product is determined by the manufacturer. The FDA will work with all stakeholders to help facilitate the continued availability of naloxone nasal spray products during the time needed to implement the Narcan switch from prescription to OTC status, which may take months. Other formulations and dosages of naloxone will remain available by prescription only. 
Drug overdose persists as a major public health issue in the United States, with more than 101,750 reported fatal overdoses occurring in the 12-month period ending in October 2022, primarily driven by synthetic opioids like illicit fentanyl. 

“The FDA remains committed to addressing the evolving complexities of the overdose crisis. As part of this work, the agency has used its regulatory authority to facilitate greater access to naloxone by encouraging the development of and approving an over-the-counter naloxone product to address the dire public health need,” said FDA Commissioner Robert M. Califf, M.D. “Today’s approval of OTC naloxone nasal spray will help improve access to naloxone, increase the number of locations where it’s available and help reduce opioid overdose deaths throughout the country. We encourage the manufacturer to make accessibility to the product a priority by making it available as soon as possible and at an affordable price.” 

TO CONTINUE READING: https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray

BY EMILY ALPERT REYESSTAFF WRITER 
MARCH 9, 2023 1:14 PM PT   LA Times

The Biden administration is seeking billions of dollars for a new push to wipe out hepatitis C, a virus that has continued to kill thousands of people annually in the U.S. despite the existence of extremely effective medications that can cure the infection within months.

The five-year program, outlined as part of a broader budget proposal Thursday by White House officials, has been estimated to have a net cost of $5 billion over a decade, said Dr. Francis Collins, a special advisor to the president for special projects.

It would require an upfront investment now estimated at more than $11 billion over five years, which Collins said would be offset by government savings from preventing liver failure and other conditions that result from hepatitis C — and therefore avoiding the costs of treating them.

The exact costs would hinge on negotiations with drugmakers, who would be paid a lump sum to make an unlimited supply of direct-acting antiviral pills available to patients on Medicaid, as well as those who are uninsured, incarcerated or treated through the Indian Health Service, said Collins, the former director of the National Institutes of Health.
Such “subscription” deals have already been tested in some states in an effort to expand access to the lifesaving medication.
White House officials said the medicines can now cost roughly $20,000 per patient, but researchers have found curing patients can ultimately save money that would later be spent treating liver ailments.

TO CONTINUE READING: https://www.latimes.com/world-nation/story/2023-03-09/biden-seeks-billions-to-wipe-out-a-hepatitis-c