... almost 60 per cent of participants [ were ] unaware that
HCV could now be treated with oral
tablets that are generally well tolerated
Testing for hepatitis C involves two tests – an antibody test that establishes whether a person has ever been exposed to the hepatitis C virus , and a polymerase chain reaction ( PCR ) test to establish if the virus is still active and requires treatment . 5 Both tests are usually done from the same blood sample , however , and further testing can then be carried out to determine the extent of any liver damage , and – in the case of advanced cirrhosis – to test for liver cancer . One significant barrier to treatment identified by the LJWG report was lack of awareness of recent advances in treatment , with almost 60 per cent of participants unaware that HCV could now be treated with oral tablets that are generally well tolerated . 4 In the past , long-term treatment with interferon was the norm , the side effects of which could include fatigue , fever , nausea and insomnia . 6
Along with people presenting late through absence of symptoms or fear of the treatment itself , another key reason why people are reluctant to come forward for testing is the stigma that still surrounds drug use . 7 Some primary care professionals can still adopt a judgemental approach towards people who use drugs , and many people will be concerned about being stigmatised further in the case of an HCV diagnosis . However , GP surgeries , sexual health clinics , genitourinary medicine ( GUM ) clinics and drug treatment services all now offer testing for hepatitis C .
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... almost 60 per cent of participants [ were ] unaware that
HCV could now be treated with oral
4
tablets that are generally well tolerated
FOR WIDER HEALTH PROFESSIONALS DISCUSSING DRUG USE WITHOUT STIGMA
NEGATIVE ATTITUDES towards people who use drugs remain common in the media and in society as a whole . The sense of stigma attached to words like ‘ junkie ’ and ‘ addict ’ – and the assumptions that people can often make about people who use drugs – can have a profound impact on mental health and discourage people from seeking the help they need .
A 2017 report from the Global Commission on Drug Policy found that stigmatising language and attitudes in the media were increasing discrimination against drug users , and helping to create an image of them as ‘ sub-human , non-citizens , scapegoats for wider societal problems ’ and undeserving of the right to health . 7 The report adds that no medical condition is ‘ more stigmatised ’ than drug use , with former head of the Global Fund to Fight AIDS , Tuberculosis and Malaria , Michel Kazatchkine , stating that , ‘ Language matters – research has shown that even trained mental health practitioners treat differently cases where patients are referred to as “ substance abusers ” than those alluded to as “ people with a substance use problem ”.’
People who have been infected with HCV via injecting drug use can often experience the ‘ double stigma ’ associated with their diagnosis and their drug use . Nearly two thirds of respondents in a survey of drug treatment staff by the I ’ m Worth … hepatitis C awareness campaign 8 , in collaboration with DDN , felt that the stigma associated with both addiction and hepatitis C meant that people were ‘ often reluctant to engage with care ’.
The contact with health services that comes with testing and treatment for HCV , however , can also act as a catalyst for seeking specialist support from drug treatment services – as well as help for other health issues – so all of this means that it is vital that health professionals discuss their clients ’ drug use in a non-judgemental way .
Professionals should try to make sure that they interact with clients in an open and approachable manner , and work to build a professional relationship with them that is built on trust , empathy and respect . As part of this it ’ s essential that they avoid using terms like ‘ addict ’, ‘ drug abuse / drug abuser ’, or ‘ clean ’ to denote someone who is no longer using drugs .
The chaotic lifestyles experienced by many people who use drugs also means that , even if they are tested and diagnosed , they may still fail to engage with treatment , so professionals will need to adopt a positive , supportive and encouraging attitude , and provide service users with all the information they need on the next steps and available treatment options .
If you do drink alcohol , always alternate your drinks with glasses of water
Abstain from alcohol completely if possible
Eat a healthy diet with lots of fresh fruit and vegetables , and cut down on your consumption of fat and salt
Never share needles or any other injecting equipment such as syringes , spoons , swabs or filters
Wider Health Series | DDN | 5