Illicit Drug Use Drives Hepatitis C, HIV Infections

Illicit drug use is a global problem that results in the spread of infections, abuse, and overdose-related deaths. Curbing this problem has been a challenge for individual countries around the world.

A new report from the United Nations Office on Drugs and Crime (UNODC) indicates that one-quarter of a billion individuals worldwide were drug users in 2015. Of this population, 29.5 million had a drug misuse disorder or engaged in problematic use.

The investigators found that opioids were involved with 70% of negative health occurrences linked to drug misuse disorders globally. Many countries are currently facing an opioid epidemic, where individuals are dying from overdoses at an alarming rate.

The investigators also discovered that amphetamine-related conditions accounted for a sizeable portion of global disease burden.

Despite the relatively small market for new psychoactive substances, drug users are generally unaware of what is actually in the drug and the content of psychoactive substances, according to the study. This can lead to an uptick in overdoses and adverse health events.

The report also indicated that hepatitis C virus (HCV) has resulted in significant harm among injection drug users (IDUs) globally. Of IDUs, more than half (6.1 million) have HCV, while 1.6 million have HIV. Approximately 1.3 million IDUs have both HIV and HCV.

Notably, the authors report that 3 times more individuals who use drugs die from HCV than from HIV. Despite advances in HCV treatment, access and adherence to therapy remains a challenge, according to the study.

“Recent advances in the treatment of hepatitis C, using direct-acting antivirals, have created a new opportunity to reduce the heavy burden of the disease among people who use drugs,” the authors wrote. “Nevertheless, accessibility remains poor for many of those in need, as such treatment options remain very expensive in most countries.”

The UNODC recognizes that more needs to be done to reduce supply and demand of illicit drugs to improve global health.

"There is much work to be done to confront the many harms inflicted by drugs to health, development, peace and security, in all regions of the world," said Yury Fedotov, executive director, UNODC.

One challenge that remains significant is the ever-changing nature of illicit drugs, with many novel substances being created and sold.

In particular, the authors point out that the opioid market is becoming more diverse and includes controlled substances and adulterated prescription drugs. By 2015, NPS spikes to 483 compared with only 260 in 2012, according to the report.

Additional actions to control the sale and use of illicit drugs are desperately needed to improve global health, including driving down new cases of HCV and HIV.

“With the continuing shifts and changes in the multiple facets of the drug problem, the timely global monitoring of drug demand and supply has never been so crucial,” the authors wrote.