The opioid epidemic in the United States is taking a tremendous toll on public health and the economy. It has also led to an increase in cases of Hepatitis A and other contagious diseases. According to officials, since 2016, there have been Hepatitis A outbreaks in at least 29 states. These outbreaks have increased attention to the link between opioids and hepatitis.

Hepatitis A Outbreak Throughout the U.S.

Opiates and liver disease might not be two factors that you necessarily think of as related, but they are. Hepatitis A is a contagious liver disease that has made more than 23,600 people sick since 2016 and killed more than 230. The outbreaks in all states — except California and Utah — are ongoing, and public health experts believe the outbreak will make its way to every state.

Hepatitis A tends to follow the spread of the opioid epidemic, and it’s mostly spread among people who use drugs or are homeless, but anyone not vaccinated can get hepatitis A.

Hepatitis A tends to thrive in unsanitary conditions, and it can be transmitted as easily as through a stomach virus. If you’re exposed to tiny amounts of someone’s stool when they’re infected, you can get it. This transmission can occur through touching doorknobs, food, drinks, or items used to administer drugs. Ohio has seen more cases of Hepatitis A than any other state aside from Kentucky. In Kentucky, more than 4,800 people have been infected, and at least 60 have died from it.

Hepatitis A affects liver cells and causes inflammation. It can be mild to severe, and it can lead to liver failure and death. A vaccine was introduced in 1995 which significantly reduced the number of cases in the United States, but only 9.5% of adults 19 and older have the vaccine.

In 2018, the Eliminating Opioid-Related Infectious Diseases Act was introduced to help address the rates of infectious diseases linked to substance use disorders. If this legislation passes, it will authorize the Centers for Disease Control and Prevention (CDC) to expand an existing initiative that works to eliminate diseases caused by injection drug use. The program would grow to include education programs, surveillance, and the treatment of diseases related to opioid use, such as HIV and hepatitis C.

Hepatitis-A Risk Factors for Opioid Users

Hepatitis A is a virus, and it affects the function of your liver. You are most likely to get hepatitis A from consuming contaminated food or water, or from having close contact with someone infected. Hepatitis A causes that are linked to opioid use can include the sharing of needles and living in or visiting unsanitary places. For example, in rural areas hard-hit by the epidemic, it’s been especially hard to control the virus because there aren’t as many homeless services and shelters.

Signs and Symptoms of Hepatitis A

Hepatitis A symptoms can include:

  • Fatigue
  • Nausea or vomiting
  • Abdominal pain, especially in the upper right side
  • Clay-colored stool
  • Loss of appetite
  • Low fever
  • Joint pain
  • Dark urine
  • Yellowing of the skin and the whites of eyes
  • Itching

Hepatitis A Vaccine Administration

The CDC has been working on preventing or reducing Hepatitis A outbreaks. One way they’re doing this is by making the hepatitis A vaccine more widely available. The more people who get vaccinated, the better, particularly when people at the highest risk are vaccinated. Additionally, it’s important to continue working on opioid crisis prevention strategies such as education, medication-assisted treatment and treatment accessibility, since so many of these diseases that are quickly spreading are linked to the crisis.