scholarly journals 1315. Mind the Gap: Medical Trainees Require Training in Hepatitis C, Drug Use and Mental Health to Help Address the Opioid Crisis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S402-S402
Author(s):  
Kimberly Corace ◽  
Isabelle Ares ◽  
Nicholas Schubert ◽  
Jason Altenberg ◽  
Melanie Willows ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Hepatitis C ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Opioid Epidemic ◽  
Hcv Treatment ◽  
Medical Trainees ◽  
Opioid Crisis

Abstract Background Dramatic increases in acute hepatitis C (HCV) incidence is linked to the opioid epidemic and increased injection drug use. Over 50% of people with HCV also have a mental illness. IDSA/HIVMA calls for the integration of infectious diseases, addiction medicine, and mental health as key to addressing the opioid epidemic. Barriers identified include limited physician education and stigma. This study examined medical trainees’ gaps in training and attitudes toward HCV, drug use, and mental illness. Methods Medical students and residents (N = 98) at a large Canadian University completed questionnaires assessing stigma, attitudes, knowledge, and training related to HCV, drug use, and mental illness. Results Most participants were medical residents (71%). Within-subjects ANOVAs showed that trainees worked with more patients with mental illness (71%) than drug use (55%) or HCV (21%) (P’s < 0.001). Trainees reported less positive experiences with patients with drug use (34%) and HCV (36%) compared with those with mental illness (55%) (p’s < 0.05). They reported that injection drug use (68%), prescription opioids (66%), and heroin use (59%) were the most challenging substance use problems to treat (P < 0.001). They were less satisfied working with patients with drug use (40%) or HCV (40%) than mental illness (59%) (P’s < 0.01). Trainees reported they were more able to help patients with mental illness (83%) than HCV (65%) or drug use (73%) (P’s < 0.01). Only 34% saw HCV treatment as central to their professional role. Their training better prepared them to treat mental illness (58%) than drug use (41%) or HCV (19%) (P’s < 0.001). They were more interested in training in drug use (76%) and mental health (71%) than HCV (62%) (P’s < 0.01). Conclusion Medical trainees report being ill-equipped to treat patients with HCV and drug use (specifically opioids) and are less satisfied with this work. Many report attitudes that may be viewed by patients as stigmatizing. There is a large knowledge gap related to the effectiveness of HCV treatment. Addressing the opioid crisis requires a physician workforce that is prepared to integrate treatment for HCV, drug use, and mental illness. Infectious disease specialists can take a leadership role in building capacity to foster integration. Disclosures All authors: No reported disclosures.

scholarly journals Why the Treatment of Mental Disorders Is an Important Component of HIV Prevention among People Who Inject Drugs

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Elizabeth Buckingham ◽  
Ezra Schrage ◽  
Francine Cournos
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Drug Use ◽  
Mental Disorders ◽  
Hiv Infection ◽  
Injection Drug Use ◽  
People Who Inject Drugs ◽  
Injection Drug ◽  
Hiv Care ◽  
Hiv Positive

People who inject drugs are more likely to be HIV positive and to have a mental disorder than the general population. We explore how the detection and treatment of mental illness among people who are injecting drugs are essential to primary and secondary prevention of HIV infection in this population. Aside from opioid addiction, few studies have been conducted on the links between mental disorders and injection-drug use. However, independent of the injection-drug use literature, a growing number of studies demonstrate that untreated mental illness, especially depression and alcohol/substance use disorders, is associated with HIV-related risk behaviors, acquiring HIV infection, failure to access HIV care and treatment, failure to adhere to HIV care and treatment, and increased morbidity and mortality from HIV-related diseases and comorbidities. In our review of both the published literature and gray literature we found a dearth of information on models for providing care for both opioid addiction and other mental illnesses regardless of HIV status, particularly in low- and middle-income countries. We therefore make recommendations on how to address the mental health needs of HIV-positive people who inject drugs, which include the provision of opioid substitution therapy and integrated mental health, substance abuse, and HIV services.

Knowledge and attitudes towards hepatitis C and injecting drug use among mental-health support workers of a community managed organisation

2013 ◽  
Vol 37 (5) ◽  
pp. 654 ◽  
Author(s):  
Grenville Rose ◽  
Elena Cama ◽  
Loren Brener ◽  
Carla Treloar
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Hepatitis C ◽  
Drug Use ◽  
Injecting Drug Use ◽  
Negative Attitudes ◽  
Positive Attitudes ◽  
People With Mental Illness ◽  
Mental Health Support ◽  
Health Support

Objectives People with mental illness are at significantly higher risk of acquiring hepatitis C virus (HCV) compared with the general population. This study assessed knowledge of and attitudes towards people with HCV and people who inject drugs (PWID) among support workers of clients with mental illness. Methods Support workers from a community managed organisation (CMO) in Australia were recruited to complete an online cross-sectional survey. The survey collected data about their knowledge of HCV and attitudes towards PWID and people with HCV. Results Valid responses were received from 117 support workers. Although HCV knowledge was moderate, there were significant knowledge gaps around transmission and treatment of HCV. Higher HCV knowledge was significantly associated with more positive attitudes towards PWID, but not with attitudes towards people with HCV. Participants had more positive attitudes towards people with HCV than towards PWID. Additionally, those with more positive attitudes towards HCV tended to also have more positive attitudes towards PWID. Conclusions Given that people with mental illness are at higher risk of acquiring HCV, these results point to the need for education targeted at support workers of clients with mental illness to increase HCV knowledge and promote positive attitudes towards PWID and people with HCV. What is known about this topic? The limited research available suggests that there are gaps in HCV knowledge among mental-health-service providers, although such research has generally targeted physicians. What does this paper add? This paper is the first to assess HCV knowledge, attitudes towards PWID and HCV among mental-health support workers. The findings suggest that although HCV knowledge is moderate, significant gaps exist, which are related to negative attitudes towards PWID. What are the implications for practitioners? Supportive and non-judgemental care is essential for people with mental illness and HCV, due to the potential for a double stigma arising from negative attitudes towards both mental illness and injecting drug use. This paper highlights the importance of targeted education for workers in the mental-health sector, to increase HCV knowledge and promote positive attitudes towards people with co-occurring mental-health, substance use problems and HCV.

scholarly journals Injection Drug Use and Hepatitis C as Risk Factors for Mortality in HIV-Infected Individuals

2015 ◽  
Vol 69 (3) ◽  
pp. 348-354 ◽  
Author(s):  
Margaret T. May ◽  
Amy C. Justice ◽  
Kate Birnie ◽  
Suzanne M. Ingle ◽  
Colette Smit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug

Significant differences in clinical outcomes between HIV-hepatitis C virus coinfected individuals with and without injection drug use history

AIDS ◽  
2014 ◽  
Vol 28 (1) ◽  
pp. 121-127 ◽  
Author(s):  
Angela Cescon ◽  
Keith Chan ◽  
Janet M. Raboud ◽  
Ann N. Burchell ◽  
Jamie I. Forrest ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Use ◽  
Clinical Outcomes ◽  
Injection Drug Use ◽  
Injection Drug

The natural history of hepatitis C infection acquired through injection drug use: Meta-analysis and meta-regression

2010 ◽  
Vol 53 (2) ◽  
pp. 245-251 ◽  
Author(s):  
Ava John-Baptiste ◽  
Murray Krahn ◽  
Jenny Heathcote ◽  
Audery Laporte ◽  
George Tomlinson
Keyword(s):  
Hepatitis C ◽  
Drug Use ◽  
Natural History ◽  
Injection Drug Use ◽  
Meta Analysis ◽  
Injection Drug ◽  
Hepatitis C Infection ◽  
History Of ◽  
Meta Regression

scholarly journals The hepatitis C epidemic in Canada: An overview of recent trends in surveillance, injection drug use, harm reduction and treatment

2021 ◽  
Vol 47 (12) ◽  
pp. 505-514
Author(s):  
Lillian Lourenço ◽  
Marian Kelly ◽  
Jill Tarasuk ◽  
Kyla Stairs ◽  
Maggie Bryson ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Use ◽  
Harm Reduction ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Health Concern ◽  
Prescription Opioid ◽  
Direct Acting Antiviral ◽  
Life Years ◽  
Hcv Transmission

Hepatitis C continues to be a significant public health concern in Canada, with the hepatitis C virus (HCV) responsible for more life-years lost than all other infectious diseases in Canada. An increase in reported hepatitis C infections was observed between 2014 and 2018. Here, we present changing epidemiological trends and discuss risk factors for hepatitis C acquisition in Canada that may have contributed to this increase in reported hepatitis C infections, focusing on injection drug use. We describe a decrease in the use of borrowed needles or syringes coupled with an increase in using other used injection drug use equipment. Also, an increased prevalence of injection drug use and use of prescription opioid and methamphetamine injection by people who inject drugs (PWID) may be increasing the risk of HCV acquisition. At the same time, while harm reduction coverage appears to have increased in Canada in recent years, gaps in access and coverage remain. We also consider how direct-acting antiviral (DAA) eligibility expansion may have affected hepatitis C rates from 2014 to 2018. Finally, we present new surveillance trends observed in 2019 and discuss how the coronavirus disease 2019 (COVID-19) pandemic may affect hepatitis C case counts from 2020 onwards. Continual efforts to i) enhance hepatitis C surveillance and ii) strengthen the reach, effectiveness, and adoption of hepatitis C prevention and treatment services across Canada are vital to reducing HCV transmission among PWID and achieving Canada’s HCV elimination targets by 2030.

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