Research: Availability of Viral Hepatitis Services in U.S. Drug Treatment Programs

The prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) is disproportionately high among individuals in U.S. drug treatment programs. Therefore, such programs are ideal settings for the provision of services targeting viral hepatitis, including screening, education, vaccine prevention, and treatment. This National Institute of Drug Abuse Clinical Trials Network (NIDA-CTN) study assessed the availability and comprehensiveness of viral hepatitis services within US drug treatment programs. Administrators from 319 drug treatment programs within the NIDA-CTN were invited to participate via survey, and 84% responded. Data were compared between programs that provided methadone (n=89) and those that did not (n=180). Most programs were private, not-for-profit, free-standing facilities but varied in most other aspects (e.g., geographic location, program size, and medical versus nonmedical staffing).

Testing for HCV-antibody was performed in 28% of programs and was more likely to be offered at methadone programs (55%) compared with programs that did not provide methadone (15%).

Vaccination for hepatitis A virus and HBV were offered either on-site or through contractual agreement with another provider in 68% of programs.

For all substance abuse treatment programs, HCV-related treatment was provided either on-site or through contractual agreement at 29% of programs and was more common in programs providing methadone than in programs that did not provide methadone (48% versus 22%, respectively). Fifteen percent of programs offered on-site HCV treatment, 3.5% offered treatment through contractual agreement with another provider, 67% referred patients to a community resource, and 15% did not offer treatment at all.

Comments: Less than one-third of drug treatment facilities offered HCV-antibody testing or HCV treatment either on-site or through contractual agreement with another provider. Programs that provided methadone were more likely to provide these services than programs that did not provide methadone. These data are likely biased in that they reflect programs enrolled in the NIDA-CTN, a group of programs that may be more likely to provide such services, and are limited by their self-report nature. The findings suggest a need to improve access to HBV and HCV screening and treatment at drug treatment programs to address this public health agenda.

Source: Alcohol, Other Drugs, and Health: Current Evidence – May/June 2012, Jeanette M. Tetrault, MD

Original Source: Bini EJ, Kritz S, Brown LS Jr, et al. Hepatitis B virus and hepatitis C virus services offered by substance abuse treatment programs in the United States. J Subst Abuse Treat. 2012;42(4):438–445.

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