Hepatitis And Substance Abuse And Addiction
Hepatitis is an inflammation of the liver tissue. The condition has 5 major viral varieties and several metabolic forms as well.
There are three forms of viral hepatitis that are commonly associated with alcohol and drug use, including:
Hepatitis B (HBV) is contracted through contact with infected body fluids, including blood, semen, and vaginal fluids. The most common methods by which HBV spreads in the United States are sexual contact and needle sharing. The CDC estimates that 1.2 million Americans are currently infected with HBV, a very large percentage of which are injection drug users. Between 95% and 99% of HBV cases resolve without long-lasting effects, although a small percentage become chronic, long-term infections.
Like HBV, Hepatitis C (HCV) spreads through contact with infected body fluids, such as blood, semen, and vaginal fluids. Similar to HBV, the most common ways in which HCV spreads in the United States are sexual contact and needle sharing. One of the most common bloodborne infections in the world, HCV currently infects between 2.7 and 3.9 million Americans.
HCV is extremely common among injection drug users.
Hepatitis D (HDV or delta hepatitis) spreads in the same manner as HBV and HCV. However, HDV is a defective virus that can only spread in people who are already infected with HBV. HDV is very rare in the United States, only occurring in a small percentage of HBV sufferers.
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A wide range of liver diseases and conditions that are not spread through infectious organisms are known as metabolic hepatitis. They may be caused by long-term exposure to chemicals.
Long-term excessive alcohol consumption can cause hepatitis. In fact, alcoholic hepatitis is the single most common cause of cirrhosis in the United States. Between 10% and 20% of those who struggle with long-term alcohol abuse will eventually develop the condition.
Toxic And Drug-Induced Hepatitis
A number of chemicals found in commonly used substances can cause hepatitis, including certain Inhalants, prescription medications, and illicit drugs. The duration of use and amount of the substance necessary to induce the condition varies wildly, with some substances causing liver damage after years and others after only brief exposure.
How Hepatitis Develops
As hepatitis worsens, the liver tissue becomes inflamed. Some affected individuals show no symptoms. Others experience reduced appetite, vomiting, constant tiredness, abdominal pain, diarrhea, and yellowing of the skin and eyes. Known as jaundice, this discoloration is perhaps the most well-known and easily recognized sign of the condition.
Hepatitis can either be acute or chronic. The acute form consists of three phases. During the prodromal phase, flu-like symptoms appear. During the next phase, liver-specific symptoms such as dark urine and yellowing of the skin and eyes appear. Enlarged livers and spleens are common during this phase. The recovery phase follows. Most HBV cases improve within 3-4 months, but less than 20% of HCV cases ever completely resolve.
If hepatitis persists for longer than 6 months, it is considered chronic. The chronic form of the condition has many of the same symptoms of the acute form, only they generally take longer to develop. Chronic hepatitis severely impacts the long-term functioning of the liver, eventually causing severe damage and scarring; this condition is known as cirrhosis. Cirrhosis permanently impedes the functioning of the liver and can cause a number of potentially fatal conditions. In many cases, prevention can be achieved by receiving preemptive treatment.
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Symptoms Of Hepatitis
Symptoms of hepatitis vary wildly depending on the variety and the stage. Some symptoms include:
- Yellowed skin and eyes/jaundice
- Flu-like symptoms
- Abdominal pain
- Dark urine
- Dark or pale stool
- Reduced appetite
- Weight loss
- Enlarged liver
- Enlarged pancreas
Because many symptoms of Hepatitis are similar to those of other diseases, the only way to accurately determine a diagnosis is to see a doctor.
Because Hepatitis is a very serious condition that can even lead to fatal complications, any individual who believes that they may have been exposed to any relevant virus should contact their doctor immediately. HCV particles are detectable 1-2 weeks after infection, and antibodies are detectable 3-12 weeks after infection.
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Because of their association with illicit drug use, alcoholism, and sexual activity, many people attach a stigma to sufferers of the condition. However, most addiction counselors and treatment centers are very familiar with treating symptoms and effects of stigma and can help sufferers cope and deal with both.
Most cases of HBV will not require treatment. Some patients will require hospitalization, however, especially if factors such as advanced age and co-occurring medical conditions are present. In the rare cases where HBV becomes chronic, medication may be required.
Not even 20% of HCV cases will resolve without medical intervention. Over 80% will develop into a chronic, potentially permanent infection. In many cases, HCV treatment is focused more on preventing serious complications such as cirrhosis than on curing the disease itself. Generally, HCV is treated with a suite of medications.
It is imperative that anyone suffering from metabolic hepatitis immediately cease consumption of alcohol and any other substances that may be causing the condition. In early stages, reversal of liver damage may be possible. Unfortunately, the prognosis for severe alcoholic hepatitis in particular is very poor. Without medical intervention, between 20% and 50% of sufferers die within a month.
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Because of the immediacy and severity of hepatitis, it is critical that those diagnosed seek help for any addictions that they may have.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience