Despite the connection between injection drug use and infectious diseases, addiction treatment centers in the U.S. don’t routinely test or offer treatment for hepatitis C. Only 36.5 percent of the 16,000 substance use treatment facilities in the U.S. offered testing for hepatitis C in 2024, according to a national survey by the Substance Abuse and Mental Health Services Administration. Just 17 percent offered medications for hepatitis C treatment.
England has taken a different approach, targeting drug treatment centers as key venues for testing and treatment of the blood-borne virus. The country reached a deal with drug companies in 2019 to lower the government’s cost of hepatitis C treatment, with a large share of the program focused on expanding testing and treatment through drug treatment settings. The strategy is called “micro-elimination”—a focused approach to eliminating hepatitis C within specific high-risk populations such as those served by drug treatment programs, prisons, and other settings. In 2024, chronic hepatitis C among people who inject drugs in England was 5.2 percent, compared to almost 30 percent in 2022.
Opioid treatment programs, also called methadone clinics, pose a unique opportunity to treat hepatitis C because federal regulations already require patients to pick up their methadone—a treatment for opioid use disorder—in person several times a week. According to survey data, while 70 percent of opioid treatment programs offered testing for hepatitis C in 2024, only 22 percent offered medication. A key finding is that research has shown treatment uptake is higher when provided at the same site. Dr. Tom Hutch, medical director at We Care Daily Clinics in Washington state, noted: “To get serious about eliminating hepatitis C, we need to go to where it is.”
Hutch’s clinics in Washington state use an opt-out testing model, similar to England’s, in which everyone is offered testing when they walk in the door. Between January 2020 and December 2024, his clinics treated 92 people. The approach in the U.S. remains scattered, with no nationally funded hepatitis C elimination plan or consistent funding stream. While legislation sponsored by Sen. Bill Cassidy, R-La., would establish a national hepatitis C elimination program, it has not been considered by Congress. Centers may have few staff trained to draw blood for testing or prescribe treatment, and reimbursement rules from government programs and private insurers can make it difficult to bill for services not directly related to addiction treatment.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.arcamax.com/newsheadlines/s-4206434