About four years ago, caregivers at Princeton House Behavioral Health began noticing a growing trend: Young patients who inject drugs were frequently testing positive for hepatitis C virus (HCV), which silently attacks the liver and can lead to liver cancer or liver failure. To address this problem, Princeton House partnered with ID Care (New Jersey’s largest network of infectious disease specialists) in 2014, and hired a social worker whose primary role is to support these patients by linking them to behavioral health services and HCV treatment providers.
In addition, to better characterize the HCV epidemic and further understand the body’s immune response to the virus, Princeton House and ID Care partnered with Rutgers Robert Wood Johnson Medical School and Rutgers Center for Advanced Biotechnology and Medicine. This innovative multidisciplinary care model was designed to integrate addiction, behavioral health, and HCV treatment to effectively engage patients.
The partnership presented an ideal opportunity to conduct research assessing the scope of the problem. As part of these efforts, Ronald Nahass, MD, Senior Attending Physician at Princeton HealthCare System and President of ID Care, Kathleen Seneca, APN, an ID Care nurse, and Ruth Homer, LCSW, LCADC, the Linkage to Care Coordinator with Princeton House, uncovered some startling statistics. They found that:
- Nearly 41 percent of Princeton House patients who are injecting drug users tested positive for hepatitis C.
- Of these, 67 percent were ages 35 and under.
“In light of the growing opioid epidemic among young people, the numbers make sense,” says Homer. “Young people in particular are not well educated about HCV, which can be easily passed through sharing needles and drug use equipment like cookers and cottons, and via intranasal use by sharing straws or bills.”
Hepatitis C is a growing public health issue, and curing the disease can prevent serious, long-term health consequences and save lives. In fact, a recent national report predicted that 90,000 deaths could be prevented nationwide by 2030 by implementing better hepatitis C screening and treatment.1
“The good news is that HCV is now easily curable with an 8- to 12-week course of medication,” adds Homer, who meets with patients and family members to provide counseling, case management, and education on transmission, disease progression, treatment, and prevention of HCV. “We’re working to identify these patients, facilitate access to care, and provide the support they need to follow through with treatment.”
Examining Care Barriers
Homer notes that the group is working to address some of the impediments to care, which were uncovered through their research. The most common barriers to treatment were found to be:
- Communication issues, insurance limitations, and socioeconomic instability
- Relapse and challenges in addiction treatment follow-up
“In addition to connecting patients to treatment for both HCV and addiction, we’re spreading the word among health care providers about the importance of HCV education, screening, and early access to treatment,” says Homer. “Treatment is a key part of prevention efforts, as curing patients with HCV reduces the number of people that can transmit the virus to others. Our hope is that better advocacy at state and national levels will create additional screening opportunities and accessible treatment options.”
More than 900 patients, 70 percent of whom were under the age of 35, have now been seen for HCV consultation at Princeton House. In the meantime, our partners at Rutgers continue to analyze blood samples with an ambitious goal: to discover a vaccine for HCV.
“The ultimate goal is to eradicate hepatitis C through education and treatment or—hopefully one day soon—through a vaccine,” says Homer.
Therapists and other health care providers can help by educating patients about hepatitis C testing and treatment. Homer suggests:
Providers with questions about hepatitis C or access to treatment can contact Homer at 609-497-3363.
1. National Academies of Sciences, Engineering, and Medicine. 2017. A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report. Washington, DC: The National Academies Press.
In addition to sharing HCV insight with other professionals through published research and conference presentations, Princeton House was named a finalist in the 2017 NJBIZ Healthcare Heroes Awards in recognition of its research to identify individuals who are infected with HCV and link them to treatment. “Princeton House has been ahead of the curve on this issue,” says Barry S. Rabner, President and CEO of Princeton HealthCare System. “This research is crucial for people with hepatitis C who otherwise might not have known until the disease was advanced and more difficult to treat.”
Article as seen in the Fall 2017 issue of Princeton House Behavioral Health.