Injecting Prescription Opioids Carries Specific Increased Risk of Hep C


A new study from researchers at CUNY’s Graduate School of Public Health and Health Policy found that misusing prescription opioids via injection raises one’s risk of contracting hepatitis C, a blood-borne virus that targets the liver. The results point to the need for improved harm reduction strategies that are tailored to the methods people use to prepare and inject drugs.

Sharing needles and other injection equipment is already a known risk factor for infections, but by interviewing prescription opioid users, the researchers found that these drugs come with their own specific risk.

The study appears in Harm Reduction Journal. Professors Pedro Mateu-Gelabert and Honoria Guarino authored the study with research scientist Chunki Fong and research assistants Heather Goodbody and Carli Salvati of the Institute for Implementation Science in Population Health.

The researchers interviewed young people in New York City and tested each volunteer for hepatitis C. They interviewed one group for descriptions of the injection process and preparations, and another group for quantitative data on their current usage and history. The results show that ever having injected prescription opioids was a significant predictor of testing positive for the virus.

Whereas heroin dissolves easily in water, extended-release or abuse-deterrent prescription opioids require more water to fully dissolve. Because the syringes people commonly use aren’t big enough to hold that much liquid, it’s common to do multiple injections, the interviewees reported. If more than one person is using the same needle or cooker, multiple injections means more chances for viral transmission. Some interviewees also said they reused cotton filters from others, or did “rinse shots” from the residue left in cookers. Each of these steps presents added risk of hepatitis C transmission.

Most of the study volunteers said they used heroin more frequently than prescription opioids. These kinds of trends vary across regions of the country depending on prices and availability, the authors said. Even so, the study shows that the nature of the prescription pills presents specific risks.

The authors suggest possible harm reduction strategies that are specific to prescription opioid injection. For instance, if someone is using a larger syringe, they should avoid using those with detachable needles because they hold a larger amount of residual blood, which raises the risk of virus transmission.

Beyond SUM

Work By

Pedro Mateu-Gelabert (Associate Professor, Community Health and Social Sciences) | Profile 1
Honoria Guarino (Research Associate Professor, Institute for Implementation Science in Population Health) | Profile 1