Hepatitis C, HIV and tuberculosis cause greatest harm for drug users globally

27 June 2017

The UNODC highlights disease burden, increased opioid abuse and a lack of treatment access in their global state of drug use report.

People who inject heroin relax in their ward at the government-run Jangalak rehabilitation centre in Kabul, Afghanistan.

Among people who use drugs hepatitis C is now causing greater harm than HIV – accounting for more years of ‘healthy’ life lost among this population. Over half of the 12 million people who inject drugs globally are living with hepatitis C (6.1 million), and one in eight (1.6 million) are living with HIV, with these two diseases having the biggest negative health impacts on people who use drugs globally.  

Opioids, including heroin and prescription misuse of morphine and fentanyl, were the most harmful drug type, accounting for 70% of health-related issues from drug use and the large majority of premature deaths.

The figures were released last week in the UN Office for Drugs and Crime (UNODC) World Drug Report, which looks at the global state of drug markets, trafficking and the health impacts of taking drugs on users and those around them.

Despite advances in treatment for hepatitis C, 3.5 times more people who used drugs died from hepatitis C than from HIV in 2015, and the number of ‘healthy lives’ lost (known as disability adjusted years, or DALYS) is nearly 2.5 times higher than that of HIV.

The divide between the two diseases may be the result of a lack of treatment access for hepatitis C. Treatment for hepatitis C, in the form of sofosbuvir, can cure most forms of the disease but remains cripplingly expensive and out of reach for those most in need around the world.

The report also highlighted the significant burden of tuberculosis (TB) among people who use drugs, which has received limited attention in recent years, despite it being a possible direct consequence of drug use.

Close contact with other drug users, high incarceration rates and homelessness are all high risk factors for the spread of TB. Prevalence of TB among people who inject drugs is estimated at 8%.

A complex set of social circumstances affect burden of disease among people who use drugs. Injecting drug use causes the most harm – and the greatest vulnerability to blood-borne diseases such as HIV and hepatitis C through unsafe injecting practices. Risk of overdose is high and a lack of access to healthcare common.

Criminalisation of drug use, incarceration, other health issues such as mental health and social marginalisation also drive vulnerability. A lack of access to harm reduction services, such as needle exchanges and opioid substitution treatment, is a major issue that requires strong political will and commitment and an active civil society to implement.

According to the report, around a quarter of a billion people used drugs in 2015, with around 29.5 million thought to have a drug-use problem, including dependence – meaning that they are in need of treatment. Yet just one in six have access to treatment.

UNODC Executive Director Yury Fedotov said: “The report reinforces the importance of united action to address drug challenges, and confirms the emphasis of UNGASS on the need for science- and rights-based drug use prevention, treatment and care.”

The report is released in advanced of the International Day Against Drug Abuse and Illicit Tracking (26 June), which falls on the same day as ‘Support Don’t Punish’ – a civil-society founded global day of advocacy in favour of decriminalisation of drug use and policy rooted in human rights and health access.

Photo credit:
Jordi Bernabeu Farrús/ CC-BY

Written by Caitlin Mahon

Content Specialist - HIV & Sexual Health