Integrating Hepatitis Services into Substance Abuse
Programs
By Erin Bryant
 Individuals seeking help for certain types of substance
abuse are often infected with viral hepatitis, which
is most often spread through needle sharing by injection
drug users.
Along with HIV/AIDS, viral hepatitis infection is
a major public health issue for clients
and care providers in substance abuse treatment programs.
In response, SAMHSA launched two initiatives seeking
to prevent hepatitis infection among clients seeking
treatment. These programs integrate hepatitis services
into substance abuse treatment programs to reach people
at high risk of infection.
A highlight of these initiatives is included in a
recent issue of the journal Public
Health Reports (Volume
122, Supplement 2, 2007). Authors from
SAMHSA’s
Center for Substance Abuse Treatment
(CSAT) include CSAT Director H. Westley
Clark, M.D., J.D., M.P.H., Robert
Lubran, M.P.A., Director, Division of
Pharmacologic Therapies; Kenneth Hoffman,
M.D., Medical Officer; and Thomas Kresina,
Ph.D.
Current Programs
SAMHSA developed two new initiatives to prevent and
control the spread of hepatitis.
- Hepatitis Education
and Training in Opioid Treatment
Programs. This initiative provides onsite
training in prevention, care, and
treatment for providers who work in opioid treatment
programs. Opioid drugs include heroin, OxyContin®,
and morphine.
An expert panel of clinicians
and researchers developed a half-day
curriculum, which describes the latest
data on hepatitis infection, means of transmission,
diagnosis, and treatment. Providers also receive
information on how to promote immunizations and the
importance of care and treatment for patients with
HIV and hepatitis co-infections.
This initiative
was developed in collaboration with
the American Association for the Treatment of Opioid
Dependence.
- Disease Prevention Hepatitis Vaccinations
for At-Risk Individuals. This 1-year
pilot program provides free combination
hepatitis A and B vaccinations for
substance abuse treatment programs.
Between January and September 2006,
38 programs in 21 states received
a total of 43,950 vaccine doses. Lessons
learned from this pilot will be
published shortly.
Researchers found that more than 90 percent of patients
who were offered the vaccine accepted at least one
dose of it. Results of the pilot program also showed
that clients in opioid treatment programs are more
likely to complete the vaccination series than in other
public settings.
SAMHSA is using the feedback from these two initiatives
to work more closely with the Centers for Disease Control
and Prevention and state hepatitis C coordinators to
expand the range of preventive services offered by
substance abuse treatment programs.
For more information, visit www.samhsa.gov/Matrix/matrix_HIV.aspx. 
Citation: Integrating
Hepatitis Services into Substance
Abuse Treatment Programs: New Initiatives
from SAMHSA. Thomas F. Kresina, Ph.D.,
Kenneth Hoffman, M.D., M.P.H., Robert
Lubran, M.P.A., H. Westley Clark,
M.D., J.D., M.P.H. Public
Health Reports, Volume
122, Supplement 2, 2007.
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