Hepatitis C is a liver infection that you can pass on through contact with blood that carries the hepatitis C virus (HCV). Even though young people who inject drugs can often have the highest chance of infection, less than 5 percent of this population gets treatment for hepatitis C.

Prompt treatment is important to prevent cirrhosis, liver cancer, and liver failure. Treatment also significantly decreases the chances of people with hepatitis C passing the infection to others.

Taking direct-acting antiviral drugs (DAAs) for 12 weeks can typically cure most people of hepatitis C. Yet, many people who need this treatment don’t get it because of stigma, a lack of insurance, and other barriers.

Finding the right treatment program — one that addresses both substance use and hepatitis C — is usually the best way to cure hepatitis C, prevent complications, and avoid passing on the infection.

Almost three-quarters of new hepatitis C infections occur among people who inject drugs. But this group often doesn’t receive diagnoses or treatments, even though they may have just as good treatment outcomes as people who do not inject drugs.

One small 2021 study, found that several barriers stand in the way of people with substance use disorder getting treatment for hepatitis C, including:

  • a lack of knowledge about hepatitis C and its treatments
  • stigma surrounding the disease and drug use
  • a lack of referrals to specialists for treatment
  • fear that the treatment won’t work

Mental health conditions can also be barriers to treatment, and they tend to be more common in people who inject drugs. Having a mental health condition can often make it harder to stay on a treatment program. And some of the medications that treat mental health conditions interact with hepatitis C drugs.

Bias among doctors is another problem. Some doctors won’t offer DAAs to people who actively use drugs because they think this population won’t carry out their treatment plan or they’ll get a reinfection after treatment. Yet, studies show that people who inject drugs do carry out their hepatitis C treatment and have low reinfection rates.

Cost is also a barrier to treatment. The full 12-week course of DAAs costs between $27,000 and $47,000. That price may be unaffordable for anyone without the health insurance coverage.

State laws can also hinder access to treatment. Research shows that, as of 2020, there are still 13 states with Medicaid programs that require some period of abstinence from injectable drugs — ranging from 1 to 6 months — before qualifying for hepatitis C treatment.

In addition, Medicaid may require you to take a drug test before it will cover your hepatitis medications. The embarrassment of having to undergo a drug test keeps some people from getting treatment.

Treatment is usually very effective at preventing cirrhosis and other complications of hepatitis C, whether you use injectable drugs or not. Taking a DAA can also prevent you from passing the infection to someone else.

Sustained virologic response (SVR) is the measure that doctors use to see if the treatment is successful. You have an SVR when blood tests show no trace of the virus 12 weeks or more after you finish the medication.

The average SVR rate for people who take DAAs is 95 percent. SVR rates among people who inject drugs are also close to 95 percent.

Because hepatitis C often doesn’t cause symptoms, you may not know if you have it unless you get tested. If you use injectable drugs or you used them, a blood test called the HCV antibody test can show whether you have hepatitis C.

It can help to get your test at a center that also offers hepatitis C treatment. Then, if you test positive, you can get counseling and treatment advice in the same place.

There are inpatient and outpatient addiction treatment centers around the country. Some of them offer free or low cost services. The Substance Abuse and Mental Health Services Administration has a directory of agencies in every state to help you search.

An effective program can treat both hepatitis C and substance use disorder. Finding an addiction treatment center that treats both conditions can increase your odds of achieving your treatment goals.

In a 2022 study, 110 people receiving substance use treatment also received hepatitis C treatment, and their hepatitis C was cured. The participants said they found it helpful to get treatment while pursuing substance use treatment, and at various stages of recovery.

You don’t need to stop using drugs to get treated for hepatitis C, but continuing to use them could make it harder for you to remember to take your medication. And you may not be able to achieve an SVR if you skip doses.

Although it typically takes 12 weeks to fully treat hepatitis C, the process may be longer for people who use injectable drugs. You’ll need time to establish a relationship with your treatment team and find a treatment plan that works for you and your unique situation.

It’s rare to get a reinfection with hepatitis C after finishing treatment, but it can happen if you continue to use drugs and share needles. If you do get a reinfection, you can get treatment again.

One way to reduce your chance of reinfection after treatment is by using a clean needle every time you inject. If the substance that you inject is an opioid, medication like methadone or buprenorphine may help reduce cravings and help prevent further opioid use.

Using injectable drugs increases the chance of hepatitis C. Many people with substance use disorder don’t get treatment for hepatitis C because of stigma and other barriers. Getting into a program that treats both substance use disorder and hepatitis C can help treat both conditions at the same time and prevent you from having liver complications.