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Smoking Pipes May Transmit HCV

September 9, 2009

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In an effort to circumvent the spread of Hepatitis C, many drug users assume they are safe from viral acquisition if using a non-injection drug delivery system. However, new research shows that a pipe passed between people is capable of transmitting the Hepatitis C infection.

by Nicole Cutler, L.Ac.

As the Hepatitis C virus (HCV) increases in prevalence, so does concern about avoiding this potentially chronic liver disease. In order to reduce the number of new infections, campaigns to educate the public about possible routes of transmission are crucial. While a few obvious routes capable of transmitting the virus have been widely publicized, new research shows that a previously unsuspected item may be passing HCV to new hosts.

Hepatitis C Transmission
Because HCV is primarily a blood-borne virus, transmission occurs when blood of an infected individual makes contact with the blood of someone who is not infected. Although intravenous drug use and tainted blood transfusions are suspected in most cases of acquiring HCV, there are many more ways one can come into contact with infected blood. Experts estimate that approximately 20 to 40 percent of those infected with HCV have not been able to accurately identify the manner in which they contracted their illness. Due to this statistic, previously unrealized routes of viral acquisition must exist.

Although the likelihood of acquiring Hepatitis C is highest with intravenous drug use and tainted blood transfusions, there are many possible routes of infection. According to the U.S. Centers for Disease Control, Hepatitis C transmission could occur in any of the following ways:

1. Injecting street drugs, whether it was done once, a thousand times, yesterday or 40 years ago.

2. Being the recipient of treatment for clotting problems with a blood product made prior to 1987.

3. Being a blood transfusion or solid organ (e.g., kidney, liver, heart) recipient from an infected donor.

4. Being a recipient of long-term kidney dialysis.

5. Working in health care with frequent contact with blood in the work place, especially accidental needle sticks.

6. Being born to a mother who had Hepatitis C at the time of your birth.

7. Having sexual contact with an HCV-infected person.

8. Living with someone who was infected with HCV and sharing items such as razors or toothbrushes that might have had blood on them.
In addition to the eight high risk categories listed by the Centers for Disease Control, sharing drug delivery items other than needles have been implicated in HCV transmission.

Drug Delivery Systems
Although there is a wide variety of drugs and corresponding delivery systems in use, the target for any illicit drug remains the bloodstream. Drugs that are taken orally must pass through the digestive system before reaching the bloodstream. However, injection, inhalation and snorting provide the drug quicker access to circulating blood, thereby creating a faster high. As it turns out, any paraphernalia used to inject, smoke or snort drugs can become contaminated with blood thus rendering it a potential HCV transporter.

1. Injection Materials - While sharing drug paraphernalia has long been implicated in the spread of infectious disease, most people assume that this only refers to intravenous injection equipment. When evaluating the potential transmission of blood through injection drug use, items that could be tainted with blood - such as syringes, cotton and cookers - can all be vehicles for spreading this virus.

2. Snorting Materials - Drug sniffing and/or snorting has also been implicated as a major risk factor for the acquisition of HCV. Due to nasal irritation and trauma, snorting cocaine and heroin can cause bleeding in the nose. Although the amounts could be microscopic, blood from the nose can remain on the surface of sniffing and snorting equipment, such as straws or rolled money, which can be passed on to the next person. Because snorting drugs easily damages the nose's delicate lining to cause bleeding, a previously uninfected person is instantly vulnerable to viral transmission through this activity.

3. Smoking Materials - A new study by the University of Victoria's Centre for Addictions Research suggests that HCV could be passed on between crack smokers who share pipes. Although not typically considered an item susceptible to blood exposure, many crack users have chronic burns and sores in their mouth that may facilitate oral HCV transmission. However, this smokable form of cocaine is not the only drug that uses the pipe as a delivery system. While further proof is necessary to conclude the dangers of pipe-sharing, just about any drug smoked through a shared tool could be a potential HCV spreader. Because a common HCV symptom is dry mouth, which can easily cause cracked and bleeding gums or lips, passing a pipe could spread more than a drug's effects.

Ironically, many individuals snort or smoke drugs in an attempt to avoid acquiring HCV and other infectious viruses through injection. Regardless of the method used, people who share drug paraphernalia place themselves and others at risk of HCV infection.

Since such a large proportion of individuals infected with Hepatitis C do not know how they became infected, all suspected avenues - including sharing pipes - must be made public knowledge. By thoroughly educating society about all of the places HCV transmission can potentially occur, real strides to minimize this disease's impact will be seen.

References:

Fischer, et al., Hepatitis C virus transmission among oral crack users: viral detection on crack paraphernalia, European Journal of Gastroenterology & Hepatology, January 2008.

www.cdc.gov, If You Have Hepatitis C, U.S. Department of Health and Human Services, 2007.

www.hepatitisaustralia.com, Hepatitis C: How People Get It, Hepatitis Australia, 2007.

www.hepcaz.net, Hepatitis C and Harm Reduction, Arizona Hepatitis C Coalition, 2007.

www.hivandhepatitis.com, Risk Factors for Hepatitis C in People with Unknown Transmission Routes, Liz Highleyman, hivandhepatitis.com, December 2006.

www.phac-aspc.gc.ca, Hepatitis C virus transmission in the prison/inmate population, Public of Health Agency of Canada, August 2004.

www.physorg.com, Shared Crack Pipes May Spread Hepatitis C Virus, PhysOrg.com, 2007.

www.thebodypro.com, Canada: British Columbia Health Officials Welcome Crack Pipe Study and Link to Hepatitis C, US Centers for Disease Control and Prevention, December 2007.

Posted by Editors at September 9, 2009 3:25 PM

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