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Cocaine snorters, beware! >> Hepatitis C is not just a tainted blood problem
by KATHERINE ADDLEMAN
And the infections can get far more serious than the common cold. One of the more deadly diseases currently being passed through straws is hepatitis C--a disease that is quickly becoming a serious public health problem. A recent study in the New England Journal of Medicine showed that cocaine use was one of the highest-risk activities for contracting hepatitis C. While the hepatitis C virus (HCV) attacks the liver, the virus flows freely through the bloodstream. Regular coke users are more likely to contract HCV because of the damage they do to their noses: regular snorting destroys nasal membranes, making blood vessels break down and bleed from tiny pinpoint ulcerations. As a result, HCV-infected snorters are increasingly likely to pass the virus along, and non-infected snorters are increasingly likely to pick it up. "Hepatitis C is a severe problem right now, and it will only get more severe because attention hasn't been focused upon it," says Tim McClemont, Executive Director of the Hepatitis C Society in Canada. "This will definitely have an impact on the entire health care system." According to McClemont, about one Canadian in 50 is infected with HCV. That amounts to a total of approximately 400,000 Canadians, compared to 75,000 people in Canada who are HIV-positive. HCV is a counterculture killer. Like the transmission of HIV/AIDS, snorting coke is only one of the vices that can transmit HCV. The majority of HCV infections are passed on through needles shared during intravenous drug use. But it can also be transmitted by tattoo and body-piercing instruments if they aren't properly sterilized between clients, and through unprotected vaginal or anal intercourse. HCV can even be transmitted by sharing a razor blade or a toothbrush that was just used by a carrier. >>> Ironically, the most highly publicized way of contracting hepatitis C--blood transfusions--is only responsible for about five per cent of infected Canadians. Despite all the recent political wrangling in Ottawa over compensation for those infected by tainted blood, little information about the disease itself has been reported. Because hepatitis C is a recently discovered disease (the blood test used to identify it was developed in 1986), its status is the subject of some confusion in the medical community. According to Dr. John Carsley of Montreal's public health department, the exact number of cases in the Montreal area is unknown. The government does not require doctors to report all cases of HCV, though Carsley says his department has requested them to do so. Adds Carsley: "This is still an important concern for us." Carsley also noted that, technically, hepatitis C is less contagious than HIV: the hepatitis C virus is transmittable only through an exchange of blood, whereas HIV is present in vaginal and seminal fluids as well. "The hepatitis C risks from unprotected vaginal intercourse aren't as bad, because bleeding is less common." On the other hand, notes McClemont, hepatitis C is a stealthier disease than HIV/AIDS. While people can be infected with HIV for months or even years without knowing, people with hepatitis C can remain perfectly healthy and show no symptoms for well over a decade. During that time, an HCV carrier can unknowingly spread the disease. "The lack of physical symptoms is probably related to its spread," McClemont says. "Public health authorities tell us they now get far more reports of HCV than HIV." During the time the disease is undetected, irreversible liver damage can occur which can ultimately lead to cirrhosis and even liver cancer. There is no vaccine for HCV. However, for reasons not yet understood, the virus spontaneously disappears in about 30 per cent of HCV carriers in the first 20 years after they've been infected--particularly those who were young when they picked it up. For those who carry the virus, the best way to slow the disease's progress is to give up the last acceptable intoxicant: alcohol. Those who stop drinking can keep their livers healthy for up to 20 years; liver cells bathed in beer can't regenerate themselves.
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Who knows what evil lurks at the end of a cocaine straw? The microscope knows: every time someone snorts up they leave traces of blood-tinged mucous at the nose-end of the straw, and with it they also leave whatever contagious diseases might be swimming around in their bloodstream. A recent article in the New Yorker described it as a "scrim of viral-laden material." Sharing a cocaine straw, the article notes, is a great way to pass viral infections from one person to another.