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Substance use and hepatitis C: an ecological momentary assessment study
Karran A Phillips1, David H Epstein1, Massoud Vahabzadeh1
1National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health.
Summary
Hepatitis C virus (HCV)+ patients on methadone treatment reported more negative moods and triggers for drug use compared to HCV- patients. These findings suggest HCV status may influence treatment approaches for substance use disorders.
Area of Science:
- Addiction Medicine
- Hepatology
- Psychiatry
Background:
- Opioid and cocaine use disorders are significant public health issues.
- Hepatitis C virus (HCV) infection is prevalent among individuals with substance use disorders.
- Understanding the interplay between HCV status, mood, and drug craving is crucial for effective treatment.
Purpose of the Study:
- To compare craving and mood in asymptomatic Hepatitis C virus-positive (HCV+) versus HCV-negative (HCV-) patients undergoing methadone maintenance therapy.
- To investigate the relationship between HCV status and self-reported triggers for opioid and cocaine use.
Main Methods:
- A 28-week prospective ecological momentary assessment (EMA) study.
- 114 methadone-maintained individuals reporting heroin and cocaine abuse.
- Real-time data collection via handheld computers on mood, craving, triggers, and drug use.
Main Results:
- 61% of participants were HCV+; none were symptomatic or receiving HCV treatment.
- HCV+ individuals more frequently attributed drug use to negative moods (boredom, worry, sadness, discomfort).
- HCV+ participants reported significantly higher exposure to environmental drug-use triggers.
Conclusions:
- HCV+ individuals experienced more negative moods, which were more often cited as reasons for drug use.
- While HCV+ individuals encountered more drug-use triggers, they did not cite them more frequently as causes for use.
- Findings suggest HCV+ intravenous drug users may have more labile moods and greater mood reactivity, potentially informing tailored treatment strategies.
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