Hepatitis B and C are transmitted through exposure to infected blood and body fluids, leaving people who engage in high risk sex practices and/or share drug solutions or preparation equipment at an increased transmission risk. Between 50-80 percent of IDUs become infected with HCV within 5 years of beginning injection use. What are the risks and complications associated with HCV and substance abuse?

•  Injection drug users often jointly purchase drugs, preparing and using them in social networks with other people. Sharing of substances, solutions, syringes, cottons, filters, mixing containers, and other equipment increases the risk of transmission.
  
  
•  Multiple interactions among a large number of people who are infected increase the odds of transmission.
  
  
•  HCV is transmitted very efficiently through blood exposure, presenting a daily risk.
  
  
•  People who drink alcohol or are poly substance abusers are at high risk for liver damage. If they are an IDU and have HCV, the progression of their liver disease will be accelerated.
  
  
•  Adherence to treatment of chronic hepatitis can be complicated by substance abuse, mental health issues, and unstable living situations.
  
  
•  Co-infection with HIV and HCV is very high among IDUs.
  
  
•  High risk sexual activity and drug use behaviors increase transmission risk.