Introductory
Workshop Session
Anika Alvanzo, MD, MS, DFASAM
Assistant Professor/ Associate Medical Director
Johns Hopkins University School of Medicine
Yngvild Olsen, MD, MPH, DFASAM
Medical Director
Institutes for Behavior Resources, Inc.
Oluwaseun Falade-Nwulia, MBBS, MPH
Assistant Professor
Johsn Hopkins University School of Medicine
Megan Buresh, MD
Assistant Professor
Johns Hopkins School of Medicine
This 90-minute workshop will use didactic instruction and small group discussion to provide models for integration of concurrent treatment of hepatitis C virus (HCV) and substance use disorder (SUD). Globally, HCV is a leading cause of liver-related mortality. In the United States, HCV is the most common blood-borne pathogen and deaths from HCV exceed those associated with HIV infection. Injection drug use is the foremost risk factor for HCV acquisition in the United States and estimates of the prevalence of HCV infection among persons who inject drugs (PWID) ranges between 40 – 80%, dependent upon the sample. With the advent of direct-acting antiviral (DAA) regimens for treatment of HCV infection, it is now a curable disease. Despite recommendations for treatment of HCV in PWID, regardless of their current drug use status, treatment initiation in this population remains low.
Using the opioid epidemic as a framework for the discussion, the presenters will discuss their own experiences in integrating HCV and SUD treatment, within 3 different modalities: 1) integration of HCV treatment into an opioid treatment program 2) integration of office-based buprenorphine treatment (OBOT) into a HCV clinic and 3) integration of HCV treatment and OBOT into a primary care practice.
The session will start with a brief overview of HCV epidemiology, screening and treatment, followed by description of the 3 different models of integration. The group will then break into three/four smaller groups for facilitated discussion to allow participants to brainstorm how to best integrate HCV and SUD treatment in their own clinical settings. In each small group, a presenter will facilitate the dialogue ensuring discussion of key points for consideration. At the end of the session, the large group will reconvene. One participant from each small group will report on the content of their discussion providing an opportunity for cross-learning amongst workshop participants. Presenters will provide a brief summary emphasizing the key concepts for the workshop and answer any outstanding questions on integration of HCV and SUD treatment.
Proposed Timeline (in minutes):
0:00 – 0:15 Introduction and Overview of HCV epidemiology, screening, and treatment
0:15 – 1:00 Discussion of 3 HCV/SUD treatment integration models
1:00 – 1:15 Small Group Case Discussions
1:15 – 1:20 Large Group Discussion of Cases
1:20 – 1:30 Questions and Answers/Session Evaluation