In this blog, the authors explain the importance of reducing or eliminating alcohol use for persons with chronic hepatitis C (HCV) to prevent further progression of liver disease, and how the US Department of Veterans Affairs (VA) is working to assist veterans to do so. Maggie Chartier, and Janet Durfee of the VA’s Office of Public Health discuss the importance of people with liver disease—including viral hepatitis—abstaining from alcohol use, as heavy drinking can increase the risk of developing cirrhosis of the liver in people with hepatitis. They note that of the more than 6.1 million veterans in VA care in 2011, 170,119 have been diagnosed with chronic hepatitis C and 55 percent of them have been diagnosed with an alcohol use disorder.
Although HCV antiviral treatment can help manage HCV, it may not be an option for all patients. However, limiting alcohol and finding ways to keep the liver healthy is important for all HCV patients. The VA provides many ways to help veterans resolve problem drinking. The VA has trained psychologists through a postdoctoral psychology fellowship in HIV/HCV to treat the mental health needs of veterans living with those chronic illnesses and has trained over 430 frontline HCV clinicians in delivering brief alcohol interventions. Each VA medical center has a substance use treatment program that usually includes group and some individual counseling. There are also drop-in support groups offered through local VAs, veteran’s centers, or community supportive partners, and 12-step groups provide support daily and on weekends. In addition, patients can discuss with their medical providers the use of medications that can lessen their cravings for alcohol.
While some people may prefer to work with a therapist, others prefer to try to stop on their own. Helpful resources are available on the VA’s hepatitis website. The authors emphasize the VA’s commitment to providing high quality care for patients with HCV, including addressing alcohol use. Training VA HCV providers from different disciplines in providing brief interventions for drinking and integrated care of the whole patient also illustrates how the VA is leading in providing comprehensive care to HCV patients.