Here's Why Surge in Hepatitis B Cases is No Surprise

By Josh Bloom — Feb 08, 2016
There's been a sharp uptick in the number of hepatitis B cases in the U.S. This isn't unexpected, because since 2010 heroin use has skyrocketed, and with that use, needles are shared more frequently. We're recently seen HIV and Hep C outbreaks from needle sharing. Is this any different? Very unlikely.

Screen Shot 2016-02-08 at 1.25.47 PMAccording to the CDC, there has been a sharp increase in the number of hepatitis B cases in three Appalachian states since 2006, and especially after 2010. The agency seems puzzled, but it shouldn't be. It all makes perfect sense. Why?

Hepatitis B (HBV) (no relation to A or C, except that they all infect the liver) is rare in the United States, since in 1968 a vaccine became available, and is now on the CDC vaccination schedule for children. Theoretically, no one should catch it, but it is obvious that there are people who were not vaccinated. Unlike hepatitis C (HCV), which is almost exclusively transmitted by blood, HBV can easily be transmitted by blood, or sexual contact. But, what is going on here has little to do with sex. It's almost certainly from needle sharing.

Why? It is a perfect example of the law of unintended consequences. Try to convince us that the following is a coincidence:

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OxyContin Abuse, 2009-2013 (Journal of Medical Internet Research)

2010: After many years of effort, Purdue Pharma, the maker of the perpetually-abused drug OxyContin (a very high, time-release dose of oxycodone), finally came up with a formulation for the pill to make it very difficult to abuse. Within two years, OxyContin use dropped by 80 percent. Also, note (in yellow) how many people are abusing the new formulation: close to zero.

And then, there's this:

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Heroin Deaths 2000-2013 (

At the precise time (red circle) when OxyContin became "abuse proof," heroin use went through the roof. Addicts are going to get their fix one way or another.

So, as pills became harder to get or abuse, addicts switched to heroin, which means needle sharing the perfect way to spread blood borne infections. So, it cannot be a surprise that there have been recent outbreaks of HIV, and HCV. Since HBV is also transmitted by blood, this is all the part of one big picture.

As I have written before, the "War On Drugs" is more like a game of whack-a mole than a real war; and there are no winners. The only question is how many losers there will be.

Josh Bloom

Director of Chemical and Pharmaceutical Science

Dr. Josh Bloom, the Director of Chemical and Pharmaceutical Science, comes from the world of drug discovery, where he did research for more than 20 years. He holds a Ph.D. in chemistry.

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