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Supporting people with hepatitis C treatment who are using drugs

Key points

  • Treatment is highly effective at curing hepatitis C for all people, including people who use drugs.
  • Canadian and international hepatitis C treatment guidelines recommend that all people with chronic hepatitis C infection receive treatment, including people who use drugs.
  • It may be helpful for a person using drugs to have a support system throughout treatment. Service providers can facilitate and support treatment uptake and access to harm reduction resources.

Hepatitis C treatment is highly effective at curing hepatitis C for all people, including people who use drugs. Cure rates among people who inject drugs are similar to cure rates among people who do not. However, people who use drugs face more barriers to accessing hepatitis C treatment, making them an underserved population when it comes to hepatitis C treatment. 

Canadian and international hepatitis C treatment guidelines recommend hepatitis C treatment for people who use drugs. People who use drugs should be offered hepatitis C treatment, regardless of whether they plan to continue, reduce or stop their use of substances.

Concerns about hepatitis C treatment adherence

Although treatment adherence has been a concern among some service providers, evidence suggests there is no significant difference in adherence between people who inject drugs and those who do not. For more information, see CATIE’s statement on hepatitis C treatment efficacy among people who use drugs.

Concerns about hepatitis C reinfection

Reinfections are a reality of hepatitis C work, and service providers will work with people who have ongoing risks for getting a new hepatitis C infection. The risk of hepatitis C reinfection can be reduced when people have access to harm reduction knowledge, new harm reduction equipment and support. People who are at risk of reinfection after treatment should be regularly tested for hepatitis C. This will help identify a person in the early stages of reinfection and engage them in care as early as possible.

Considerations in supporting clients who use drugs through hepatitis C treatment

Connecting a person to treatment supports can reduce challenges that may otherwise make it difficult for them to complete the full course of care. There are many ways to support clients who use drugs through hepatitis C treatment. Certain considerations may be important, such as the ability to manage side effects or the need for support to adhere to the treatment regimen. Other considerations may include negative perceptions about blood draws and healthcare providers. Lack of personal support systems can also be a challenge.

With effective care and the right supports in place, people who use drugs can make educated decisions about hepatitis C treatment and receive the support they need to successfully complete treatment and be cured of hepatitis C.

Here are some ways to support clients who are using drugs through hepatitis C treatment:

  • Talk to clients about hepatitis C treatment. Discussing treatment information, potential barriers to care, adherence to treatment and plans to manage any obstacles can boost confidence and ease fears.
  • Enlist a variety of supports. Supports can include doctors, nurses, counsellors, social workers, outreach and harm reduction workers, peer support workers and advocates. These supports can check in with clients and coordinate various aspects of care. 
  • Help clients identify potential allies, such as family and friends, who can support them through the treatment process.
  • Address mental health issues. When appropriate, monitoring and referrals to counselling or psychiatric care may help clients with mental health issues to adhere to treatment.
  • Identify and link clients to resources, such as housing support, income assistance and healthy food sources. It is easier for a person to engage and remain in care and adhere to treatment when their basic needs are met. Nutritional support may be especially important if a person’s medication should be taken with food.
  • Promote peer support before, during and after treatment. Peers can provide many types of support, such as accompanying people to medical appointments, sharing experiences and coping strategies and providing emotional support. 
  • Promote and support harm reduction before, during and after treatment. Let people know that they can seek out harm reduction education and resources without being judged. For more information on safer drug use, see Prevention and harm reduction.

Resources for service providers

Resources for clients

Revised 2025.