%0 Thesis %9 Master Essay %A Annarumo, Cheyenne %D 2019 %F pittir:38060 %I University of Pittsburgh %P 89 %T The intersection of opioids and hepatitis C virus in a rural Pennsylvania county - improvements in policy %U http://d-scholarship-dev.library.pitt.edu/38060/ %X Problem: In 2016, the CDC released a report outlining the high vulnerability of particular counties to widespread dissemination of Human Immunodeficiency virus and Hepatitis C virus (HCV) infections among people who inject drugs. This report included Crawford County, a rural area in Pennsylvania where the opioid epidemic and injection drug use are becoming increasingly prominent. Rural Americans experience disparities in access to care, availability of drug treatment resources, and availability and access to syringe exchange programs. Many of these disparities are rooted in a lack of policy and/or outdated policies related to injection drug prevention and treatment. This essay’s public health significance is to understand the intersection of HCV and opioids in Crawford County and to provide ideas for strategies that will help resolve this public health challenge. Methods: A policy analysis was completed to examine the current situation in Crawford County regarding the need for treatment and prevention of opioid use and related HCV infections. Pennsylvania state related policies on opioid use, monitoring, prevention and treatment were examined. A summary of key literature related to opioid use and HCV, and a review of the current policies were used to develop recommendations for changes in policies related to opioid use and HCV prevention and treatment. Results: Currently policies in Pennsylvania and in the United States as a whole have played an important role in reducing HCV transmission through injection drug use. These policies include opioid prescribing and dispensing guidelines, the implementation of the Pennsylvania Prescription Drug Monitoring Program, allotment of a portion of the state’s budget to address the opioid epidemic, and the HCV treatment action plan introduced by the United States Department of Health and Human Services. Nevertheless, HCV and injection drug use rates are still alarmingly high in Crawford County and additional policy improvements are needed. Conclusion: The linkage of patients to care, development of new programs, allocation of addition resources to at-risk counites, providing the opportunity for alternatives to incarceration for drug offenses and providing trainings and education services to providers and communities are promising and important changes that would decrease HCV transmission through injection drug use.