About one-third of Americans in prison have HCV. Instead of spending money helping Americans with a substance abuse problem we spend money incarcerating them. This breaks up families and ruins lives. The US military guards poppy fields in Afghanistan. That crop is converted to narcotics and imported into the USA. Substance abusers have to purchase it illegally and when caught face imprisonment. The taxpayer pays for the criminal justice system that replaces dangerous criminals with non-violent drug addicts. The war on drugs is a complete failure and Americans should finally wise up.

Michael Paulley was my patient who was the first to get a federal court order for HCV treatment. He was incarcerated and consulted me at the Louisville VAMC for treatment of his HCV cirrhosis. The medical director of the Kentucky Department of Corrections cancelled his treatment and he filed suit. He was able to cure his HCV with pegylated interferon and ribavirin. He subsequently developed liver cancer as a complication of his cirrhosis. He was refused liver transplantation because he was in prison and he died shortly before his scheduled release.