Americans diagnosed with opioid addiction are nine times more likely to be infected with hepatitis C virus (HCV) than the general population, according to a new report from health tech company Amino, Mother Jones reports. 

For the study, the company (which helps match patients with doctors online) examined the claims of more than 300 million patients with private health insurance between 2014 and 2016. Researchers found that addiction to opioids — including prescription painkillers, heroin or fentanyl — was associated with an increased risk for a wide variety of health conditions, from mental health concerns, including alcoholism, suicidal ideation and post-traumatic stress disorder, to physical maladies, such as hep C infections and chronic back pain.

The biggest risk disparity between opioid users and the general population involved hepatitis C. Study authors estimated that those diagnosed with an addiction to the class of drugs were 9.1 times more frequently diagnosed with HCV than those not diagnosed with opioid use disorder. Other comorbidities uncovered in the report included HIV, cirrhosis, bipolar disorder, depression, fibromyalgia and various other spinal problems.

The report didn’t directly examine whether the other diagnoses caused the opioid addiction or vice versa. However, researchers noted that some of the conditions, especially hepatitis C, are often a result of needle sharing and other lifestyle risk factors associated with injection drug use. The study also speculated that other diagnoses, such as chronic pain, could be the reason patients started taking opioids in the first place. 

Finally, the report noted that hepatitis C rates are soaring across the United States. According to the Centers for Disease Control and Prevention, the number of new infections tripled between 2010 and 2015. Last spring, the CDC tightly restricted opioid prescription guidelines in response, saying the powerful drugs should be prescribed for chronic pain only after other solutions, such as NSAID painkillers like acetaminophen (Tylenol) or physical therapy have been considered.