Persons who use drugs (PWUD) commonly experience complex illnesses, psychosocial stressors, housing insecurity, and stigma, which may play a key role in their struggles with addiction. In a study of hospitalized PWUD with hepatitis C virus infection (HCV), participants described treating HCV as part of recovery. These findings led us to explore patient perceptions of the relationship between substance use disorder (SUD) and readiness to engage with HCV curative treatment.