Appalachian States Debate Needle Exchange Programs As Hepatitis C Catastrophe Looms

HAZARD, Ky. (AP) — Patton Couch shook his head and clenched his teeth, recounting the night four years ago when he plucked a dirty needle from a pile at a flophouse and jabbed it into his scarred arm.

He knew the odds; most of the addicts in the room probably had hepatitis C.

“All I cared about was how soon and how fast I could get it in,” he says. “I hated myself, it was misery. But when you’re in the grips of it, the only way I thought I could escape it was one more time.”

Couch, 25 years old and one month sober, is one of thousands of young Appalachian drug users recently diagnosed with hepatitis C. Yet public health officials warn that it could get much worse.

Two-hundred miles north, Scott County, Indiana, is grappling with one of the worst American HIV outbreaks among injection drug users in decades. Kentucky, with the nation’s highest rate of acute hepatitis C, might be just a few dirty needles away from a similar catastrophe.

“One person could be Typhoid Mary of HIV,” said Dr. Jennifer Havens, an epidemiologist at the University of Kentucky’s Center on Drug and Alcohol Research, who has studied Perry County drug users for years as the hepatitis rate spiraled through small-town drug circles there. An explosion of hepatitis C, transmitted through injection drug use and unprotected sex, can foreshadow a wave of HIV cases.

In a study last month, the Centers for Disease Control and Prevention found that hepatitis C cases across four Appalachian states — Kentucky, Tennessee, West Virginia and Virginia — more than tripled between 2006 and 2012. Kentucky leads the nation in the rate of acute hepatitis C, with 4.1 cases for every 100,000 residents, more than six times the national average, according to the CDC.

Havens has tracked 503 —> Read More