Dangers of HIV and hepatitis from intravenous drug use reach far beyond addicts and families, threatening a wide swath of Ky.

The growing use of heroin and the abuse of prescription painkillers in Kentucky also mean that the state “is being ravaged by the diseases that follow in their wake: hepatitis and HIV. These dangers also reach far
beyond addicts and their families, threatening a wide swath of the
population,” Laura Ungar reports for The Courier-Journal.

Kentucky has one-fourth of the 220 U.S. counties that the U.S. Centers for Disease
Control and Prevention
had judged to be at high risk for outbreaks of HIV and hepatitis C among intravenous drug users, Ungar notes in the second installment of a three-part series on heroin in Kentucky and adjoining states.

“Acute hepatitis B rose 114 percent in Kentucky, Tennessee and West Virginia
from 2009 to 2013, even as incidence remained stable nationally, according
to one study,” she reports. “According to another study, the rate of new hepatitis C
cases among people 30 and younger more than tripled from 2006 to 2012 in
Kentucky, Tennessee, Virginia and West Virginia. More recently, cases of
acute hepatitis B and C in Kentucky reached 281 last year, up from 120
in 2003.”

Dr. Nora Volkow, director of the National Institute on Drug Abuse, told Ungar that hepatitis C has become the top cause of death from reportable infectious
diseases in the U.S., and an HIV outbreak in Austin and Scott County, Indiana, “was a wake-up
call” for the country. Ungar notes, “Addicts may also be spreading both diseases without knowing it. Up to
three in four people with hepatitis C, and one in eight with HIV, don’t
know they have it, experts say.”

Dr. William Cooke, an Austin physician “who treats dozens of patients with HIV and hepatitis, said many
communities are ill-equipped to handle the threat,” Ungar writes. “All over the region
and nation, he said, there’s too little substance abuse treatment, too
little emphasis on the poverty that often accompanies addiction and too
little compassion.”

Kentucky has authorized needle exchanges where addicts can get clean syringes to avoid the threat of infection from contaminated needles. “Officials say needle exchanges are an important part of a comprehensive strategy to control disease,” Ungar notes. “But
critics argue these programs enable drug use, and many area residents
reject the idea of using public money to fund them. So the prospect of
more syringe exchanges in the region remains uncertain.”

Ungar gives the basics of how the diseases spread: “HIV, which can be transmitted
through semen and other bodily fluids in addition to blood, is mainly
spread by having unprotected vaginal or anal sex with someone who has
HIV, or sharing used needles, which can harbor live viruses for up to 42
days. But it also can be transmitted to health care workers by needle
sticks, or from mother to child during pregnancy, birth or
breastfeeding, especially if the mom isn’t taking medicine.

B and C, which are caused by separate viruses, are easier to catch than
HIV because there are higher levels of virus in the blood. Hepatitis B
is more often contracted through sex or accidental needle sticks than
hepatitis C, but both types are commonly spread by sharing tainted

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