(CNN) - Kentucky is a state hit hard by the opioid epidemic.
“I was in New York for 10 years and I've never seen people inject this many times,” said Donald Davis of the Kentucky Harm Reduction Coalition.
The use of IV drugs is now fueling another crisis - hepatitis C. If left untreated, the disease can be deadly.
Kentucky has the highest incidence of hep C in the country, increasing at seven times the national rate.
Officials are tackling the problem with clean needle exchanges.
Hidden here in the lush rolling hills of Appalachia is the town of Hazard, where the virus is rampant.
“We've got a little over 300 individuals in our needle exchange program,” said Scott Lockard, public health director of the Kentucky River District Health Dept.
The program is anonymous.
Participants give their initials and birth date for a registration card but aren’t asked to provide much more except their used needles.
“Of course, the ultimate goal is we try to get everyone into treatment, because if a person participates in a needle exchange program, research shows that they are five times more likely to go into treatment than individuals that don’t,” Davis said.
The exchange also provides other sterile drug equipment like tourniquets and cotton balls.
In Louisville, Davis mans this mobile exchange unit.
“We gave out 136,000 syringes, and we got back 103,000, so that’s a very good return rate,” Davis said.
Jennifer Twyman has a post at the health department.
“A couple of weeks ago, I had a 52 year old man sitting in this chair crying because he didn’t want to go to the hospital,” she said.
“We give them the number of syringes they need per week according to the number of times they inject. If they inject 12 times a day, we give them 84,” Davis said.
Both are on the front lines of the epidemic, and both are in longterm recovery from drug addiction.
“I was using and I used to donate plasma every week, and they called me in one day and told me I couldn’t donate anymore because I had hep C,” he said.
The 71-year-old Davis said he’s now cured of the virus. He encourages others to get tested and educates users on how to prevent contracting hep C.
The majority of the people that come in appreciate what we do.
Not all feedback on the program is positive, but these warriors said they won’t give up
“We want to make sure they're safe and a person can't recover if they're dead, so this is the logic that we give people when they say we'll you're enabling them,” Davis said. “So I guess I'm enabler because I'm going to enable someone to stay alive so they can get the treatment.
“What does it mean to me to be able to do this? Everything. It means everything,” Twyman said.