In 2010, there were only 39 new cases of Hepatitis C reported in North Carolina. Last year there were 186 reported to the health department. Those numbers might not stand out in a state of 10 million people. But they are alarming because they represent a fast growth in a chronic illness that already afflicts more than 110,000 people in North Carolina. And there are probably more who don't know they have it. In response, groups are trying to prevent the spread by giving addicts clean needles.
Michelle Mathis and Vicki came to the southern style restaurant in Hickory for the chicken fried steak and the salad bar. Then they headed out to Michelle’s car. She pulled out a paper bag wrapped in plastic.
“I have a kit for you,” she said, “There’s enough in here or you to share.”
Mathis hands the bag of clean syringes to Vicki. The markings on Vicki’s arm are an indication of what she’ll use them for - to inject heroin.
“I am a functioning addict,” Vicki said. “I’m not proud of what I do and neither is Michelle, but Michelle helps me to keep a clean environment with what I do instead of spreading disease.”
Vicki asked that we use only her first name, because, well, heroin is illegal after all.
She said since she and her friends have been getting clean needles from the syringe exchange for the past seven months, she’s noticed a difference in the people she shoots up with.
“I’ve seen many people who used to always share back and forth,” said Vicki. “Then Michelle came through and they keep backpack with their own and they don’t do that anymore.”
Syringe Exchanges became legal in North Carolina last year. Now there are more than 20 around the state. Exchanges have to register and report back to the North Carolina Department of Health and Human Services which reports so far they have distributed more than 1 million syringes to almost 4,000 people. No state funds can be used to buy syringes and other supplies distributed. Mathis and her wife run the exchange for seven rural counties to the north and west of Mecklenburg County with donations, grant dollars and some of their own money.
“We can see month to month the people that we serve who may be Hep C negative one month and then they start to get sick and show signs,” Mathis said.
During the day Mathis is an executive assistant at a hospital. She says her faith drew her to this volunteer work. She was a minister at a non-denominational church. But a few years ago she decided rather than preaching to addicts from the pulpit she wanted to be on the streets and country roads to help them keep from spreading disease. An act Christina Caputo with North Carolina Department of Health and Human Services has found quite valuable.
“Harm reduction is a fantastic resource in prevention of Hepatitis C,” she said.
The department estimates there are more than 110,000 people across the state living with Hepatitis C. And the Centers for Disease Control reported new cases reached a 15-year high across the country in 2015. Caputo and other public health officials fear even those numbers don’t include all the cases. Many people don't know they have the disease because not everyone has immediate symptoms. And that’s why testing is so important. All public health departments now offer it.
“They are not going to come to the health department or go to their doctor and get tested,” Nolan said. “They need to be tested where they are at," says nurse practitioner Tim Nolan.
He works at an HIV clinic by day. By night he works with Mathis’ syringe exchange to test drug addicts for Hepatitis C and HIV. He brought a case of the finger prick tests and offers to test everyone he delivers syringes to. It takes about 20 minutes to get results.
“Many of them will say well I’m already Hep C,” Nolan said. “Which is amazing to me. So it’s really out there.”
The tests Nolan uses are pretty 98 percent accurate, but need to be confirmed by a more extensive blood test. The good news for people infected with Hepatitis C is its mostly curable with medicines. The bad news...they are pricey. Last year North Carolina Medicaid spent $72 million treating just more than 1,000 patients. Which is partially why prevention is so important to John Faircloth. He’s the state representative who led the effort to legalize syringe exchanges.
“We certainly haven't solved drug problem,” said Faircloth. “But we’ve kept some people from getting Hepatitis C and other diseases. And I think that’s been a great step forward.”
Faircloth was a police chief in High Point from 1976 to the early 90’s. He says he wouldn’t have supported the idea of a syringe exchange back then. But now, he says, it’s become clear that drug addiction is a public health problem.
Correction: This story has been updated. An earlier version said no public funds can be used to buy syringes and other supplies for needle-exchange programs. That's not true. While state funding is off-limits, local public funding can be allocated. The story now says that no state funds can be used.