injection drug use

Injection drug use is rising, state officials say, and that brings with it the risk of overdose and outbreaks of hepatitis C and HIV.

Appanoose County is among the 10 most vulnerable counties in the state of Iowa for outbreaks of overdoses, and both hepatitis C and HIV.

The concerns were the topic of a two-hour town hall Tuesday, hosted by the Iowa Department of Public Health with local emergency responders and health professionals. The topic: working together to curb the risky practices that can result in other overdoses or disease spreading.

Intersection of HIV, HCV, and Substance Use

A state map showing the most vulnerable counties for hepatitis C or overdose outbreaks.

According to Iowa’s Vulnerability Index, shared by the Department of Public Health, Appanoose County ranks second in the state as counties “most at-risk” for hepatitis C or HIV outbreaks. The county was seventh on the list of at-risk counties for overdoses.

Among those under 40 years old, public health data shared Tuesday show Appanoose County as one of the highest rates of positive hepatitis C screenings per 100,000 from 2000-2017. Statewide, the disease is becoming chronic more frequently among those under 40. It spiked at 479 in 2016. Preliminary data for 2018 recorded 412.

Intersection of HIV, HCV, and Substance Use

A map showing, on a county-level, the rate of methamphetamine-related admissions from 2012-2016, at a rate of per 100,000 population.

Public Health officials say the increase in hepatitis C and HIV is triggered by more people injecting drugs, but also means more hospital visits, more treatment admissions, more drug arrests and more overdoses for communities.

Additionally, the amount of opioid-related deaths and hospitalizations are increasing statewide, and Appanoose County was among the higher rates per thousand in both categories.

Among the solutions presented was offering a medication assisted treatment opportunity in the county. Currently, Wapello is the closest county offering a program in Iowa. The treatment plan allows those addicted to opioids to gradually wean their dependence on the drug.

Heather Smith, outreach education and overdose prevention specialist at public health, also urged some harm reduction principles be considered. For instance, a needle exchange program to provide clean needles to help curb re-use or sharing. Additionally, she urged person-centric language, such as saying someone has a dependence on a drug instead of calling them an addict.

At the close of the presentation, local participants were able to share their experiences or feedback to public health officials.

Attendees reported that drug use among young individuals is a concern. A Hospice worker said they are seeking some younger clients as a result. A registered nurse reported commonly seeing students, even pre-teens, that are using drugs.

“I think people have no idea the amount of kids that are using drugs in our town,” the nurse said. “It’s shocking.”

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Kyle Ocker can be reached at or by calling the newsroom at 641-856-6336. Follow him on Twitter @Kyle_Ocker



Kyle Ocker is the editor of the Daily Iowegian. Prior to becoming editor, Ocker was a correspondent, sports editor and associate editor at the Daily Iowegian, and was the managing editor of the Knoxville Journal-Express.

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