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.
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