CLINTON COUNTY — Narcotic opioids heroin, fentanyl and carfentanil were responsible for more than 64,000 drug overdose deaths in 2016 and the drug crisis continues to grow across the country.
As the rate of drug use increases in rural Ohio, the number of life-threatening MRSA (Methicillin-resistant Staphylococcus aureus) and chronic hepatitis C infections are on the rise among people who use shared needles.
Stephanie Ottesen arrived at Clinton Memorial Hospital emergency department overwhelmed with pain in 2015.
“I thought, because I had been using a little bit of meth, but I was mostly a heroin addict, I had been staying up for days and I thought it was related to that meth and I just needed sleep. But then I had to take my jacket off at the hospital and the nurses saw my arm and I had open sores on my arm,” said Ottesen.
The open sores, near her wrist, remained covered most of the time. Ottesen said she was trying to hide the infection and described how it was caused by using shared syringes when she injected heroin or methamphetamine with her friends in her hometown of Blanchester.
“They knew right away that it was MRSA and rushed me in for treatment,” said Ottesen.
She spent hours in the emergency department. She learned that the multi-drug resistant MRSA had spread into the valves around her heart. Ottesen was placed into a Warren County nursing home for three months and said she was treated with a strong antibiotic, vancomycin, to kill the MRSA bacteria.
Ottesen said she thought she was going to die from the MRSA infection but over time the antibiotic healed her heart.
She will always be a carrier for MRSA and will have to cope with having permanent skin abscesses and high blood pressure. Losing a piece of the skin on her arm from MRSA was traumatic, she said, and it wasn’t the last time she would rush to the emergency department to be seen for overwhelming pain.
Additional tests during her stay at the nursing home confirmed the MRSA infection was co-morbid with the hepatitis C virus, Ottesen said. Hepatitis C is transmitted primarily through contact with blood and using shared needles when injecting drugs.
Recent research has shown that the hepatitis C virus can also survive outside of the body on surfaces for three weeks, with some research reportedly showing that it can remain active for six weeks.
Ottesen said she was surprised by how suddenly the permanent damage set in once she had become infected with the pathogens. Left untreated, hepatitis C becomes a chronic disease that can possibly cause liver cancer or the kidneys to shut down.
Today she is on a waiting list for hepatitis C treatment and doesn’t yet know what her specific treatment plan will look like. Generally, the treatment for a chronic hepatitis C infection costs tens of thousands of dollars. One treatment cycle can cost a minimum of $65,000.
A treatment cycle varies depending on the nature of the infection, but a single treatment can be a two, three, or four month program, or longer, depending on which medication is used and if a combination of medications are required to cleanse the body of the virus.
“I’m in the process of treatment for hep,” said Ottesen. “They have a recommendation for a liver doctor at the University of Cincinnati who told me I have to be clean six months to start the treatment. For treatment I heard you take a pill every day for four months. Hepatitis is curable. In the past you’d have to get an injection every day in your stomach.”
Ottesen said that like other small towns in Ohio, the opioid crisis is obvious in Blanchester. At 27, she can name four people who have died here, including her best friend and her boyfriend. During high school and after graduation, Ottesen said she and her friends used methamphetamine and it was widely available in the community.
“Then the meth dried up,” said Ottesen. “I’d hold onto 20 dollars for a while but couldn’t find anyone who had any meth. Suddenly everyone had heroin. Eventually I tried it.”
In 2013, she began driving each day to Dayton — a two-hour round trip — to purchase heroin. She wasn’t alone. Ottesen said dozens of other people in the area were driving to Dayton to pick up drugs.
Across town, a 26-year-old woman recalled what it was like making daily trips as an 18-year-old to purchase heroin in Dayton.
“When you’re from Blanchester, Dayton is Shangri-La for a junkie. It’s the dope candy mountains of Ohio,” the 26-year-old said, who asked not to be named in this report.
Ottesen said herself and other methamphetamine users had already begun to inject methamphetamine when heroin was initially introduced to her in 2011 from Dayton.
“At that time no one ever overdosed. Heroin wasn’t that strong, it didn’t have all that stuff that is mixed in now. When the new stuff came out on the market, carfentanil, you were too afraid to use. I was still using,” said Ottesen.
The 26-year-old said, “There should be a needle exchange. People should use needles only one time ever but there’s no other option, you only have the one needle. You just clean it out or whatever.”
She said needles are hard to find, increasing the chances of someone sharing syringes.
When people can’t find clean needles, Ottesen said people use bleach to clean their used syringes, as the CDC recommends. That could mean re-using the same needle 60 times or more. A needle can last a user approximately one week, or until they start rigging it — replacing parts of the needle to keep it functioning.
“They call the needles ‘weapons of mass destruction,’” said Ottesen. “It’s crazy what people will do to fix their needle. Some use sandpaper just because it would be so dull, to try to sharpen it up. I’ve seen people cut the top off, use ear wax on the plunger, super glue, and some people rub it on their jeans to sharpen it up.”
When asked how many people in Clinton County are active users who have been known to share needles, both women agreed that several dozen people at least, or perhaps hundreds of people, have hepatitis C infections from sharing syringes in the community but remain untreated, and therefore, undocumented.
“I don’t have hep,” said the 26-year-old in Blanchester. “But one time in jail, a girl asked me, ‘Oh, you don’t have hep?’ She was surprised because everybody has hepatitis C — all the friends I had while I was using (heroin), they all have hep, even if they haven’t been tested, they all know they have hep. Everybody in jail has hep.”
For residents in Clinton County, the nearest health department-approved syringe exchange is in Greene County at SafeTrade, 600 Pierce Drive in Fairborn.
SafeTrade Program Manager Jessica Warner said the syringe exchange opened in November and has five clients. Partial funding comes from the Greene County Department of Health general fund. The program offers services to people in any county, but Warner said that of the five current clients, none are from Clinton or Fayette.
Contact Ashley at (740) 313-0355 or connect on Twitter by searching Twitter.com for @ashbunton and sending a message.