Whether fairly or unfairly, Kentucky's Appalachian region has long been regarded as a place of poverty and hopelessness. Although blanket statements such as this are rarely 100 percent correct, recent numbers published regarding rising hepatitis C rates in the region and the drug use which could be causing them certainly do not paint an encouraging picture. In the four Appalachian states of Kentucky, Tennessee, Virginia, and West Virginia, hepatitis C infections rose a staggering 364 percent between 2006 and 20012, with Kentucky, unfortunately, leading the way. The Center for Disease Control has identified drug use as a majorly contributing factor in this rise. Kentucky has attempted to establish needle exchange programs to curb this trend, but, as one former addict remarked, “A needle exchange program is like giving a gun to someone suicidal.” The rapid spread of the virus has caused many to worry that an outbreak of HIV could be right around the corner. Drug addiction is a hopeless game, and the residents of Appalachia must realize this before it is too late. This has, literally, become a matter of life or death.