Needle exchanges are gaining wider acceptance in areas of the country where HIV and hepatitis C are spreading through injection drug use, Reuters reports.

In March, Indiana Governor Mike Pence declared a public health emergency as the state battled an outbreak of HIV linked to intravenous use of the painkiller Opana. The governor authorized a short-term program in one county to exchange used needles for sterile ones, to reduce the risk of contaminated needles being shared. In May, Pence signed a law that extends the program, allowing Indiana localities with health emergencies to begin their own needle exchanges.

Kentucky passed a similar law after the state saw a rise in hepatitis C cases linked to injection drug abuse. West Virginia has approved a pilot needle exchange program that is scheduled to begin in September. Southern Ohio has had exchanges in two cities since 2012, the article notes.

Prescription painkiller abuse is largely to blame for a big increase in the rate of hepatitis C among young people in rural areas of four states, according a recent report from the Centers for Disease Control and Prevention.

Acute hepatitis C infections more than tripled from 2007 to 2012 among young people in rural areas in Kentucky, Tennessee, Virginia and West Virginia. About 73 percent of those hepatitis C patients said they injected drugs. Injecting drugs can spread HIV and hepatitis C when people share needles.