Specifically, these 18 states do not have laws authorizing a syringe exchange program. That's because hepatitis C is commonly spread when injection drug users share their needles and other equipment.
The annual numbers of hepatitis C reported to the CDC have almost tripled, rising from 850 in 2010 to 2,436 in 2015. The U.S. Department of Health and Human Services (HHS) has brought five specific strategies to fight against the opioid epidemic that will save lives and reduce the impact of injection-related infectious diseases.
In the Valley, the Mahoning County Board of Health told 21 News the number of reported infections with the virus has gone up noticeably.
The fact that contaminated needles are among the causes of hepatitis C infections leads many to believe that the opioid epidemic is somehow linked to the rise in cases.
"We know that most of the folks we work with say that they do not share their needles with anybody, so that's going to prevent the transmission of Hepatitis C to others", Stokes said.
According to the Kentucky Department for Public Health, the state had the highest rate of new acute Hepatitis C infections from 2008 to 2015, with more than 1,000 cases.
Physician Jonathan Mermin, who heads CDC's hepatitis prevention center, says there needs to be more testing, curing and prevention of Hepatitis C to "protect generations of Americans from needless suffering and death".
Hepatitis C is being kept track due to the dangers it poses on those infected.
"Despite being the seventh leading cause of death in the world - and killing more people every year than HIV, road traffic accidents, or diabetes - viral hepatitis accounts for less than 1 percent of the National Institutes of Health research budget", he said. Though they have adopted permissive Medicaid treatment policies, they still rank among the 17 states with highest rates of new hepatitis C virus infections.
New hepatitis C virus infections are increasing fastest among young people, with the highest overall number of new infections among those 20 to 29 years old. A child can also catch it if born to an infected mother.
Dr. Raymond Chung, a member of the committee of the American Association for the Study of Liver Diseases that provides hepatitis C treatment guidance to doctors, said there are several impediments to treating the drug-using population.
"While this study focuses on pregnant women and a high-risk area in Tennessee, it is also important to remember that hundreds of thousands of people throughout the USA have hepatitis C, and a large percentage of them do not know it", Jones said in a statement.
It's a problem experts describe as a "dual epidemic" because it's directly tied to opioids such as heroin.