AUSTIN, Indiana – A small Indiana town of just over 4000 people is now ground zero for the Centers for Disease Control and the Indiana State Health Department after an HIV outbreak that, as of today, has reached 143 new cases (138 confirmed and 5 preliminary positives). It has sparked a nationwide debate on controversial needle exchange programs, since health officials say 4 out of 5 of the cases report intravenous drug use, more specifically heroin. This has caused state officials to probe into possible overprescribing of the highly powerful and addictivepainkiller Opana, often used in heroin mixtures.
What’s even more disturbing is the CDC warning we are experiencing the worst HIV/Hepatitis C outbreak in two decades. At the urging of Indiana’s Republican Attorney General Greg Zoeller, lawmakers have been asked to expand the state’s needle exchange programs.
“As the HIV outbreak continues to grow in Scott County, it has become abundantly clear that the Austin community and other locations that may be at risk need a serious, immediate solution to curb rampant needle sharing among users,” says Attorney General Zoeller. “I urge the General Assembly to approve legislation that authorizes the Indiana State Department of Health to conduct syringe exchanges in Scott County and other at-risk counties on a continuing basis, so that we can contain the current outbreak and prevent a similar outbreak of HIV or Hepatitis from devastating another Hoosier community.”
The Indiana State Department of Health has given press conferences twice a week updating the outbreak. Grace Covenant Church has offered shuttle bus transportation for people to get to Austin’s Community Outreach Center for testing. Since March 30 they have utilized services for over 740 people including HIV testing and aftercare.
On April 20, Governor Mike Pence, on the heels of a highly publicized debate about gay wedding cakes, issued an Executive Order declaring a public health emergency in Scott County and permitting the Scott County Health Department to administer a limited short-term needle exchange program which will expire May 24 (receiving little to no national media coverage). During the past week 166 people have brought in 6,494 needles in exchange for 7,146 new, safe syringes – a program that is obviously working.
“Providing clean syringes is the fastest way to halt further spread of the virus from infected individuals to non-infected ones,” says Attorney General Zoeller. “The costs of not providing the medically necessary needle exchange in the legislation in terms of both human suffering and public funds for treatment are too high.”
Scott County Sheriff Dan McClain, in a twist of events, tells us he has taken a similar stance to the Attorney General’s request.
“If you had asked me 6 months ago if I approved of needle exchange programs I probably would have told you no,” says Sheriff McClain. “With what we’re going through now, we’ve had to work out a plan of education, treatment, and without that third piece we’d be losing the effort.”
Sheriff McClain says since the outbreak, they have offered testing to any inmates in the Scott County Jail that desire it, resulting in 15 new cases within the jail. Sheriff McClain says there’s not a reason to believe they were positive before the outbreak, and that it’s part of the new strain.
“Several of these inmates tested positive because outside sources they had previously shared needles with tested positive and contacted them here,” says Sheriff McClain. “It’s because of the efforts of the programs set in place to identify new cases as quickly as possible. Those inmates are now in the process of being set up for treatment of the disease.”
Sheriff McClain thanks Governor Pence, and says when they first realized what was happening, he had a lengthy conversation with the Governor, without whom he says none of the efforts would have been possible.
Lawmakers worked all week and feel they have worked out a compromise, assessing each county health department on a local level, and then letting the state Health Commission decide whether or not to enact a clean needle exchange program in that area.
From a law enforcement perspective, the Sheriff says opiates are the biggest problem, specifically the powerful and addictive painkiller Opana, and it’s hardest to arrest.
“It’s a lot easier to fight drugs like meth and marijuana,” says Sheriff McClain. “With prescription pain killers, they’re legal, so it’s difficult to make arrests oftentimes. And people are using it intravenously, crushing it up, cooking it. Pharmaceutical companies and doctors prescribing them unnecessarily need to be held accountable.”
Opponents of the needle exchange expansion say the initiative will make it easier for someone to get the tools they need to use more drugs. But Sheriff McClain says this particular debate has a bigger picture.
“You have to look at both sides,” says Sheriff McClain. “I understand the hesitant nature in it. But now, this has become a medical issue. When you look at the root at the cause of the spread of this disease, the use of dirty needles, it makes sense to have a needle exchange program in place in those areas.”
Those in recovery from heroin addiction, like student Branden Cooper of Vertava Health, say the needle is a hard addiction to fight.
“The other day I had to get treatment for some stomach issues I was having,” says Cooper. “They stuck me with an IV. I wanted to stick myself with something so bad.”
Cooper, who is a diabetic, and used to use his insulin needles to shoot heroin, reveals his personal fight with the needle and shocking revelations about his family’s drug use in an exclusive special report with reporter Darcy Thomas that is set to air mid-May on WHBQ Fox13 News in Memphis.
The Centers for Disease Control is supporting Indiana, as well as county public health officials, with efforts to diagnose the people who have been infected with HIV and Hepatitis B and C, and ensure that they receive appropriate care and treatment.
“This includes interviewing people who have been infected, identifying possible risks to others and educating HCPs and the public about what they can do to protect themselves and others,” says Donnica Smalls with the CDC News Media Team. “CDC issued the Health Advisory to alert public health departments and health care providers nationwide of this increasing Hepatitis C epidemic and the possibility of current or future HIV outbreaks among people who inject drugs.”
The CDC is also asking states to take a close look at their most recent data on HIV and Hepatitis C diagnoses as well as overdose deaths, admissions for drug treatment and drug arrests to help identify communities that could be at risk for unrecognized clusters of HCV and hiv infections, as well as those who would benefit from expanded prevention efforts.
“We are also recommending increased testing and follow-up of contacts for all newly diagnosed cases of HIV,” says Smalls.
Sheriff McClain says they have had incidents in the past of officers getting stuck with needles, and members of the trash department accidentally getting stuck picking up trash bags, but thankfully none were recent nor did they test positive. But, he does issue advice for other Sheriff Departments.
McClain says if sheriffs know a source of their population is using heroin, testing positive for Hepatitis C in the emergency rooms, encourage testing in your communities.
“The exchange program is at a slow start, and we are still arresting people with syringes that aren’t in the program, and we arrest them if they have other drugs on them,” says Sheriff McClain. “But there’s a fear that if we have that information we will go after them. If they are part of the needle exchange program and have their card, they don’t go to jail for having that needle. We won’t arrest them for that.”
The outbreak is obviously changing minds in Indiana, but will it do the same in other states like Tennessee, where overdose deaths continue to rise? All over the U.S., where opiates have surpassed alcohol as the drug of choice? IS ANYONE LISTENING? We’ll continue to talk, because in the words of ActUp, the leading activist group during the first HIV/AIDS crisis in the early 1980s, SILENCE = DEATH.
About Greg Zoeller
Gregory Francis Zoeller (born March 28, 1955) is the current and 42nd attorney general of the U.S. State of Indiana. A Republican, he was elected in November 2008, defeating Democrat Linda Pence, and took office on January 12, 2009 and was re-elected to a second four-year term in 2012.
About Governor Mike Pence
Michael Richard “Mike” Pence is an attorney who has served as the 50th Governor of Indiana since 2013. A member of the Republican Party, he previously represented Indiana’s 2nd congressional district in the United States House of Representatives from 2001-2013 and served as Chairman of the House Republican Conference from 2009-2011. Pence, a former Democrat who has been compared to Ronald Reagan, has been mentioned by analysts as a potential candidate for the Republican nomination for President of the United States in 2016.
About Sheriff Dan McClain
Sheriff Dan McClain is now the Sheriff in Scott County, Indiana. He was part of SEAL team 6, the same team that raided Osama bin Laden’s compound in Pakistan and ultimately killed the terror leader.
About Vertava Health
Vertava Health provides the most comprehensive addiction treatment program in the country by going beyond the standard 30 day plan and treating persons struggling with addiction mentally and spiritually to break the cycle of repeated visits to treatment. Utilizing our addiction campus environment we have the depth of caring staff, industry experience and clinical proficiency to effectively treat the disease of addiction for life. Vertava Health’ admissions center is trained to assess and place the client into one of the Vertava Health treatment centers across the country within a 1 hour time frame. This speed in service delivery and thorough commitment to the client long term allows the person struggling with addiction to get quickly on the road to recovery and create a life that’s worth living.