Things are going from bad to worse in Scott County, Indiana as new HIV cases continue to soar amongst IV drug users in Scott County and Indiana Governor Mike Pence and the GOP controlled legislature bear the responsibility for all of this and need to get their heads out of the sand.
As many of you know, the legislature and governor in Indiana shut down the Scott County Planned Parenthood facility in 2013, and four others were shut down across the state as far back as 2011. Each of the five clinics all provided HIV testing and information about HIV transmission, etc., but were closed in large part due to funding cuts to the state's public health infrastructure passed by the GOP controlled legislature and signed by Governor Mike Pence. Those cuts came amid a national/local political campaign to demonize Planned Parenthood due to it providing contraception and abortion services at some of their clinics. Sadly, the Scott County location did not provide abortion services but seems to have fallen victim to the war waged by irrational conservatives across the country and in Indiana.
As a result of these misguided steps taken by the legislature and governor, HIV rates have soared from the usual 5 cases per year to over a 120 this year and climbing:
There are now 120 confirmed H.I.V. cases and 10 preliminary positive cases tied to Scott County, the Indiana State Department of Health said on Friday. That is up from 106 the previous week.
Health officials who declared an epidemic last month have said that they expect the number of cases to rise as more people are tested. The Centers for Disease Control and Prevention sent staff members to Indiana last month to help with testing, the Health Department said in a news release. The growing number of cases could put pressure on Gov. Mike Pence to extend the 30-day needle exchange program that he approved on
The Scott County outbreak has occurred among IV drug users and primarily involves the use of the high-powered painkiller Opana, rather than Heroin. I had never heard of Poana before so for those of you in the same boat, here is some info on the drug:
Opana (oxymorphone) is an opioid pain medication. An opioid is sometimes called a narcotic.
Opana is used to treat moderate to severe pain. The extended-release form of this medicine is for around-the-clock treatment of severe pain. Opana ER is not for use on an as-needed basis for pain.
You should not use Opana if you have severe asthma or breathing problems, a blockage in your stomach or intestines, or moderate to severe liver disease.
Opana can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take this medicine in larger amounts, or for longer than prescribed. Do not crush, break, or open an extended-release pill (Opana ER). Swallow it whole to avoid exposure to a potentially fatal dose.
http://www.drugs.com/...
Reuters was reporting as far back as 2012 that Opana had become the new scourge of rural America:
http://www.reuters.com/...
Clearly, based on this article, there are a number of overdoes deaths being attributed to Opana, in addition to the current HIV outbreak.
According to health department officials in Indiana, since Governor Pence approved the temporary needle exchange program, 5,322 clean syringes have been provided to 86 participants and about 1,400 used syringes have been returned. But clearly, 86 participants is not a large number so their outreach program is not reaching their entire universe. But based on the numbers above and the number of participants, the numbers of syringes being taken and returned per participant seems to be quite large so perhaps they are reaching larger numbers of people than the 86 they report.
In the meantime, the future of the Scott County needle exchange program, and other type programs across the state, still appear to be in jeopardy:
A spokeswoman for the governor, Kara Brooks, said on Friday that Mr. Pence was reviewing reports and recommendations from health officials and would decide within the next few days whether to extend the program beyond April 25.
Mr. Pence, a Republican, opposes needle exchanges as an antidrug policy. David Long, the State Senate’s president pro tem, said Thursday that the emergency exchange for Scott County was “the right reaction” but added that he was not sure if it was the correct long-term approach. Nor was he sure, he said, whether the Senate would support legislation sponsored by the chairman of the House Public Health Committee, Representative Ed Clere, that would allow the 23 Indiana counties with the highest rates of hepatitis C to establish their own needle exchange programs.
Health officials say that high rates of hepatitis C are an indicator of needle-sharing.
The House approved the bill on April 7 in a 54-to-39 vote. The measure is scheduled for a hearing on Monday in a House-Senate conference committee, which will try to work out a final version for lawmakers to consider before the legislature’s April 29 adjournment deadline.
Mr. Long said the governor was not alone in his concerns that needle exchanges could promote instead of prevent drug use. “At the same time, you adapt and you evolve based on the world we live in, so we’re going to have to see if that requires a pivot for us,” he added.
Mr. Clere said he appreciated the governor’s approval of the needle exchange, but he added: “It doesn’t help in other areas of the state that are at risk for a similar outbreak. It’s just not enough.”
He said the association between needle exchanges and illegal drug activity made many people, including lawmakers, uncomfortable. But he said the exchange program should be viewed as “a proven and effective harm-reduction policy,” not as an antidrug policy.
“We simply can’t afford to view this as a short-term problem,” Mr. Clere said.
As time goes by, I suspect HIV rates are going to continue to climb in Scott County, as more people get tested, but at a slower rate. But the state of Indiana needs to restore funding cuts that would allow Planned Parenthood to re-open their facility. Planned parenthood would have a much better chance of getting more people tested for HIV than a state of county clinic since they are third party and are would be perceived as protecting privacy better.
And I think Planned Parenthood would also handle the second wave of this outbreak quicker and more effectively, when the sexual partners of these IV drug users who are HIV positive, either show up to get tested, or who show up down the road sick.
http://www.nytimes.com/...
http://www.huffingtonpost.com/...