Indiana Governor, Mike Pence (R), will be revealing the details necessary to declare a public health emergency, in Scott County, in order to address an HIV epidemic due to intravenous drug use. However, it is unclear if he will allow needle exchange programs. Pence has said that he is usually against the idea of needle exchange programs for drug control, however, he is listening to experts. Needle exchange programs work by people turning in used hypodermic needles for clean needles. These programs help to keep diseases, such as HIV and Hepatitis, from spreading.
Wednesday, Pence held a news conference to declare Scott County to be in a public health emergency. A House panel had a three-hour hearing to determine if an emergency amendment should be passed; opening the opportunity for needle exchange programs. There are a number of medical experts that believe needle exchange programs are crucial to slowing down this outbreak and any more that may be on the rise.
The first case of HIV was diagnosed in December and since then there have been 72 more diagnoses in five counties, mostly Scott County. Every case can be attributed to intravenous drug use. There are seven more with preliminary infections. Most are shooting-up with Opana, a prescription painkiller. More cases are expected in the upcoming weeks. Scott County normally has five HIV cases a year. Officials are currently trying to contact up to 100 people who are linked to those with confirmed diagnoses.
Kentucky Governor, Steve Beshear signed a bill allowing needle exchange programs on Wednesday. Pence, did not genuinely approve of the practice himself. Pence said that even though he did not approve of using needle exchanges as part of an anti-drug policy, there is a public health emergency to be stopped. Pence promises to make a decision using the best science and determine the absolute best way to stop the epidemic.
He is expected to announce a 30 day plan Thursday. Pence met with local officials and a team of experts from the Centers for Disease Control and Prevention (CDC). The CDC is in support of needle exchange programs. Clark County’s public health officer, Dr. Kevin Burke, is hopeful that even if the needle exchange program is temporary that it will move through legislation swiftly. However, he did say that a 30 day program would not be long enough to help people long-term. Also, a needle exchange program in only one county will not help the HIV epidemic either.
Foundations Family Medicine in Austin has seen many local HIV cases. The foundation’s office manager, Jeanni McCarty, talked about a patient who has been seen there most of her life, and recently confessed that she used IV drugs and shared needles with others. She also said she paid for her habit through prostitution. In January, she tested positive for HIV. Since then, she has had sex with approximately 75 truck drivers.
An internist in Scottsburg, Dr. Deepak Azad, believes an isolated needle exchange program makes little sense concerning public health. One county with a needle exchange program will not help the current HIV epidemic. Deputy state health commissioner, Dr. Jennifer Walthall, testified at the hearing and said Pence is not interested in supporting needle exchange programs for the entire state to stop the spread of HIV. He is only even considering a needle exchange program to help solve the public health emergency. Pence is considering a surgical strike for only the affected areas. Pence is opposed to the needle exchange program as a “systematic 92-county solution.”
Current efforts are primarily focused on a short-term fix. A Scottsburg family medical doctor, Dr. Shane Avery, does not believe it will be long before the HIV outbreak spreads to other counties. Hepatitis C cases, have also been on the rise in the past few years.
It has been determined by Governor Mike Pence that a short-term needle exchange program with help contain the HIV outbreak. The health department has been ordered to set up a command center. The command center will coordinate HIV and substance abuse treatment. It will also establish a mobile unit and enroll people in state-run health programs.
Indiana does not allow needle exchange programs. However, Pence has agreed to a short-term exchange program based on the advice of the CDC and other health officials. There is a current public campaign that is focused on HIV prevention, drug treatment, needle disposal, safe sex and HIV testing and treatment.
By Jeanette Smith
Photo courtesy of Sesab Sus – Flickr License