HIV di­ag­noses sky­rocket among abusers of painkillers in In­di­ana


Cases of HIV have sky­rock­eted among in­jec­tion drug users in a ru­ral com­mu­nity in the Mid­west­ern state of In­di­ana where 142 peo­ple have been di­ag­nosed since the be­gin­ning of the year, of­fi­cials said Fri­day.

Preg­nant women, grand­par­ents, their adult chil­dren and grand­chil­dren are among the new cases of HIV linked to abuse of oxy­mor­phone, a po­tent pre­scrip­tion painkiller that drug users crush, liq­uefy and in­ject into their veins.

In­di­ana State Health Com­mis­sioner Jerome Adams de­scribed the cur­rent out­break as “un­prece­dented,” not­ing that HIV used to be quite rare in Scott County, a com­mu­nity of 4,200 peo­ple and just one doc­tor in south­east­ern In­di­ana.

Only three new cases of HIV were recorded there from 2009 to 2013.

“We lit­er­ally have new cases be­ing re­ported ev­ery day, lit­er­ally on an hourly ba­sis,” Adams told re­porters.

A public health emer­gency was de­clared in Scott County on March 26 by Gov. Mike Pence.

The U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion is­sued a na­tion­wide alert to health care providers to be on the look­out for the pos­si­bil­ity of out­breaks of hu­man im­mun­od­e­fi­ciency virus — and hep­ati­tis C, which of­ten ac­com­pa­nies it — among in­jec­tion drug users else­where in the coun­try.

“At this point, there is no sign that in­fec­tions are in­creas­ing on a na­tional level among peo­ple who are in­ject­ing drugs,” said Jonathan Mer­min, direc­tor of the Na­tional Cen­ter for HIV/AIDS, Vi­ral Hep­ati­tis, STD and TB Pre­ven­tion.

But, he added that the sit­u­a­tion in In­di­ana “should serve as a warn­ing that we can­not let down our guard against th­ese deadly in­fec­tions.”

In the late 1980s, when heroin use was driv­ing the HIV/AIDS epi­demic among nee­dle-shar­ers, there were about 35,000 new cases an­nu­ally in that group.

Now, there are about 3,900 new HIV in­fec­tions per year in the United States linked to in­jec­tion drug use.

Heroin is less popular th­ese days but pre­scrip­tion painkiller abuse is on the rise in the United States, where opi­oid poi­son­ing deaths have nearly quadru­pled from 2009 to 2011.

‘Com­mu­nity ac­tiv­ity’

In­ject­ing painkillers may prove even more danger­ous than heroin be­cause opi­oid ad­dicts tend to shoot up more fre­quently, as of­ten as ev­ery few hours, ex­perts said.

Also, since the pills can be dif­fi­cult to crush into pow­der, they use big­ger nee­dles than heroin users typ­i­cally do, rais­ing their risk of ex­po­sure to HIV.

Scott County has an un­em­ploy­ment rate of 8.9 per­cent, while 21.3 per­cent of adults have not com­pleted high school and 19 per­cent of the pop­u­la­tion lives in poverty, ac­cord­ing to the CDC’s Mor­bid­ity and Mor­tal­ity Weekly re­port on the cri­sis.

Four out of five of those di­ag­nosed with HIV have ad­mit­ted to in­ject­ing drugs, health au­thor­i­ties ex­plained dur­ing a con­fer­ence call with re­porters.

Their drug of choice is a painkiller known by the brand name Opana, which comes in a pill that they crush and dis­solve, even though it is sold in an abuse-de­ter­rent form.

The prob­lem of painkiller ad­dic­tion in the area be­gan more than a decade ago.

“Many fam­ily mem­bers will use drugs to­gether,” said Joan Duwve, chief med­i­cal con­sul­tant for the In­di­ana State Depart­ment of Health.

“There are chil­dren and par­ents and grand­par­ents who live in the same house who are in­ject­ing drugs to­gether, sort of as a com­mu­nity ac­tiv­ity.”

The age range of those in­fected so far is 18-57. Just over half are men. 7 per­cent of the fe­male pa­tients have iden­ti­fied them­selves as com­mer­cial sex work­ers, the CDC said.

Each drug user in the HIV clus­ter has re­ported shar­ing nee­dles with an av­er­age of nine other peo­ple.

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