INDIANAPOLIS (AP)
— Indiana Gov. Mike Pence overrode state law and his own anti-drug
policies Thursday to authorize a short-term needle-exchange program
designed to help contain HIV infections in a rural county where more than
six dozen cases have been reported, all of them tied to intravenous drug
use.
Pence issued an
executive order declaring a public health emergency in Scott County, an
economically depressed area about 30 miles north of Louisville, Kentucky,
that has seen 79 new infections since December. The county typically sees
only about five HIV cases each year, health officials said.
All of those
infected either live in Scott County or have ties to the county, and all
of the infections have been linked to needle sharing among drug users.
Most of the
infections involve people who injected a liquefied form of the
prescription painkiller Opana. Methamphetamine and heroin account for the
remaining cases, health officials said.
Pence, a
Republican, said officials from the Centers for Disease Control and
Prevention who arrived in the county Monday said it would be "medically
appropriate" to authorize some type of needle-exchange program to help
stem the infections.
Such programs are
illegal in Indiana, and Pence has opposed needle exchanges as part of
drug-control efforts. But his order allows Scott County officials to
request state approval for a limited, short-term program.
The governor said
he was acting to halt the spread of the virus "despite my reservations"
about providing clean needles to addicts.
Needle-exchange
programs allow drug users to turn in used hypodermic needles in return for
sterile ones in an effort to contain diseases such as HIV and hepatitis.
Pence's executive
order will run for 30 days. After that period, he will consider whether to
extend it for another 30 days.
Scott County's
cases have surged from 26 in late February to nearly 80, and that number
is expected to rise. Officials are trying to contact as many as 100 people
tied to those with confirmed infections of the virus that causes AIDS.
Pence's order
directs the state health department to set up a command center to
coordinate HIV and substance-abuse treatment and establish a mobile unit
to enroll people in a state-run health program to get HIV testing and
treatment.
The state has
also launched a public-awareness campaign focusing on drug treatment,
infection prevention, safe sex, needle disposal and HIV testing and
treatment.
"This is all
hands on deck. This is a very serious situation," Pence said.
After meeting
with Pence, Scott County Sheriff Dan McClain said Wednesday that his
county has been fighting prescription pills for years, and the infections
tied largely to Opana are just the latest development in a long-running
drug-abuse trend that's drained local resources.
"We have become
the local rehab, mental health and treatment center, as well as the
correction center here," McClain said.
Don Des Jarlais,
director of research for the chemical dependency institute at Mount Sinai
Beth Israel in New York, said the places most vulnerable to infections
include rural and suburban communities where a new group of drug users
started with prescription painkillers and moved onto injecting heroin.
Without drug
treatment or syringe-exchange programs, these areas "are ripe for
outbreaks, and we should expect more of them unless we really ramp up our
HIV-prevention services in those areas," he said.
The county's 79
HIV cases represent more than half of the 146 new HIV cases that have been
confirmed statewide in Indiana since January, said Ken Severson, a
spokesman for the Indiana State Department of Health. The recent surge in
infections is the state's largest-ever HIV outbreak.
Des Jarlais
called on Pence to make the needle-exchange program permanent.
"The potential
for continued transmission," he said, "will be there for a decade or more"
in southern Indiana.