Concerted, sustained effort required in taming Hoosier HIV/AIDS epidemic


(Bloomington) Herald Times

The Scott County HIV/AIDS epidemic shocked the Hoosier state into action, a little late perhaps, but fast for most situations requiring action at the state level.

Gov. Mike Pence, despite his personal belief that needle exchange programs that facilitate consumption of illegal drugs are bad policy, accepted the view of public health professionals that exchanges were the only real way to curb the alarming rate of HIV infection in Scott County.

In most cases, the vehicle for transmission of the virus was a needle that drug users would share to inject their drug of choice, often heroin or one of several other opioids that began life as prescription painkillers.

Another marker of opioid addiction is the dramatic increase over the past several years in the number of cases of Hepatitis C, an incurable disease that attacks the liver.

That also is frequently transmitted by sharing needles to inject illegal drugs, but because the virus can live for days on a contaminated needle while the HIV virus dies within minutes, a shared needle has much more damage potential.

In the five years from 2009 to 2014, reported cases of hepatitis C almost doubled from 76 to 139 in Monroe County. Equally alarming is the death rate from heroin poisoning. Nineteen people per 100,000 population in the county died in 2013, the last year complete figures are available.

In Morgan County, the rate was 13 deaths per 100,000 and in Lawrence County, it was eight per 100,000.

Public health officials here link the easy accessibility of opioid painkillers to the ballooning rate of addiction, with some doctors pointing out that potentially addictive drugs are prescribed in this country on a routine basis for pain that in other countries might be treated with Tylenol or other nonprescription remedies.

It is a difficult and multi-faceted problem. Physicians want to alleviate pain but also recognize the dangers of introducing a patient to the effects of many prescription drugs.

Addicts live in a gray space that too often drives their lives. They may be mentally ill or have problems with alcohol as well being in thrall to the drug they have come to need. Or these days, they may as easily be middle class college students or moms or dads.

Some shop for physicians who can be more easily convinced of the need.

Others turn to the street, where illegal prescription drugs are easy to find.

Scarily, a $10 hit of heroin, perhaps the most deadly of illegal drugs, can give the same high as a single pill of OxyContin, with a street value of $80.

We can’t expect this danger to disappear.

It will take a concerted effort to stay ahead of it.

Yes, it is a law enforcement issue.

But it is also a public health issue and an issue for medical professionals who must be conscious of the dark uses of some of the drugs they prescribe to help their patients cope with chronic pain.

Bloomington, with its young population, is a ripe ground for growth of the opioid market.

Perhaps the toughest job will be to make the crisis real for state policymakers and legislators who must fund programs that track the problem and treat those who most need it.

Give away needles to junkies? That’s got to be a bad idea, Statehouse people might say.

But in this they should take the lead of their governor, who despite his misgivings, moved decisively to tame the Scott County disaster.

This was distributed by Hoosier State Press Association. Send comments to [email protected].

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