April 28--Students can learn about the HIV/AIDS epidemic in their American history classes. But in Indiana, they don't have to read up on the 1980s to learn about how the deadly disease can spread. It qualifies as "current events."
In the southern part of the state, there has been a frightening spate of infections. Rural Scott County normally sees no more than five new cases of HIV a year, but since December, at least 142 people have contracted the virus. There is no mystery as to why: 4 out of every 5 say they were injecting a prescription opioid called Opana or another drug. Most of them also have hepatitis C.
This painkiller does not carry the HIV virus. What carries it are syringes that are contaminated by people who already have the virus. Sterile needles are so hard to come by that Scott County drug users report sometimes reusing them hundreds of times.
This mode of transmission has been around for decades, and public health agencies know how to prevent it: by making clean syringes easy for addicts to get. Needle exchanges allow them to turn in used devices and receive new ones, encouraging them to avoid needless risks. Such programs are in operation in some 200 cities across the country.
One of those is New York. The American Foundation for AIDS Research offers an example of how effective needle exchange can be, based on the New York experience.
Back in the 1980s, half of New York's injecting drug users had HIV. But syringe exchange programs drastically reduced this form of transmission.
Today, New York has an estimated 100,000 injecting drug users -- four times as many as Scott County has people. Yet in the first three months of 2015, there were fewer new HIV cases among those New York drug users than there were in Scott County. It's clear that needle exchange saves lives. It also saves the public money needed to treat victims.
Gov. Mike Pence recognized the urgency of the problem in March when he declared a public health emergency in the county, allowing local officials to permit syringe exchanges for 30 days. He later extended it for another 30 days. But he still opposes legislation allowing needle exchange on a permanent, statewide basis.
Short-term fixes are not sufficient for a disease as tenacious and dangerous as this one. What the state needs to do is embrace needle exchange as the safe and reliable long-term remedy it has proved itself to be. That notion may catch on: the state House approved a bill making it easier for high-risk counties to allow it.
Illinois lifted its ban on the possession of syringes without a prescription in 2003. That step facilitated needle exchange programs while allowing drug users to buy clean needles without a prescription. It's probably not a coincidence that we haven't had the kind of epidemic that has erupted in Indiana.
It would be better, of course, if the people shooting up painkillers would simply conquer their addictions -- thus eliminating the risk of HIV as well as the many other health hazards that go with drug abuse. But that's a tougher task than getting addicts to use sterile equipment.
The other good news about needle exchange is that research indicates it doesn't lead to more addiction. In fact, when paired with outreach efforts that offer counseling and treatment, it is a helpful method of getting addicts on the road to recovery.
The advent of drugs that suppress HIV, once a death sentence, is no reason for complacency. It's still incurable, expensive to treat and potentially fatal. In the fight against the disease, every useful weapon should be put to use. Needle exchange is an option Indiana can't afford to reject.
