INDIANAPOLIS - After 13 years in the military - most of them with a special operations team that pursued terrorist targets around the world - Dan McClain was ready to come home to rural Scott County and raise his family.
He soon discovered, he said, “It’s not what it used to be.”
Now the county sheriff, McClain finds himself amid the largest single HIV outbreak in the state’s history. A growing number of inmates in his jail are diagnosed with HIV, the virus that causes AIDS.
Every one of 55 newly confirmed cases of HIV in Scott County - more are pending confirmation - is linked to intravenous drug users who shared needles while injecting a highly addictive painkiller called Opana.
The cause of the scourge is well known to those who live in Scott County, as health officials scramble to control the crisis.
But just last week, McClain and his deputies came upon a flophouse where a group of addicts was shooting drugs into their veins.
“Everybody knew of the risk,” he said, “but that’s the nature of addiction - that they just don’t care.”
The bust was another heartbreaking moment for McClain, who left home after high school to join the military and go on to become a Navy SEAL. He was honored by the state Senate in 2011 for his distinguished military service, including time spent in Iraq after the 9/11 terrorist attacks.
He took office as sheriff in early 2011. That year, 19 people in his county with a population of 24,100, died of Opana overdoses. McClain saw more than a dozen overdose deaths the next year.
Why Scott County has become the epicenter of a growing health crisis is something that McClain and other local leaders are trying to figure out.
Their community is poorer and less educated, with fewer work opportunities, than most of the state. It has ranked 92nd among Indiana’s 92 counties on the state Health Index for six years, put at the bottom of the list by childhood poverty, lack of healthcare access and other factors.
“We’re like many rural communities in Indiana. You drive through our small towns and see a lot empty storefronts,” McClain said. “Too many people here just feel hopeless.”
McClain notices another, unique debris when driving though the county.
“We find a lot of old needles along the roadside,” he said.
The drugs aren’t new. About a decade ago, law enforcement in Scott County and throughout Indiana saw growing abuse of the prescription painkillers hydrocodone and oxycodone. As manufacturers changed those drugs to make them harder to inject, addicts just turned to other opiates.
The surge in drug use lead to a surge in crime. McClain’s jail is so crowded with addicts that he’s farmed out prisoners to neighboring county jails.
Now he faces a public health crisis, as well.
An immediate worry for McClain is how to pay the medical costs of the newly infected, HIV-positive inmates. He had 10 confirmed cases last week, with more expected. And those are just the ones he could convince to get tested. Others are likely infected but refuse the test.
McClain worries not just about them but their families. Most HIV cases involve people in their 20s and 30s. Many have children. Two cases involve pregnant women.
“I worry about the lost generation,” he said. “A lot of people we’ve arrested have kids who are now being raised by their grandparents. We’re going to have whole generation of children who don’t know what it means to be raised by their parents.”