Scott County and Daviess County have a lot in common. Both communities are basically rural. Both sit along interstate highways. Both are located just to the north of metropolitan areas along the Ohio River. One big difference though is that an AIDS and Hepatitis C outbreak in Scott County has reached what officials call epidemic proportions. State officials report 142 cases of of people testing positive for HIV so far this year in Scott County. The outbreak was fueled largely by drug users sharing needles as more and more people became hooked on heroin.
Local officials have noticed that Scott County is not the only community with an increase in IV drug users and heroin users. Police locally say they have seen a steady growth in drugs and syringes and it has changed how officers approach suspects now. “We are a lot more aware of needles now,” said Daviess County Chief Deputy Gary Allison. “Kevlar gloves are now standard issue for our officers.”
Authorities report the IV drug use began showing up in Daviess County several years ago. “We first noticed it when meth arrived in the area,” said Allison. “Things started changing two or three years ago. That’s when we began to see more heroin use. Now we get complaints about syringes everywhere. You can’t walk down a county road without finding a syringe.”
Daviess County’s rates of HIV and Hepatitis C infection may not be as large as Scott County’s, but those syringes are considered an indicator that there could be bigger problems in the future.
“The syringes are the smoking gun,” said State Rep. Ed Clere, of New Albany. “No community is immune to this and these diseases don’t respect county lines.”
Rep. Clere spent much of the last session of the General Assembly trying to craft a law that would give local health departments a route for responding to outbreaks of HIV or Hepatitis C and even let those counties do needle exchanges. The move received a lot of opposition from Gov. Mike Pence. “The governor has taken a cautious view,” said Clere. “I feel we have a statewide need. Putting together a procedure that allows us to do this somewhere other than Scott County, then it’s a good first step.”
Officials recognize the reluctance by some people to support needle exchange programs. For many the thinking is the victims have put themselves in this situation by the own poor choices, but Clere points out that needle exchange programs are also about saving the innocent.
“Drug addiction is a disease,” said Clere. “Yeah, they made a bad decision, but they still should get treatment. If you don’t use needle exchange programs to stem the spread of the disease, then it winds up costing more for medical treatment. Then you have the spouses who get infected who were doing nothing wrong and the children who either are infected by parents or are being raised by parents who can no longer support them.”
The new needle exchange law requires several steps before a county can begin. The local health officer has to make a declaration based on the number of Hepatitis C and HIV cases. The Indiana State Board of Health would also have to approve the decision. In addition, there would be public hearings and the County Commissioners would have to give their approval.
“All of these steps are really needed to make certain everyone is informed,” said Daviess County Health Nurse Kathy Sullender. “The bad side on this is the financial.”
Even though the state has put together a procedure for needle exchange programs, it did not put in any funding for a county that needs to implement it. “We would have to go find the money to buy needles if we were to face this,” said Sullender.
Needle exchange programs are not popular with many in law enforcement. The Indiana Prosecuting Attorneys Council has opposed them and came out against the plan approved in the last session of the general assembly. Health officials believe the program can be a positive. “This would give us a chance to show those people exchanging needles some of the treatment services available to them,” said Sullender.
Officials believe the problems with HIV use and in particular heroin is something that is going to be difficult to eliminate. “It really is hard to get your arms around this,” said Sullender. “We also have to deal with prescription opiates. Four out of five addicts start with prescription pain killers, then they turn to heroin because it is a cheaper alternative. We have to work on the problem with prescription opiates. We know every county is different and every county has a drug problem.”
“If we don’t do a good job of containing the current outbreak, our community could be next,” added State Sen. Eric Bassler (R-Washington) who supported the needle exchange bill. “Needle exchanges make sense. A lot of people may not like the idea, but I tell them I live in the real world. Things happen in the real world that we may not like, but we have to deal with it. Needle exchange is a step in the right direction.”
No one believes that a needle exchange law or program will put an end to drug abuse or HIV or Hepatitis C. What it will do is give local health officials something they can use to try and fight the spread of those diseases.
“This is a tool for us to use if we have to,” said Sullender.