Laura Ungar, USA Today 6:17 p.m. EST February 26, 2015
Drugs are prepared to shoot intravenously.(Photo: Spencer Platt, Getty Images)
A quickly spreading outbreak of HIV in southeastern Indiana is linked to injection of the powerful painkiller Opana — raising concern among health officials across the region and nation as they face an epidemic of prescription drug abuse.
Indiana state health officials said Wednesday they have confirmed 26 cases and four preliminary cases since mid-December, most linked to Opana injection and a few spread through sexual transmission. They called it the largest HIV outbreak the state has experienced in one region.
"Addicts use and misuse needles," said Karyn Hascal, president of the Healing Place in Louisville, which serves southern Indiana addicts. "When you have injectable drugs like prescription pills and other narcotics being abused as much as they have been, (Hepatitis) C and HIV are soon to follow."
That's a concern nationally as well. According to the Centers for Disease Control and Prevention, injection drug use is a well-known route of transmission for blood-borne infections such as HIV, and injection drug users represent 8% of new HIV infections each year and 15% of those living with HIV, which causes AIDS.
Jerome Adams, Indiana state health commissioner, said he's especially concerned because most of the residents who tested positive for HIV recently contracted the virus and may spread it to others.
"Because prescription drug abuse is at the heart of this outbreak, we are not only working to identify, contact and test individuals who may have been exposed, but also to connect community members to resources for substance abuse treatment and recovery," Adams said.
Prescription drug abuse has skyrocketed in the past two decades across the nation. Nationally, someone dies of a prescription drug overdose every 25 minutes. The CDC said drug overdoses were the leading cause of injury death in 2012, causing more deaths among 25- to 64-year-olds than motor vehicle crashes.
Drug overdoses kill about 1,000 people a year in Indiana. According to the Substance Abuse and Mental Health Services Administration, 5.68% of Indiana residents used prescription painkillers non-medically in 2010-11, the latest year for which statistics are available.
Brandon Holman of Louisville, a recovering Opana and heroin addict who has been at the Healing Place for three months, said he used to worry about contracting HIV, "but at the time, I was just maintaining a drug habit" and spent most of his energy on getting the drugs he craved. Holman, 24, said he never contracted a blood-borne disease, and "I consider myself real blessed."
Holman said he shot up Opana from 2009 to 2011, when it was relatively easy to find, crush and inject. In late 2011, the Food and Drug Administration approved a new, crush-resistant formulation of Opana ER, an opioid containing oxymorphone. Two years later, the FDA rejected a petition by Opana drugmaker Endo Pharmaceuticals, clearing the way for generic versions of the original formulation to be approved and marketed.
FDA officials argue that the generic product is a useful therapy for pain if used correctly and that abuse-deterrent properties don't make an opioid impossible to abuse.
"While there is an increased ability of the reformulated 'abuse-deterrent' version of Opana ER to resist crushing relative to the original formulation, study data show that the reformulated version's extended-release features can be compromised when subjected to other forms of manipulation, such as cutting, grinding or chewing, followed by swallowing," FDA officials said in a statement. "Development of abuse-deterrent technologies is a priority for FDA, and we strongly encourage companies to continue innovating in this area. However, abuse-deterrent science is still in the early stages."
Indiana health officials warn people to stay safe by not injecting drugs, sharing or reusing needles, engaging in unprotected sex or having sex with commercial sex workers. They encourage people to get tested for HIV and seek help if they struggle with substance abuse.
Holman suggested people may want to visit needle exchange programs, where they can get clean needles in exchange for dirty ones — and seek treatment for their substance abuse. If someone does contract HIV, he said, it shouldn't be viewed as a death sentence. He said he learned that from a friend who contracted HIV through drug use and keeps it under control with medications.
"I'm grateful I didn't pick (HIV) up," he said. "But for those who have it, there's still hope."
Read or Share this story: http://usat.ly/1BCZSMw
Drugs are prepared to shoot intravenously.(Photo: Spencer Platt, Getty Images)
A quickly spreading outbreak of HIV in southeastern Indiana is linked to injection of the powerful painkiller Opana — raising concern among health officials across the region and nation as they face an epidemic of prescription drug abuse.
Indiana state health officials said Wednesday they have confirmed 26 cases and four preliminary cases since mid-December, most linked to Opana injection and a few spread through sexual transmission. They called it the largest HIV outbreak the state has experienced in one region.
"Addicts use and misuse needles," said Karyn Hascal, president of the Healing Place in Louisville, which serves southern Indiana addicts. "When you have injectable drugs like prescription pills and other narcotics being abused as much as they have been, (Hepatitis) C and HIV are soon to follow."
That's a concern nationally as well. According to the Centers for Disease Control and Prevention, injection drug use is a well-known route of transmission for blood-borne infections such as HIV, and injection drug users represent 8% of new HIV infections each year and 15% of those living with HIV, which causes AIDS.
Jerome Adams, Indiana state health commissioner, said he's especially concerned because most of the residents who tested positive for HIV recently contracted the virus and may spread it to others.
"Because prescription drug abuse is at the heart of this outbreak, we are not only working to identify, contact and test individuals who may have been exposed, but also to connect community members to resources for substance abuse treatment and recovery," Adams said.
Prescription drug abuse has skyrocketed in the past two decades across the nation. Nationally, someone dies of a prescription drug overdose every 25 minutes. The CDC said drug overdoses were the leading cause of injury death in 2012, causing more deaths among 25- to 64-year-olds than motor vehicle crashes.
Drug overdoses kill about 1,000 people a year in Indiana. According to the Substance Abuse and Mental Health Services Administration, 5.68% of Indiana residents used prescription painkillers non-medically in 2010-11, the latest year for which statistics are available.
Brandon Holman of Louisville, a recovering Opana and heroin addict who has been at the Healing Place for three months, said he used to worry about contracting HIV, "but at the time, I was just maintaining a drug habit" and spent most of his energy on getting the drugs he craved. Holman, 24, said he never contracted a blood-borne disease, and "I consider myself real blessed."
Holman said he shot up Opana from 2009 to 2011, when it was relatively easy to find, crush and inject. In late 2011, the Food and Drug Administration approved a new, crush-resistant formulation of Opana ER, an opioid containing oxymorphone. Two years later, the FDA rejected a petition by Opana drugmaker Endo Pharmaceuticals, clearing the way for generic versions of the original formulation to be approved and marketed.
FDA officials argue that the generic product is a useful therapy for pain if used correctly and that abuse-deterrent properties don't make an opioid impossible to abuse.
"While there is an increased ability of the reformulated 'abuse-deterrent' version of Opana ER to resist crushing relative to the original formulation, study data show that the reformulated version's extended-release features can be compromised when subjected to other forms of manipulation, such as cutting, grinding or chewing, followed by swallowing," FDA officials said in a statement. "Development of abuse-deterrent technologies is a priority for FDA, and we strongly encourage companies to continue innovating in this area. However, abuse-deterrent science is still in the early stages."
Indiana health officials warn people to stay safe by not injecting drugs, sharing or reusing needles, engaging in unprotected sex or having sex with commercial sex workers. They encourage people to get tested for HIV and seek help if they struggle with substance abuse.
Holman suggested people may want to visit needle exchange programs, where they can get clean needles in exchange for dirty ones — and seek treatment for their substance abuse. If someone does contract HIV, he said, it shouldn't be viewed as a death sentence. He said he learned that from a friend who contracted HIV through drug use and keeps it under control with medications.
"I'm grateful I didn't pick (HIV) up," he said. "But for those who have it, there's still hope."
Read or Share this story: http://usat.ly/1BCZSMw
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