An unprecedented HIV outbreak in Indiana has caused the governor to declare a health emergency and set up a short-term needle exchange. But what’s fueling the epidemic in Scott County, Ind.? Experts say it’s the illegal use of Opana, a powerful pain medication that has been called the “new scourge of rural America.”
Indiana public health officials tell WKMS that Opana, otherwise known as oxymorphone, is “an incredibly powerful and potent opiate.” The drug is usually prescribed to patients with pain that has resisted non-opioid painkillers or who have had insufficient pain relief with immediate-release opioids. But Opana has gained a whole other life as an underground drug in rural communities like Scott County.
In its illegal form, Opana is crushed and injected, defeating the drug’s extended release properties and creating a potent high that’s comparable to that of heroin or OxyContin. Before 2011, the drug was “relatively easy” to shoot up, notes USA Today’s Laura Ungar, but a crush-resistant formulation was created in late 2011 to prevent Opana abuse.
However, those precautions haven’t been enough, and abuse of the drug rose dramatically in 2012. In a 2013 statement, the FDA admitted that the reformulated version of Opana could still “be compromised when subjected to other forms of manipulation, such as cutting, grinding, or chewing.”
All of the people who have been identified as HIV positive in the current outbreak have admitted to intravenous drug use, ABC News reports. And while it’s still unclear whether the governor’s temporary needle exchange will quell the spread of HIV, which is also spread through sexual contact, Indiana isn’t the only state approving needle exchanges for the first time. This Thursday, Kentucky’s governor signed a bill that will allow health departments to create needle exchanges in the state.