Sept. 16 2015 01:48 PM

As more people use drugs, injection drug use increases — and so do cases of HIV, other diseases

In December 2014, a small Southern Indiana county started registering an explosion of HIV cases. Scott County had usually identified only five news cases of the infection every year. But in December that changed. By February of this year, state health officials said there were 26 confirmed HIV cases and four preliminary positives since December 2014. In June of this year, that number had soared to nearly 175 cases, the Indianapolis Star reported. In August, the state reported 181 cases.

The striking feature of the outbreak was that it was driven by a combination of a raging prescription opioid abuse crisis and needle sharing. The outbreak was so serious, Indiana Republican Gov. Mike Pence declared a public health emergency and established a temporary needle exchange program. The federal Centers for Disease Control and Prevention was called in to assist in tracking down users who might have been exposed.

Scott County is a cautionary tale that Ingham county officials are heeding. As well they should. Ingham County has the highest HIV prevalence rate outside of Detroit, according to state statistics.

About 14 percent of Michigan residents with HIV were exposed through intravenous drug use, said Jake Distel executive director of the Lansing Area AIDS Network.

“The re-emergence of heroin use, addiction and abuse directly correlates with such increases,” he said.

Injecting drugs is one of the easiest ways to contract HIV, says the CDC. Federal drug stats show that for every 10,000 exposures to HIV through intravenous drug sharing, 63 new infections will happen. Only tainted blood transfusions, which will result in infection nearly 9 out 10 times, and receptive anal sex, which has a risk of 138 infections per 10,000 exposures, are riskier.

Despite what health and law enforcement officials call an “epidemic” and “surge” in heroin related overdoses and deaths, neither Lansing nor Ingham County operate a needle exchange program.

“The time to act from a public health perspective is now. Lives are at increasing risk,” Distel said.

Detroit, Flint and Grand Rapids have needle exchanges. Wellness, an HIV organization in Flint, has operated its needle exchange program since 2010. The agency distributes 500 to 1,000 clean needles every week. Teresa Springer, director of programs for the organization, said it has about 300 clients engaged in the needle exchange program.

Health officials and HIV advocates were unsure why the county does not have an exchange, as do Detroit, Flint and Grand Rapids. However, the intervention has often run into objections from law enforcement and others. The federal and state governments prohibit taxpayer dollars from being used for needle exchanges, forcing agencies to turn to grants and fundraising to pay for the programs.

“While our community does not have a needle exchange program like Grand Rapids or Detroit, we do have progressive and safe policies on injection drug use,” said Linda Vail, health officer for the Ingham County Health Department. “We have two needle disposal sites, and local pharmacies sell clean needles without restriction or prescription.”

The county is engaging in the fight against heroin and opioids, she said.

“In addition, ICHD is engaging community partners and working to address the heroin use epidemic,” she continued. “We are also aware of other efforts going on such as the Mason-Capital Area Prescription Drug Task Force, and we are working to make sure we enhance work rather than duplicate it.”

How those partners will fully respond is unclear right now.

“We’re concerned about overdose, the transmission of blood borne diseases, and of course, the heavy toll addiction has upon families and the community,” she said. “ICHD is actively working to address heroin addiction in the county and no doubt that will take a multipronged approach. Indeed, I am sure needle exchange programs will be part of the discussion, and ultimately may be pursued as part of the solution. It is my understanding that in Michigan programs are typically run by nonprofit organizations rather than local health departments.”