INDIANAPOLIS -- Gov. Mike Pence set aside his longtime opposition to programs that give needles to drug users amid pleas from health officials and conservative legislators to respond to the spreading HIV outbreak in Southeast Indiana.
On Thursday, Pence announced that he would suspend state laws barring health officials from distributing needles to intravenous drug users on an emergency basis. The decision makes room for health officials in Scott County to start a needle-exchange program to help fight an outbreak that now includes at least 79 new cases of HIV.
Among those who pushed Pence on the issue was Sen. Jim Smith, a conservative Republican whose district includes Scott County, the epicenter of the outbreak that began when an HIV-infected drug user started sharing dirty needles.
Local health officials have said all 79 cases involve intravenous drug use, though they warn the virus is also spreading through sexual contact.
Smith said he talked last weekend with Scott County leaders, then met with Pence's chief of staff on Monday to make the plea for a needle exchange.
“I was adamantly against it initially,” Smith said. “But I quickly realized we had a serious issue that could quickly get out of control.”
He noted the dire warnings of Scott County Sheriff Dan McClain, who said providing clean needles to addicts was an essential step in stopping the swift spread of the virus that causes AIDS.
McClain told Smith he may have up 30 jail inmates who are HIV-positive, and the county is responsible for providing them with expensive, anti-viral drugs at a cost of about $2,500 month.
Smith said the numbers – and the long-term costs – were stunning.
Smith said an emergency needle exchange "doesn't condone illegal drug activity.”
“It’s a needed tool to triage the situation to contain the outbreak," he said. "I have no question this is the right thing to do.”
A similar message was delivered to the governor by Sen. Jean Leising, a conservative Republican whose district borders Smith’s.
A nurse by training, Leising met with addiction experts three weeks ago and heard their fears that HIV-infected women working as prostitutes in Scott County are spreading the disease to persons yet to be identified.
One of those women has said she had sex with up to 50 men she met at interstate truck stops before learning of her diagnosis, according to local health officials.
“When I later met with state health department officials, they felt they didn’t have a handle on this (outbreak),” Leising said. “And based on the numbers I heard today, it’s obviously not under control.”
Also urging the governor to act was Rep. Terry Gooden, a Democrat from the small Scott County community of Austin, who said he asked Pence to set aside politics and defer to the health experts.
Pence made clear Thursday that his emergency order only covers Scott County and only temporarily. In effect, his order suspends a law that makes it a felony to possess a hypodermic needle with intent to inject a prescription drug.
The Scott County HIV cases have been linked to drug users who share contaminated needles while illegally injecting a prescription painkiller called Opana.
"I do not enter into this lightly," Pence said during a press conference. "In response to a public health emergency, I'm prepared to make an exception to my long-standing opposition to needle exchange programs."
Pence said the decision was difficult. He said he prayed about the matter. He also weighed advice of many in the medical community - including those in the state Department of Public Health - who urged him to consider evidence that needle-exchanges don't increase drug use.
"I don't believe effective anti-drug policy involves handing out drug paraphernalia," he said.
Those medical experts -- including three past presidents of the Indiana State Medical Association -- urged him to heed the advice of the U.S. Centers for Disease Control and Prevention. A CDC team arrived in Indiana Monday and told the governor that a needle-exchange was the most effective way to curb the outbreak.
Another voice in support came from Scott County Prosecutor Jason Mount, who initially opposed a needle exchange because of worries about it would be administered and that it might lead to more dirty and discarded needles stewn throughout the county.
“I appreciate that we’re in an emergency situation now, and I have to trust the medical professionals,” Mount said.
Even while Pence budged for Scott County, he sounded adamant Thursday in his opposition to expanding the needle exchange.
Pence said he would veto legislation, being considered by the House Public Health Committee, that would allow the state health officials to authorize needle exchanges in other communities with high drug abuse as an attempt to ward off another outbreak.
That statement disheartened Rep. Ed Clere, R-New Albany, who filed the measure after health experts told him the HIV outbreak could spread beyond Scott County.
“I’m very disappointed,” Clere said. “I wish he’d been here to listen to three hours of compelling testimony from experts and others from all across the political spectrum who spoke passionately and in near unanimity regarding the need to facilitate needle exchange and how it should not be limited to Scott County.”
Clere’s proposal goes to a committee vote on Monday.
Maureen Hayden is the CNHI state reporter in Indiana. Reach her at firstname.lastname@example.org. Follow her on Twitter @MaureenHayden