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DEA Arrests Suspects for Dealing Opioid That Led to HIV Outbreak in Indiana

  1. Basoodler

    The Drug Enforcement Administration has arrested five alleged drug dealers that it believes helped spark the largest HIV outbreak in Indiana history — a crisis that has prompted a reassessment of the challenges posed by the combination of rural drug use and infectious diseases

    The case has focused on the drug Opana, a painkiller injected by drug addicts in liquid form, according to DEA agent Dennis Wichem. Officials described how at least four of the men are believed to have taken part in selling Opana and meth to individuals in southern Indiana, who then shared needles to inject the drugs, allowing for the spread of HIV. They dated the drug trafficking to as early as October 2014. The HIV outbreak began in mid-December, according to the Indiana State Department of Health.

    The state now has 170 cases of HIV, according to public health officials who said in March that a large majority of the cases were due to Opana injection rather than to sexual contact.

    "What we have here is an oddity," Wichem told VICE News. "A number of drug addicts in southern Indiana began shooting or injecting Opana, and we've learned by interviewing some of these people that they injected methamphetamine too. But to inject Opana you need a bigger sized needle than normal."

    Because Opana requires a large diameter needle to inject the drug, users might have been more likely to share needles. Dr. Beth Meyerson, co-director of the Rural Center for AIDS/STD Prevention and assistant professor at Indiana University School of Public Health, explained to the HIV news site Beta Blog last month that larger gauge needles used to inject Opana can more readily lead to skin abscesses and transmission of HIV and hepatitis C when needles are shared.

    The individuals who have been charged include Michael Elkins, John Morgan, Tyler Turner, William Thrower, and Charles Pruett, and the investigation is ongoing.

    The DEA alleges that Elkins, who is from Georgia, made bi-weekly trips to Scott County, Indiana, with methamphetamine and also distributed Opana pills there for as much as $160 per pill. They traced the source of his supply to Alabama and Georgia. Morgan was arrested while traveling with Elkins in his truck and was charged with dealing methamphetamine.

    Turner and Thrower, both of Indiana, are alleged to have been couriers. They were arrested in Indiana. Authorities arrested Pruett in Georgia this week.

    The ongoing health crisis in rural Indiana forced Gov. Mike Pence earlier this year to allow a needle exchange that drug users can use to get clean needles with which to inject drugs.

    "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 in March.

    The state legalized syringe exchange programs under certain circumstances — namely, convincing evidence that an HIV or hepatitis C outbreak is occurring in a defined area and the declaration of a corresponding state of emergency.

    Public health officials say that clean needle programs need to be implemented in drug-using areas throughout the United States. Dr. Chris Beyrer, a medical doctor and public health professor at Johns Hopkins University, and Steffanie A. Strathdee, director of the Institute of Global Health at the University of California-San Diego, published an article on Wednesday in the New England Journal of Medicine calling for broader access to the programs.

    "When needles are in short supply, injection-drug users have little choice but to share," they wrote. "Given increases in injection-drug use in non-urban communities and the high efficiency of HIV transmission through injection, it was only a matter of time before an outbreak ensued."

    Beyrer and Strathdee pointed out that other counties with similar problems in Indiana won't be able to institute a preventative needle exchange program — they will be forced to wait until there is a crisis and a state of emergency is declared. Madison County, in central Indiana, declared a state of emergency earlier this week due to a hepatitis C outbreak that has been tied to drug use.

    The epidemic in southern Indiana has frightened public officials throughout the rural US, where health policy experts say drug use and HIV are spreading faster than in urban areas.

    "We don't do enough testing or make enough resources available in rural health," Janice C. Probst, director of the South Carolina Rural Health Research Center, told VICE News.

    Probst said that lack of access to testing and treatment sites is a major problem. In some states residents may have to travel 250 miles to the nearest HIV testing or treatment center. If they go untested or untreated, it increases the risk of spreading the disease.

    "HIV is right now a disease of the disenfranchised, of people who don't get preventative care or education," she said.

    And as a matter of public health policy, "if you ignore it, it will become a bigger problem," she said. The federal and state governments should devote more resources to rural programs, as opposed to the traditional urban programs, to try and prevent other outbreaks from occurring and to prevent increased healthcare costs for those infected down the road, added Probst.

    Despite calls from the medical community to allow needle exchange programs, there continues to be political opposition to it, including a federal funding ban on programs.

    "Permanently lifting the ban on using federal funds to support needle-exchange programs will be a critical component of HIV prevention," Beyrer and Strathdee wrote, "since these programs reduce HIV incidence and front-line exchange workers are often the first people injection-drug users reach out to for help."

    by Colleen Curry, news.vice.com
    June 26


  1. TheBigBadWolf
    sad that it needs stuff ike this to make politicians accept the realities they don't wanna see.
    -whatever truth is behind this report..
    My god what a nonsense.

    HIV is dying instantly when it doesn't get body temperature for longer than two minutes, which is much shorter than the preparation time of the next shot.

    I'd rather say they'd give out condoms to stop spreading HIV, when it is about a rural population who are using meth and then are fucking like rabbits with whoever has a hole to stick their hardon in (excuse my latin), - without caring for prevention.

    Bah. I'm about to lose any respect for politicians who now cry-baby about problems they have created themselves by giving no care at all about what is happening in RealLife TM.

    Closing eyes for decades and - of course- blaming their faults to those who are desperate, workless, caught in a rural (="christian") environment.

    I can't eat enough to puke as much as it makes me want to.
    (I won't say it's typical US, cos I'm anyway seen by some as anti-american - which is far from true, btw, I haven't met any americans in RealLife TM who were anything but amiable people, it's the pseudo-christian moralising approach to anything that doesn't fit in the world view of those 'elected' representatives of 'belief' who are in fact nothing but fascist and try with all means to make free people obey to their un-free worldviews who make me wanna throw up.)
    ^^ Just to make my point of view clearer!

  2. RoboCodeine7610
    That's the second stupidest thing I've heard today. The dealers who sell the pills are responsible for the HIV epidemic? They're addicts. What difference does it make to HIV infection rates weather they're injecting Opana or Heroin?

    Larger diameter needle as compared to what? An IV needle for adults is the same diameter regardless of what you're injecting.

    As if this was the exception as opposed to the rule when IV drug users have no access to clean needles? How can he pretend this "public health emergency" is not direct proof that his opposition to it is misguided?

    Now on a separate note, I have to say that in my opinion, people need to be held responsible for their actions. I don't care if you're an addict, if you share needles with someone and as BBW mentioned above, within the limited time (minutes) that it takes for HIV to perish outside the human body, you're a moron, and need to face the consequences of your actions. The same goes for those who have unprotected sex and contract the disease; you took the chances now deal with the consequences.

  3. Calliope
    I worry about phrases like 'need to face the consequences of your actions' and 'you took the chances now deal with the consequences.' I don't think you meant it like this Robocodeine but reading your post made me think again about how talk of that flavour verges on, often actually becomes, the claim that people who take risks deserve whatever befalls them. From which follows easily the idea that they aren't anyone's problem but their own.

    This cluster of ideas just sits wrong with me. For one thing it is in large part still random who gets the deadly pathogen, brain injury, septicaemia and so on amongst people who do risky things. For another society really seems to only pick out certain risks as ones that leave people out in the cold to deal with their fate. And third, most telling to me, is this kind of hostile individualism is completely inconsistent with insisting that as a society we have to protect people from themselves by trying to prevent certain choices, like the choice to shoot heroin/meth/whatever using fresh sterile needles. If my choices are curtailed in that way by other people, why are the consequences of choices I do make then mine to face alone out in the cold?

    The notion of someone deserving punishment or pain or suffering is just so far outside what I think is true, and it is implicated in the kind of fear and shame based behaviours that are often the very ones that create the suffering. Using drugs in wildly unsafe ways or engaging in risky sexual behaviours are both things that clearly derive from the universal and natural human need to seek pleasure and relieve pain. Add in feeling like a shameful piece of shit because the world says people who do these things are just that and you get a person easily seduced into that cycle of self comforting, self hating, trying to be 'good' and failing and lather rinse and repeat.

    We don't make choices in a vacuum but in a social context. We aren't good at counting the real cost of future suffering. That is just the kind of creatures humans are. Social policies need to be built around both these facts and obscene lapses of logic and empathy like the ones involved in only allowing needle exchanges once there is a deemed 'emergency' have to be treated as the horrifying mistakes they are and stopped. gah!
  4. lkt004
    Where did you get the 2 minutes dying?

    Viruses don't die because they don't live, obviously in a hostile environment they will break down quicker but HIV can survive days outside the body if not longer depending on the conditions.

    HIV being a retrovirus is enveloped, thus survives better in harsh conditions.
  5. Basoodler
    Aust N Z J Public Health. 2003 Dec;27(6):602-7.

    Blood-borne viruses and their survival in the environment: is public concern about community needlestick exposures justified?

    Thompson SC1, Boughton CR, Dore GJ.



    More than 30 million needle syringes are distributed per year in Australia as a component of harm-reduction strategies for injecting drug users (IDU). Discarded needle syringes create considerable anxiety within the community, but the extent of needlestick injuries and level of blood-borne virus transmission risk is unclear. We have undertaken a review of studies of blood-borne virus survival as the basis for advice and management of community needlestick injuries.


    A Medline review of published articles on blood-borne virus survival and outcome from community injuries.


    Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) can all survive outside the human body for several weeks, with virus survival influenced by virus titer, volume of blood, ambient temperature, exposure to sunlight and humidity. HBV has the highest virus titers in untreated individuals and is viable for the most prolonged periods in needle syringes stored at room temperature. However, prevalence of HBV and HIV are only 1-2% within the Australian IDU population. In contrast, prevalence of HCV is 50-60% among Australian IDUs and virus survival in needle syringes has been documented for prolonged periods. There have been no published cases of blood-borne virus transmission following community needlestick injury in Australia.


    The risk of blood-borne virus transmission from syringes discarded in community settings appears to be very low. Despite this, procedures to systematically follow up individuals following significant needlestick exposures sustained in the community setting should be developed.
    PMID: 14723407 [PubMed - indexed for MEDLINE]
  6. DocToxin8
    Yeah, the 2 minutes outside the body was a bit of a stretch,
    suffice it to say that Hep.C spreads much easier when sharing rigs than HIV,
    while HIV spreds much easier than Hep.C when it comes to sex.
    (actually Hep.C isn't considered sexually transimitable by some, at least when it comes to "Normal" sex)

    Anyways, I can't understand why needle Exchange programs or why there should be any restrictions
    to needles. It is total BS.
    Here we can buy needles and such without a script, or get them from a needle Exchange,
    but Micron filters on the other hand!
    Fucking impossible to get! And I've asked, believe me,
    and on top of that, if I order it on the web, while not illegal, if customs see it they take it.
    I don't get a fine, but no Product either, and Micron filters can be expensive,
    at least when you add shipping.
    So Norway is totally backwards as well, no doubt about that.

    And as for People deserving what they get when using dirty rigs,
    well, I can admit that here, where you can buy needles and syringes in any sizes you want,
    along With physiologic salt water for injection, it's totally stupid to share.
    BUT, during my several years of use, I actually managed to contract Hep C at "the end" of when I was
    really serious about abusing drugs.
    I got this in a state of psychosis, not really knowing what I was doing,
    staying awake for 14 days (With 2 instances of sleep due to collapse, woke up on the floor and just continued),
    at some point i shared a rig With a friend who also never had shared a rig before.
    Well, he had ofcourse. And I ended up With Hep C just weeks before I quit.
    (I still use drugs, I'm just not that good at it anymore)

    Long story short, I managed to Cure my Hep C With a treatment that caused me to lose 14kgs of body
    weight in 7 weeks. Thats well over 30 pounds for those not metrically inclined.
    But the feeling when I got the diagnosis, it felt like not only a distant Death sentence,
    it felt as if I could never have unprotected sex With anyone I loved again,
    in fear of infecting them, even though my doctor didn't even recommend a condom if in a steady relationship.
    But there was no guarantee I wouldn't infect anyone, so that does something to you.

    Yes, Norway is fucking hilarious when it comes to contradictions and how to protect it's own People.
    I'm a patriot still, but God, the sheer stupidity of how some Things are done here,
    and the best part is that we Norwegians consider ourselves superior to other countries in many Things.
    It is getting a little better, many People have opened their eyes, and realize that what Works
    here might not work another Place; and voila - you have apathy instead!
  7. Basoodler
    In defense of BBW, I had heard the same of HIV and figured that I would find a study in support of that .

    I'm not sure why we are discussing the personal responsibility of the infected. Wether it was from an infected opana needle or wild meth sex I'm sure those people understand that a poor decision(s) let to their current predicament.

    I am sure that the only reason that the larger needle is implied is that it is the only specific "condition" that differs from like geographical areas/drug users that have no HIV breakout.
  8. TheBigBadWolf
    From working in the Hygiene department of the surgical department of a big German University Hospital over the time of 11 years. That means - I know it from knowing my job I've learned.

    nonsense. cite source.

    As you might have read in the study cited by basoodler :
    with volume of blood and temperature playing the major role.

    An of course Virii dont die cos they don't live. Figure of speech,eh?

    what leads you to the idea that HIV would be easier contractible by sex than HCV? the contrary is the case. Even a view of Wikipedia would have shown , -(who in this case even have good sources)

    And what do you mean by 'NORMAL SEX'?

    One more thing, DocToxin8 - we don't discuss sources of drugs and paraphernalia. I can tell you that it is pretty easy over the internet - to tell you brands or companies would be against the rules of DF.
    Have you tried to get micron filters over chemistry equipment sites instead medicinal supply?

  9. RoboCodeine7610
    Actually, after doing some research, it seems HIV can survive for long periods of time in vacumm-sealed environments like the barrel of an injection needle. It does, however, die (figure of speech lol) within moments of being exposed to open air.

    In any case, heroin and Opana can both be snorted in case of an "emergency". I don't see how sharing needles would be the only option under any circumstances. Re-using needles is a different story, but sharing them...I just don't get it.

  10. TheBigBadWolf
    yeh HIV survived long times in the sad blood-transmission cases back then. Exposed to daylight and Air it decays in the time of minutes.

    HIV infections by needlestick (professionals) are (to my knowledge) unknown, HCV infections are legion.

    It also seems to make a difference which Type of HIV they are.

    but that's not really what the discussion was about and it was not what this unmentonable politician was on about.
    maybe back to the topic then?

    I promise to better my expressive qualities..
  11. lkt004
    So in your role you've taken HIV out of cell culture/infected patients and used some complex measurements to detect degradation of the viral envelope of HIV from +0 - 2 minutes and noted it's degradation begins at 2 minutes? No, no you haven't, please cite a source that does this, if i used my education and work experience i could just make stuff up and people would assume it's true, but i don't, you should provide actual evidence. Lets not forget that viruses hijack the DNA machinery of the cells, which will continue to run even after being removed from the body for a period of time, so even if you don't get blood, and get a few infected CD4+ T-cells that are actively producing viral particles, you're screwed. But again, rarely happens. Needle stick injuries rarely result in viral transmission because health professionals know what they are doing when giving IV injections in comparison to someone either craving a fix or already high and injecting again.

    The study cited looks at community acquired infection through needle stick injuries, and HIV/HEP C both being retroviruses, why would they even use it as a factor. One could look at thousands of factors, but studies are limited to time and length, the biggest factor? Luck.

    You can't use a study that looks at needles sitting in the environment from long periods of time and apply it to needles shared between infected users within minutes, the type of virus would play a major role here. The rules are totally different, thus the parameters used int he study quoted are not applicable.
  12. lkt004
    Also let's remember a needle stick injury you aren't reusing the barrel where the virus is protected
  13. Basoodler
  14. BehindBlueyes
    This seemed to get off topic fairly quickly I think the point of the posting this information is that we need to have needle exchanges in place where there are people shooting drugs. Addiction has led many to do things that they know are damaging them and that in places in my country a state of an emergency has to be called to set up a needle exchange is horrible. I have many friends that have died and many more that have HepC, wainting for liver transplants ,or taking medications to clear the virus. If there was access to clean needles much of this could be avoided. I live in a state where we take harm reduction more seriously and I know it still is not easy to have a clean needle in place every time someone takes their DOC. I don't think a harms reduction Drugs Forum is the place for such harsh words about people who may have no other choice about how their DOC is administered. A little empathy please.

  15. TheBigBadWolf
    I've emailed for more info on decay time of HIV that comes out of actual organisms.

    I got the info I spread from a safety sheet that circled there at my times, this was not about what the poster made up as a setting ( why they did I don't know) but for the safety of the people who handle used operation devices that were in use in infected patients.

    I'm trying my best to lay a hand on these.

    And the poster above is right - the point of discussion is that some US states still don't give their addicts the possibility of buying injection paraphernalia.

  16. DocToxin8
    Just one more off topic issue I feel I got to answer;
    The difference between hep c and HIV when it comes to sexual and IV transmission.
    My own knowledge notwithstanding, I learned this from specialists in infection diseases, namely hep c,b and HIV when I got my treatment.

    A couple where one is infected with Hep C can have sex for decades without infecting the other partner,
    As long as it's so called "normal" sex, which means no cutting or extreme BDSM,
    No sex during menstruated, no anal (I find this normal, but hey?)

    While with HIV even though it takes a lot during "normal" sex to contract it,
    You will contract it within a month to year (I'm pulling those numbers out of my ass, but still)
    With regular sex.

    When it comes to IV transmission though, Hep C is present in higher viral concentration,
    Therefore (maybe) it transmits more easily than HIV this way.

    Sorry but thought I needed to back up my statement.

    As for needle exchange programs, or the right to buy the paraphernalia you need in a pharmacy,
    it's ridiculous you cannot do this everywhere.
    Even here where needles and syringes and exchange programs are in place,
    You still can't buy all you need easily;
    Like micron filters, test kits, etc.
  17. BehindBlueyes
    My late husband was infected with the HepC virus when he was a young lad and shooting heroin, never the less we enjoyed years of unprotected sex. My GP and his Doctor both said that while HepC could be given to a sexual partner the virus had to enter the blood stream. His Doctor was much more concerned that I might use his razor or trimming shears, something that could have blood on it. I have a number of friends that are in relationships with HepC positive partners and none of them have become infected. Everyone I know with the Hep C virus caught it from sharing dirty needles!!!! This was before we knew about the dangers of blood borne viruses and needle sharing. I also know what it means to have to get well and I know that the absence of a fresh clean needle would not stop me. I think that is true for many IV users and if they don't have the ability to get clean needles then its on to plan B and possibly sharing a needle. There must be needle exchanges in place not only in a "state of emergency" your right DocToxin how ridiculous!!!!

  18. Alien Sex Fiend
    vaginal and especially anal sex leads to tiny tear wounds like from shaving. its next to impossible to catch something from oral, unless the person scratched inside of mouth, doesn't have an ulcer down the line and the other is not circumcised. the evidence shows that uncircumcised crown of the penis is more prone to infections in general. also a man can catch std and hep from body fluids entering the pee hole. it also depends on how much blood is contaminated aka how sick the person is. you are extremely lucky

    opinions, opinions.
    if i chose to find a full time girlfriend again, there would be anal sex every time there is sex. anal sex is normal, regular and ongoing
  19. BehindBlueyes
    Hi ASF

    I don't think that I was "extremely lucky" We got very sound medical advice and we where told that it was highly unlikely that he would infect me thru sex. I have many many friends and family members that carry the HepC virus and in no single case has the infected partner given the virus to their partner having sex. They were all infected sharing dirty needles every single one of them!!! We made well thought out and informed decisions about our HepC partners and none us of were using IV drugs at the time. I don't know about the HIV virus as I don't have any first hand experience with it but I know quit a lot about HepC.
  20. lkt004
    Hepatitis C is virtually impossible to transmit sexually, especially with those on anti-viral therapy, the viral load is so low that even sharing needles they are unlikely to transmit to others.

    My rant in regards to the "2 minute" thing was that i don't want someone to read that and think "well we just wait 20 minutes and it'll all be dead".
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