HIV Outbreak Linked to IV Use of Painkiller Leads to Health Emergency in Indiana

Indiana Governor Mike Pence declared a public health emergency as the state battles an outbreak of HIV linked to intravenous use of the painkiller Opana. The virus is spread as people use infected needles.

As of last Thursday, the state health department had identified 79 confirmed cases of HIV linked to the outbreak, according to a news release from the governor’s office. State health officials said it is likely more cases will appear in coming weeks, The New York Times reports. The county, which has 24,000 residents, usually has fewer than five new HIV cases annually.

The governor has authorized a short-term program in Scott County to exchange used needles for sterile ones, to reduce the risk of contaminated needles being shared.

In 2011, the Food and Drug Administration (FDA) approved a new, crush-resistant formulation of Opana ER, an opioid containing oxymorphone. In 2013, the FDA denied a request from the maker of Opana to block generic forms of the drug.

The drug’s manufacturer, Endo Health Solutions, argued its newer tamper-resistant formula was more difficult to abuse than the original version of the drug, and asked that the agency not approve generic forms of the earlier version. The FDA decided that since the original Opana had not been withdrawn for reasons of safety or effectiveness, generic forms of the painkiller could continue to be approved and marketed.

The FDA also said the newer Opana ER could still be abused, and might be more easily injected than the original formulation.