The Centers for Disease Control and Prevention (CDC) has warned that the prescription pain pill Opana could be contributing to a rapidly escalating outbreak HIV outbreak in Scott County, Indiana.
In 2013, the Food and Drug Administration (FDA) warned Endo Pharmaceuticals that the new formulation of its widely used prescription pain pill Opana (oxymorphone) could be driving abusers to inject the drug intravenously instead of snorting it, Time magazine reports. Addicts can transmit HIV to one another when they share needles.The HIV outbreak in Scott County mushroomed from eight cases in January to166 as of early June. The Associated Press reports that previously Scott County, the center of the outbreak, had not had more than five HIV cases in a year. The Centers for Disease Control and Prevention (CDC) and county officials say the outbreak is the result of addicts dissolving and injecting Opana. The CDC said 96 percent of those who tested positive for HIV and who were interviewed said they were injecting Opana. The CDC issued a health alert in April, Time reports. In an effort to reduce the sharing of contaminated needles among addicts, Indiana governor Mike Pence authorized a needle exchange program.
In 2012, Endo introduced a version of Opana that it said was abuse deterrent. The previous version of the drug could easily be crushed and snorted or dissolved and injected, but the new version had a coating to make it more difficult to crush, according to Time. Endo pulled the previous version from the market and asked the FDA to rule that it unsafe, which would have prevented other drug makers from introducing generic versions of Opana. The FDA denied the request and rejected Endo’s claim that the new coating could help deter abuse. The FDA found that the new formulation was harder to crush but easier to prepare for injection, shifting Opana abuse “from snorting to even more dangerous abuse by intravenous or subcutaneous injection.”
Scott County officials say abusers seem to prefer Opana to heroin, despite the fact that it is more expensive and the high does not last as long, according to Time. With crushing and snorting more difficult, addicts discovered they could cook down the abuse deterrent version of Opana and dissolve it for injection. Addicts have transmitted HIV to each other by sharing needles as they inject Opana, creating the HIV crisis in the county of 24,000 residents.
Endo Pharmaceuticals specializes in pain medications and Opana produced revenues of $1.16 billion from 2008-2012. Endo denies that Opana is at fault in the HIV outbreak and has suggested that generic versions of the drug that do not have the “abuse deterrent” coating might be to blame. Scott County sheriff Dan McClain counters that his evidence room is “full of Opana . . . right now,” but he does not have any generic forms of the pill, according to Time.