Two more vignettes of the drug scourge in rural America

This is not a new story (read more here, here and here, as well as at "drug abuse" label on this blog), but I'm going to highlight some recent media coverage of the problem.  Melissa Block reported for NPR from Kutztown, Pennsylvania, population 5,012, last month.  The headline was "A Small Town Wonders What to Do When Heroin Is 'Everywhere.'"    Here's an excerpt:

I went to rural Berks County in southeast Pennsylvania to hear what the opioid epidemic means in a small town, a place where everyone knows everyone and the ripples of addiction spread wide. 

Really, I could have gone just about anywhere. No community is immune. 

The landscape in Berks County is bucolic: rolling farmland studded with silos and 19th-century stone barns. But that peaceful landscape belies a serious problem. Opioid addiction is deeply embedded in these small towns. 

"It's become a crisis," says Phil Salamone, a paramedic in Kutztown, Pa.
He points out that heroin is both cheap and readily available from nearby cities such as Reading and Philadelphia. Salamone says, "There is no exclusive demographic that's using it. It's everybody. It's kids, adults, low income, high income. It's everywhere."

The paramedics note that they are using naloxone (Narcan) effectively to save lives--and that they are using enough of it that they don't worry about expiration dates.  The two area high schools have lost six students to heroin overdoses in the past two years.  (It is odd that the reporter calls Berks County "rural" because it is metropolitan, with a population of more than 415,000; or maybe Block meant she went to the "rural" part of Berks County).

Another more recent NPR story is out of Austin, Indiana, population 4,295, in the Southern part of the state, in Scott County, population 23,744, very close to the Kentucky state line.  "Inside a Small Brick House, at the Heart of Indiana's Opioid Crisis" is the headline, and it recalls that just a year ago,  this town became "home to one of the biggest HIV outbreaks in decades, with more than 140 diagnosed cases."  The story features several local vignettes, including this extremely sobering one that makes clear the link between :

When news of the HIV infections broke, Kevin Polly was one of the few people in Austin willing to go on the record and say he was using Opana. Polly had contracted HIV, and at the time told a CBS reporter he had no plans to quit injecting the drug. 

Clyde Polly, Kevin's 73-year-old father, says his son went to a rehab facility and isn't living in Clyde's one-story brick house anymore. Even though Kevin is gone, Clyde says some of his son's friends who do drugs are still there. Not all of them are HIV positive, and not everyone is from Austin — but most of them are using Opana. 

"Everyone that's in there right now has probably done it," he says. "There's about a half-dozen in there. Some of them give me a little money for staying here, help me get by."

The other vignettes from this NPR feature include a nurse who has become addicted and William Cooke, previously the only physician in town.  About the latter, the story reports:

Cooke's staff goes door-to-door to make sure people are keeping their appointments. "When somebody walks in my door with HIV, I hug them, " he says.