Indiana Governor Mike Pence declared a public health emergency over an HIV outbreak in which about 80 people contracted the virus since mid-December, The New York Times reports. Health officials say the “epidemic” is centered in the state’s rural southeast and related to injection drug use of the prescription painkiller Opana (oxymorphone).

Pence authorized a short-term needle exchange program to address the emergency. It’ll be in effect for 30 days within Scott County. Healthline reports that Indiana State Representative Ed Clere introduced an amendment to create a needle exchange.

Carrie Elizabeth Foote, a former injection drug user who is now a professor at Indiana University, told Healthline that clean needles are “relatively easy” to get in the Hoosier state because they don’t require prescriptions. However, customers do have to register to buy them, which can be a deterrent.

Foote says the outbreak will likely get worse. “With prescription drug use the major drug problem in the United States now, and most of these folks injecting, all it takes is one positive person, who does not know their status, in a concurrent unsafe needle sharing network to rapidly spread HIV,” said Foote, adding that HIV criminalization laws and ignorance about HIV add to the problem. “The needle sharing/sex laws are linked to nondisclosure, so it’s only after people know their status that one could be potentially criminalized, so folks who do not know their status are not at risk,” she said.

According to a press release from the Indiana State Department of Health, a team from the Centers for Disease Control and Prevention is working with local health officials. The health department is releasing a campaign titled “You Are Not Alone” to raise awareness about HIV testing, drug use, needle disposal and safe sex.