It is the largest outbreak of the human immunodeficiency virus ever to hit a single region of the United States at once. Health officials said there have been 26 cases confirmed so far and four more in the preliminary stages of testing.

The outbreak has been traced to back to people injecting themselves with the prescription painkiller Opana, an opiod that is even more powerful than oxycontin.

This is the latest tragedy to strike a nation facing epidemic rates of prescription painkiller abuse. Not enough is being done to prevent the widespread use and abuse of prescription opioids. However, officials recognize the important role addiction has played in this HIV outbreak.

“Because prescription drug abuse is at the heart of this outbreak, we are not only working to identify, contact and test individuals who may have been exposed, but also to connect community members to resources for substance abuse treatment and recovery,” said health commissioner Dr. Jerome Adams.

Many are concerned that drug addicts will turn from the pill form of the drugs to the injectable form, raising the number of HIV cases in the US. According to the Centers of Disease Control and Prevention, as many as eight percent of new HIV cases are found in injection drug users.

“Addicts use and misuse needles,” said Karyn Hascal, president of The Healing Place in Louisville in a statement to USA Today. “When you have injectable drugs like prescription pills and other narcotics being abused as much as they have been, (Hepatitis) C and HIV are soon to follow. … I knew that HIV and Hep C would come back.”

The World Health Organization has recently started a campaign to make one-time use only needles the industry standard in order to combat exactly this issue- the spread of deadly diseases through improper needle sterilization.

The outbreak occurred in the southern region of Indiana principally in Clark, Jackson, Scott, and Washington counties.

Health officials are trying their best to contain the outbreak. They advise citizens to protect themselves by avoiding sharing needles as well as unprotected sex. People who are struggling with addiction are encouraged to seek help.