President Donald Trump on Thursday nominated an anesthesiologist to become the next U.S. surgeon general.

Dr. Jerome Adams is the current health commissioner of Indiana, appointed by Vice President Mike Pence when he was the governor of that state.

If confirmed, Adams would replace Rear Admiral Sylvia Trent-Adams, the acting surgeon general, who took over for Vivek Murthy, whom Trump dismissed in April.

In Indiana, Adams has been a prominent backer of allowing counties to start needle-exchange programs aimed at stemming the spread of diseases among intravenous drug users as the state struggles with opioid abuse.

As the health commissioner, Adams oversaw the effort, which Pence reluctantly supported in 2015 after more than 180 HIV cases hit a rural southern Indiana county that were blamed on needle-sharing among people injecting a liquefied painkiller.

“Syringe exchanges aren’t pretty. They make people uncomfortable. But the opioid epidemic is far uglier. It affects the student athlete who gets hooked on the pain pills he was prescribed for a sports injury. It affects the grandmother with chronic pain issues. The faces of this epidemic are our children, our friends, our neighbors,” Adams wrote in a in a June 22 commentary distributed by the state health department.

Adams also was an assistant professor of anesthesiology at the Indiana University School of Medicine.
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