opioids

Health and Wellness

Opioids: A Tennessee Crisis

Tennessee is facing a major health crisis – the opioid epidemic. We did not get here by accident. After the FDA approved Oxycotin (oxycodone) in 1995, just four years later there were 342 deaths from overdoses in Tennessee. In 2003, the number of deaths nearly doubled. The epidemic eclipsed 1,000 deaths due to overdose cases in 2011.

By 2012 Tennessee was ranked second in the nation for opioid use. More Tennesseans died from drug overdoses than in motor vehicle accidents, homicides or suicides.

In 2013, the Department of Health required all cases of drug-dependent babies to be reported. The state recorded 912 cases of neonatal abstinence syndrome that year.

In 2015, there were 1,029 babies born drug-dependent and there were 1,186 deaths from opioids, 1,631 deaths from all drug overdoses.

In the last year Tennessee leaders have woken up to this epidemic. Given the trajectory of this health crisis, the time for action is now.

Governor’s Opioid Plan

Governor Haslam unveiled a plan to address the opioid crisis in January 2018. Major elements of the Governor’s plan include:

  • Legislation to restrict new opioid prescriptions to a 5-day supply;
  • Education efforts in K-12 schools;
  • A $25 million investment in treatment and recovery services (including more prison beds dedicated to addiction treatment); and
  • Naloxone for every state trooper.

“Yes AND” to the Governor’s Plan

While there is a consensus that the Governor’s plan is a good first step, more needs to be done. Ideas that go beyond the Governor’s proposal include:

  • Require manufacturers to clearly spell out for health care providers and patients the addictive nature of their products and prosecute them when they fail to do so;
  • Regulate prescriptions by integrating real-time access to the Controlled Substance Monitoring Database. Set a date by which all opioid prescriptions are written online, allowing doctors to see if someone is doctor shopping.
  • Protecting patients by encouraging compounding pharmacies and drug manufacturers to include emetics in their formulations so drugs will be expelled at overdose levels.
  • Remove obstacles for clinics that offer non-pharmaceutical solutions to pain;
  • Allocate more resources for mental health screenings;

Role of Health Systems, Physicians, Nurses and Allied Health Providers

Health systems, physicians, nurses and other allied health providers as well as nursing homes play a vital role in managing and dispensing drugs that alleviate pain. More work needs to be done to identify and validate best practice prescribing of opioids and other addictive medications and developing systems and structures required to ensure adherence to best practices.

It is the health care providers that are responsible for limiting prescriptions, raising awareness among fellow providers, patients and families about addiction, identifying and treating opioid addicted patients, and collaborating with other organizations in the community working on this crisis. Moreover, it is of vital importance that a coordinated approach be undertaken that encompasses all stakeholders in the opioid crisis at the local, regional, state and national levels.

 

[1] Anita Wadhwani & Ayrika L. Whitney, The Tennessean.  “Timeline:  How the Opioid Crisis Took Hold,” 2017.

[2] Cindy Sanders.  Nashville Medical News.  “Haslam Unveils Opiod Plan,” February 2018.

[3] Mara Laderman, MSPH & Lindsay Martin, MSPH.  New England Journal of Medicine, “Health Care Providers Must Act Now to Address the Opioid Crisis,” April 19, 2017

Published on April 5, 2018 4:47pm

John Deane

Article By

John Deane

Born in Baltimore in 1961, John attended American University. For 32 years, John led a successful career as a senior healthcare executive. In 1998 John founded Southwind Health Partners, a start-up healthcare business focused on providing management services for hospital and health system sponsored physician practices out of his home in Nashville and over 20 years grew the business into one of the nation’s pre-eminent healthcare consulting practices. Following the acquisition of Southwind by Advisory Board John led the development of an expansive, full-service consulting and management division serving over 250 health system clients in 50 states with approximately 400 consultants and staff.

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