February 23, 2018

Panel addresses opioid crisis

Tracey Wolfe
Grainger Today Editor

NASHVILLE – A panel of representatives from various state agencies addressed the opioid crisis in Tennessee during a presentation held as part of the Tennessee Press Association’s (TPA) Winter Conference in Nashville.

Commissioner Marie Williams of the Tennessee Dept. of Mental Health and Substance Abuse Services; Jayme Simmons of the governor’s office; Commissioner Tony Parker of the Tennessee Department Correction; Commissioner John Dreyzehner, M.D. of the Tennessee Department of Health; Dr. Victor Wu, chief medical officer for TennCare; and Jason Locke, Deputy Director of the Tennessee Bureau of Investigation presented information regarding TN Together, the state’s plan to end Tennessee’s opioid epidemic.

Dept. of Health

Director of Faith-Based Initiatives with the Tennessee Department of Mental Heath and Substance Abuse Services Monty Burks spoke to attendees about his own experience with addiction.

Burks said 18 years ago he was “rock bottom, face-down homeless – the epitome of the effects of drug abuse.”

He said he came from a great family, but had become and an addict right in front of his parents.

“My parents had no idea who I’d become,” he said.

He said he was blessed enough to be introduced to a step meeting, and as a result, he became a “positive product of proper intervention by the justice system.”

While serving time in jail he was introduced to a nine-month, 170-day therapeutic treatment program. He said he learned to accept responsibility for his reckless, irresponsible behavior.

He completed the program, went back to school and earned a Master’s Degree. Upon graduation from college he was given the opportunity to work in a program assisting people like him.

“I am a byproduct of proper criminal justice intervention, mixed with recovery support and community support,” he said.

Williams said the opioid epidemic wasn’t only recently addressed by the Haslam administration, it was visited in 2012 when a group chosen by the governor was selected to look into the issue.

She said according to prevalence data more than 317,000 people were estimated to use heroin or misuse opioid pain relievers in 2016. Of that number, it appears about 82,965 would be addicted. She said many believe that number is underreported.

The unduplicated number of patients with a diagnosis of opioid substance abuse or poisoning in 2016 was 36,940. East Tennessee accounts for 17,626 of those reported.

TN Together

Simmons said the TN Together plan is the state’s comprehensive plan to address the ongoing opioid epidemic through three primary levers: prevention, treatment and law enforcement.

Entering his final year in office, she said the governor brought together officials and representatives of the senate and house and said to them, “As we go into our final year, we continue to see our overdose deaths in Tennessee rise. What can we continue to do? What else can be done to address the epidemic in the state?”

Through that work, and work with speaker Harwell, who also had a task force with other recommendations, it was all whittled down into the plan presented as TN Together, Simmons said.

The first part of the plan is legislative in nature, with two bills moving through legislature. One is prevention focused and limits the number of days of an initial opioid prescription. The limit on an initial prescription will be five days or the morphine equivalent dosage of 40 MME. She said there is an option at practitioner’s discretion, or if an individual lives far away the doctor can write second prescription at that visit for another five days at 40 MME. The second prescription could not be filled until first five days have passed, and must be filled before the 10th day. It cannot be filled later.

Simmons said the limit starts low, but can move into a larger dose if needed, if a practitioner feels it is necessary. A larger dosage would require more effort on part of practitioner, and the patient must sign a consent form acknowledging they understand the risks of taking opioids. Those of child bearing age must sign a consent form acknowledging the risks taking opioids pose to a baby.

Simmons said after the first five days of opioid use the likelihood of continuing to be on the opioid a year later rises. That is the rationale for the five-day limit, she said.

A second part of the plan focuses on treatment. Part of the treatment plan is to incentivize inmates to pursue treatment. If an inmate completes an intensive therapeutic program, consisting of  nine-12 months of treatment, they can reduce their sentence by 60 days.

A third portion of the plan focuses on law enforcement. It addresses fentanyl analogues that are not currently addressed in state codes. Such analogues will be included in the codes to allow prosecution of those trafficking them. Updating the controlled substance schedule and adding TBI agents across the state to address need around illicit activity. It also calls for each Tennessee state trooper to be provided with two doses of Naloxone (a drug that counters the effects of opioids that is administered in the event of an overdose), and includes grants for local law enforcement for a similar drug.

Adding standards in kindergarten through 12th grade courses to provide additional instruction of the dangers of opioids within health courses students are already taking is also part of the plan.

The Department of Mental Health and Substance Abuse Services will launch an awareness campaign providing information about how to find resources for treatment, and a website providing a list resources will be maintained.

An executive order for a special commission of individuals tied to medical and dental schools or other prescriber training schools is included. The commission will be charged to come together around developing best practices/best training for future prescribers around pain management, pain medicine and addiction medicine. The commission will present its findings to governor, which will be presented later for adoption into schools.

Simmons said about $27 million in state and federal funding will be put into treatment alone. Some funding will be earmarked to assist those who don’t have access to treatment due to financial circumstances.

Dept. of Corrections

Parker said he is excited for the opportunity for the department of correction to address drug addiction in a new way. He said there are nine total therapeutic communities across state in dept. of corrections. The TN Together plan calls for a wholistic approach.

Parker said they will take a complete facility, with 512 beds, and dedicate it to opioid treatment for inmates.

“We know that more than 50 percent of the people that come in our front door self-admit they have a drug issue, they need treatment.” he said. “We think that number’s higher. So, this will go a long way in treating that group of people who 95 percent of them, we should never forget, are going to be returning to our society – where we live, our communities.”

He said the sentence reduction 60-day credit is a great program to incentivize the treatment option for people who are showing interest in getting clean. “It saves money for taxpayers also. It’s a win-win.” he said.

TBI

Locke said one of the things he is most excited for is the addition of fentanyl analogues to the controlled substance list. He said fentanyl is a synthetic opioid manufactured mainly in China and shipped to the U.S. “It’s 100 times more powerful than morphine,” he said.

He said analogues are created by illegal chemists. Each drug on the schedule has a chemical makeup which is how it’s defined as being illegal. Chemists alter that makeup slightly so it doesn’t meet the definition of the illegal substance, but it basically has same effects.

He said they have seen it time and time again. Agents go in and seize a large amount of drugs but can’t do anything because doesn’t meet the chemical makeup to be illegal.

He said he is also thankful for additional personnel to target hot spots across the state.

Photo by Tracey Wolfe

A panel of state officials addressed members of the Tennessee Press Association regarding the state’s opioid epidemic Thursday, February 1, in Nashville. Pictured (l-r) are: Dr. Victor Wu, chief medical officer for TennCare; Monty Burks, director, Faith-Based Initiatives, Division of Substance Abuse Services; Commissioner John Dreyzehner, M.D. of the Tennessee Department of Health; Jayme Simmons of the governor’s office;  Commissioner Tony Parker of the Tennessee Department Correction; Commissioner Marie Williams of the Tennessee Dept. of Mental Health and Substance Abuse Services; and Jason Locke, Deputy Director of the Tennessee Bureau of Investigation.

Grainger County Business & Industry Directory

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Panel addresses opioid crisis

Tracey Wolfe
Grainger Today Editor

NASHVILLE – A panel of representatives from various state agencies addressed the opioid crisis in Tennessee during a presentation held as part of the Tennessee Press Association’s (TPA) Winter Conference in Nashville.

Commissioner Marie Williams of the Tennessee Dept. of Mental Health and Substance Abuse Services; Jayme Simmons of the governor’s office; Commissioner Tony Parker of the Tennessee Department Correction; Commissioner John Dreyzehner, M.D. of the Tennessee Department of Health; Dr. Victor Wu, chief medical officer for TennCare; and Jason Locke, Deputy Director of the Tennessee Bureau of Investigation presented information regarding TN Together, the state’s plan to end Tennessee’s opioid epidemic.

Dept. of Health

Director of Faith-Based Initiatives with the Tennessee Department of Mental Heath and Substance Abuse Services Monty Burks spoke to attendees about his own experience with addiction.

Burks said 18 years ago he was “rock bottom, face-down homeless – the epitome of the effects of drug abuse.”

He said he came from a great family, but had become and an addict right in front of his parents.

“My parents had no idea who I’d become,” he said.

He said he was blessed enough to be introduced to a step meeting, and as a result, he became a “positive product of proper intervention by the justice system.”

While serving time in jail he was introduced to a nine-month, 170-day therapeutic treatment program. He said he learned to accept responsibility for his reckless, irresponsible behavior.

He completed the program, went back to school and earned a Master’s Degree. Upon graduation from college he was given the opportunity to work in a program assisting people like him.

“I am a byproduct of proper criminal justice intervention, mixed with recovery support and community support,” he said.

Williams said the opioid epidemic wasn’t only recently addressed by the Haslam administration, it was visited in 2012 when a group chosen by the governor was selected to look into the issue.

She said according to prevalence data more than 317,000 people were estimated to use heroin or misuse opioid pain relievers in 2016. Of that number, it appears about 82,965 would be addicted. She said many believe that number is underreported.

The unduplicated number of patients with a diagnosis of opioid substance abuse or poisoning in 2016 was 36,940. East Tennessee accounts for 17,626 of those reported.

TN Together

Simmons said the TN Together plan is the state’s comprehensive plan to address the ongoing opioid epidemic through three primary levers: prevention, treatment and law enforcement.

Entering his final year in office, she said the governor brought together officials and representatives of the senate and house and said to them, “As we go into our final year, we continue to see our overdose deaths in Tennessee rise. What can we continue to do? What else can be done to address the epidemic in the state?”

Through that work, and work with speaker Harwell, who also had a task force with other recommendations, it was all whittled down into the plan presented as TN Together, Simmons said.

The first part of the plan is legislative in nature, with two bills moving through legislature. One is prevention focused and limits the number of days of an initial opioid prescription. The limit on an initial prescription will be five days or the morphine equivalent dosage of 40 MME. She said there is an option at practitioner’s discretion, or if an individual lives far away the doctor can write second prescription at that visit for another five days at 40 MME. The second prescription could not be filled until first five days have passed, and must be filled before the 10th day. It cannot be filled later.

Simmons said the limit starts low, but can move into a larger dose if needed, if a practitioner feels it is necessary. A larger dosage would require more effort on part of practitioner, and the patient must sign a consent form acknowledging they understand the risks of taking opioids. Those of child bearing age must sign a consent form acknowledging the risks taking opioids pose to a baby.

Simmons said after the first five days of opioid use the likelihood of continuing to be on the opioid a year later rises. That is the rationale for the five-day limit, she said.

A second part of the plan focuses on treatment. Part of the treatment plan is to incentivize inmates to pursue treatment. If an inmate completes an intensive therapeutic program, consisting of  nine-12 months of treatment, they can reduce their sentence by 60 days.

A third portion of the plan focuses on law enforcement. It addresses fentanyl analogues that are not currently addressed in state codes. Such analogues will be included in the codes to allow prosecution of those trafficking them. Updating the controlled substance schedule and adding TBI agents across the state to address need around illicit activity. It also calls for each Tennessee state trooper to be provided with two doses of Naloxone (a drug that counters the effects of opioids that is administered in the event of an overdose), and includes grants for local law enforcement for a similar drug.

Adding standards in kindergarten through 12th grade courses to provide additional instruction of the dangers of opioids within health courses students are already taking is also part of the plan.

The Department of Mental Health and Substance Abuse Services will launch an awareness campaign providing information about how to find resources for treatment, and a website providing a list resources will be maintained.

An executive order for a special commission of individuals tied to medical and dental schools or other prescriber training schools is included. The commission will be charged to come together around developing best practices/best training for future prescribers around pain management, pain medicine and addiction medicine. The commission will present its findings to governor, which will be presented later for adoption into schools.

Simmons said about $27 million in state and federal funding will be put into treatment alone. Some funding will be earmarked to assist those who don’t have access to treatment due to financial circumstances.

Dept. of Corrections

Parker said he is excited for the opportunity for the department of correction to address drug addiction in a new way. He said there are nine total therapeutic communities across state in dept. of corrections. The TN Together plan calls for a wholistic approach.

Parker said they will take a complete facility, with 512 beds, and dedicate it to opioid treatment for inmates.

“We know that more than 50 percent of the people that come in our front door self-admit they have a drug issue, they need treatment.” he said. “We think that number’s higher. So, this will go a long way in treating that group of people who 95 percent of them, we should never forget, are going to be returning to our society – where we live, our communities.”

He said the sentence reduction 60-day credit is a great program to incentivize the treatment option for people who are showing interest in getting clean. “It saves money for taxpayers also. It’s a win-win.” he said.

TBI

Locke said one of the things he is most excited for is the addition of fentanyl analogues to the controlled substance list. He said fentanyl is a synthetic opioid manufactured mainly in China and shipped to the U.S. “It’s 100 times more powerful than morphine,” he said.

He said analogues are created by illegal chemists. Each drug on the schedule has a chemical makeup which is how it’s defined as being illegal. Chemists alter that makeup slightly so it doesn’t meet the definition of the illegal substance, but it basically has same effects.

He said they have seen it time and time again. Agents go in and seize a large amount of drugs but can’t do anything because doesn’t meet the chemical makeup to be illegal.

He said he is also thankful for additional personnel to target hot spots across the state.

Photo by Tracey Wolfe

A panel of state officials addressed members of the Tennessee Press Association regarding the state’s opioid epidemic Thursday, February 1, in Nashville. Pictured (l-r) are: Dr. Victor Wu, chief medical officer for TennCare; Monty Burks, director, Faith-Based Initiatives, Division of Substance Abuse Services; Commissioner John Dreyzehner, M.D. of the Tennessee Department of Health; Jayme Simmons of the governor’s office;  Commissioner Tony Parker of the Tennessee Department Correction; Commissioner Marie Williams of the Tennessee Dept. of Mental Health and Substance Abuse Services; and Jason Locke, Deputy Director of the Tennessee Bureau of Investigation.