It is no new fact that the nation is in the midst of an opioid epidemic. While it is true that the entire Nation is facing this, there are some states that are harder hit. Tennessee is one of those states. In 2015, doctors wrote more than 7.8 million opioid prescriptions, which is equal to 1.18 for every man, woman, and child in the state. IMS Health data placed Tennessee’s total as second, behind Alabama, for most opioid prescriptions written. More Tennesseans died from opioid overdose than in car accidents or from firearms in 2014. Tennessee is aware of the problem and doing everything they can to try to lower the number of prescriptions written and then number of opioid deaths in their state. Tennessee was one of only four states to receive the “making progress” title in the 2016 National Safety Council on efforts to stop opioid abuse.
The National Safety Council has six indicators for success in reducing the loss of life due to opioid abuse and help in ending the epidemic. The six key indicators are Mandatory Prescriber Education. Opioid Prescribing Guidelines, Eliminating Pill Mills, Prescription Drug Monitoring Programs (PDMPs), Increased Access to Naloxone, and Availability of Opioid Use Disorder (OUD) Treatment. No state has accomplished all six indicators. Tennessee has implemented all but the availability of opioid use disorder treatment. The state requires mandatory medical education for prescribers on pain management. This will reduce dangerous prescribing methods and improve treatment plans for pain. When opioids are used for chronic pain, lower dosages are recommended and risk assessment criteria is applied to all patients. When opioids are used for emergency treatments short-term opioids are recommended instead of long-term and no longer than seven days. The state has laws that prevent pill mills. Pill mills are health care facilities that commonly prescribe opioids outside of normal medical practice. Pill mills often have non-individualized care, repetitive combinations of medications that are given to all patients, lack of referrals to specialists, and a lack of diagnostics tests. The laws require that appropriate risk assessments are done at each visit, use the state’s prescription drug monitoring programs at all pain clinics, appropriate medical evaluations with physical exams and patient history, clinic owners are held responsible by state licensing authorities, follow prescribing guidelines made by state licensing authorities and meeting standards, and restricts the dispensing of controlled substances. The state has created a prescription drug monitoring program (PDMP) to help prescribers see patient history and make sure that they do not prescribe more opioids to someone who already has a prescription with other doctors. PDMP’s also alert authorities of dangerous prescribing habits by medical professionals and about patients trying to doctor shop so that they can intervene and help stop or fix the problem. The state has also increased access to naloxone. Naloxone can help stop an opioid overdose and has no potential for abuse. Naloxone blocks opioid receptors in the brain and save someone who is overdosing. Friends and family members can get prescriptions for Naloxone if they know someone who is suffering from opioid addiction. First responders also have access to Naloxone so that if they are called in the event of an opioid overdose they can save them. They have also invoked “Good Samaritan” laws, which allows bystanders to call for medical help without fear of arrest or other negative consequences.
Where Tennessee Stands
The only indicator that Tennessee did not meet was the final one, availability of opioid use disorder treatment. Only three states met this indicator. According to Substance Abuse and Mental Health Services Administration (SAMHSA) in 2014, over 2.4 million people suffered with opioid use disorder directly related to opioid pain relievers. Opioid use disorder treatment requires certain drugs and therapy to be successful and most treatment centers are full to capacity. When treating opioid use disorders there is a lot of time and effort needed making it more difficult for others in need to get into treatment when they need it. In order to treat everyone in the state will require more treatment centers and more staff. The only three states who have met this indicator are Maine, New Mexico, and Vermont. Tennessee is trying it’s best to combat the opioid epidemic but all states still have a long way to go. Hopefully, with more time and resources, we will finally see a reversal of the epidemic. As more people become aware of the dangers of opioid prescription use and see it amongst their own friends and family, they become more vigilant and learn how they can avoid addiction themselves and how to help their loved ones. Patients and doctors are looking towards other safer options for pain treatment, especially chronic pain, like physical therapy and safer pain medications. Fighting against this epidemic is no easy task but with help from these indicators, patients, and doctors we may be able to stop it in its tracks and even reverse it. If you know someone who is struggling with opioid addiction it is best to get the treatment as soon as possible. http://www.tennessean.com/story/news/health/2016/09/19/there-more-opioid-prescriptions-than-people-tennessee/90358404/ http://www.nsc.org/RxDrugOverdoseDocuments/Prescription-Nation-2016-American-Drug-Epidemic.pdf