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As opioid overdose deaths rise, Tennessee’s grassroots organizations feel siloed and cash-strapped

Mental health care, collaboration and prevention efforts along with out-patient treatment options were flagged as priorities by people who traveled from across the state to talk about what’s needed to stem the opioid abuse crisis.

Lindsay Carr, left, and Jennifer Berven traveled from West Tennessee and East Tennessee, respectively, to explain the challenges that communities have in addressing the various problems associated with the state’s opioid abuse and drug overdose problem.  Photo courtesy/Healthy Tennessee

People on the ground across Tennessee working to stem the state’s entrenched, years-long opioid addiction and overdose crisis feel isolated from others who understand the complexity and want to collaborate on solutions or those entities with funding.

“We don’t know what the ceiling is going to be,” said Dickson County Sheriff Jeff Bledsoe, about the year-over-year budget increases for medical costs as well as purchases of equipment, including hazmat suits for officers who go into places that may have fentanyl at a summit hosted by Healthy Tennessee.

During a question and answer portion an attendee asked with audible frustration what she’s supposed to do when other organizations are looking to collaborate in rhetoric only or when churches from different denominations don’t want to work together.

She said her day-to-day feels like she’s in a silo. 

Dr. Manny Sethi, founder of the non-profit, told the crowd, “you can guarantee Healthy Tennessee is going to be in this fight with you.”

Dr. Michael Genovese, chief medical officer of Acadia Healthcare, recounted what it was like for him as a psychiatrist to try to get a patient into a provider in New York who could prescribe buprenorphine. When he couldn’t find a doctor, he got the license himself. 

In a gesture of solidarity with the people who often hit brick walls, Genovese gave out his cell phone number with the directive to anyone who needs help finding treatment for someone: call him. 

“That’s the sort of commitment we need from people,” said Genovese.

Mental health care, coordination and prevention efforts along with out-patient treatment options were routinely listed as priorities by people who traveled from across the state and country to speak at the day-long “Working Together to Find Solutions to the Opioid Crisis” forum in Nashville on Aug. 24. The Democrat and Republican candidates for both governor and U.S. Senate spoke.

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‘Without these opportunities no one would look at me’

The reality across the state is people who are dealing with substance use disorder find a disjointed treatment system. The number of drug overdose deaths rose to another record high in 2017. At least 1,776 people died.

“Addiction takes the humanity out of a person… There’s no outline on rebuilding your life,” said Dr. Basem Attum, a fourth year orthopedic resident at UC San Diego Medical Center, who had his life and career derailed for several years because of a painkiller addiction. 

After living in a halfway house for two years and trying to figure out how to remake his life, Vanderbilt University Medical Center’s orthopedic department allowed him to volunteer for a year writing papers. Then the team gave him a job and helped him get back into a residency. 

“It’s a miracle. It’s because of the opportunities I was given. Without these opportunities no one would look at me,” said Attum, who received a standing ovation from the crowd for telling his story.

Most people don’t have that experience. The state is short on both out-patient and in-patient treatment options, and Genovese said regulations mean it could take years to get approval for, and then open a treatment center. There’s a dire need for out-patient services, which are what some people need to kick the addiction and what most people need as an on-going resource.

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Trent Coffey, executive director of Schools Together Allowing No Drugs in Scott County, said there are 22,000 people in his footprint and 42,000 opioid prescriptions. 

But there’s no extra money in local budgets and it’s hard to find partners to commit to the resources he knows are needed.

He wants a structured “warm handoff” system that allows people who are identified as needing treatment to be seamlessly, as possible, connected to the appropriate level of treatment. 

He’d also love a mechanism that helps rural areas recruit and retain the type of clinicians and other resources that help people with addiction and rebuild their life. 

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It’s easy to ID people who need help, he said, but affordable treatment outside of metro areas is tough to find.

The ripple effect of addiction shows up in schools so speakers said more licensed clinical social workers need to be on-site to guide children through the turmoil. 

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Jennifer Berven, with Washington County Anti-Drug Coalition, said schools need to understand how to talk about prevention as a way to reduce rates of addiction in the future.

The roots of the problem extend beyond exam rooms, and the courts can’t be expected to fix people who have a variety of underlying reasons they abuse drugs on top of a genetic disposition, speakers said.

“We’re all hesitant to doctor blame because it’s not just the doctors. I don’t want to blame the judicial system. There are a lot of things when you begin to peel the onion back. There are a lot of complex issues we’re dealing with,” said DeWayne Holman, executive director of Nashville Prevention Partnership. 

Read more:

Read live coverage from Twitter: BirdDog | WPLN | USA Today Network-Tennessee 

Political coverage from the forum: 

Bredesen backs effort to reverse opioid law that ‘defanged’ DEA; Blackburn calls for prescription limit (USAT-TN)

Bredesen wants Blackburn-backed opioid law repealed (Associated Press)

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