Haslam outlines $30M opioid crisis plan

BY KATE Coil
TML Communications Specialist

Gov. Bill Haslam along with leadership from the Tennessee House, Senate, and Chief Justice Jeff Bivins announced a new plan to fight opioid abuse in Tennessee.

The TN Together plan is a multi-faceted initiative focuses on three major components: prevention, treatment, and law enforcement. Haslam said the initiative will include legislation, $30 million in proposed state and federal funding in the 2018-19 fiscal year budget, executive actions, and task forces.
TN Together was designed in partnership with the General Assembly’s Ad Hoc Opioid Abuse Task Force, which included House Speaker Pro Tem Curtis Johnson as chairman.

“This is a crisis that knows no boundaries and impacts many Tennesseans regardless of race, income, gender or age. Our approach will be aggressive with provisions to limit the supply of opioids and significant state and federal dollars to provide treatment to those in need,” Haslam said. “I applaud the collaboration and the considerable work of the House and Senate on the TN Together plan, as well as the judicial branch’s leadership through the Regional Judicial Opioid Initiative and National Opioid Task Force, and I ask all stakeholders around this issue to work together to achieve real reform and action that will save lives.”
Lt. Gov. Randy McNally said he believed the proposal will yield both short-term and long-term results for the state.

“I am proud to support the comprehensive TN Together plan to attack the opioid crisis in Tennessee,” McNally said. “This scourge is breaking up families, ruining lives and killing our people. The approach Gov. Haslam outlined today demonstrates the united commitment by all three branches of Tennessee state government to confront this threat. The three-legged stool of enforcement, treatment and prevention will stop the flow of these drugs in our state, help those ravaged by addiction and work to prevent our citizens from starting down the road to addiction. We are confronting this crisis from all sides and from all angles.”
House Speaker Beth Harwell, said the focus on treatment because it costs far less than any other option, including incarceration.

“The biggest thing we hear is that funding is desperately needed, for treatment programs,” Harwell said. “Only a fraction of those people get the treatment they need.”

The three components of TN Together include prevention, treatment, and law enforcement. Specifically, the plan includes:
Legislation to address prevention by limiting the supply and the dosage of opioid prescriptions, with reasonable exception and an emphasis on new patients. Initial prescriptions will be limited to a five-day supply of drugs with daily dosage limits of 40 MME (morphine milligram equivalent).

Limiting coverage for TennCare enrollees to an initial 5-day supply with daily dosage limits.
Increasing prevention education in grades K-12 through revisions to the state’s health education academic standards.
Identifying women of childbearing age who are chronic opioid users and providing targeted outreach about risks and treatment in order to aid in the prevention of Neonatal Abstinence Syndrome (NAS) births.

Investing more than $25 million for treatment and recovery services for individuals with opioid-use disorder. These services will include an increase in peer recovery specialists in targeted, high-need emergency departments to connect patients to treatment immediately.
Improving the state’s data systems to better and more timely identify critical hot spots for targeting.

Legislation that expands residential treatment and services for opioid dependence within the criminal justice system and creates incentives for offenders who complete intensive treatment programs while incarcerated – a best practice that is proven to reduce recidivism, improve lives and communities and save taxpayer dollars.

Attacking the illicit sale and trafficking of opioids by providing additional resources to the Tennessee Bureau of Investigation for rapid response teams and, through legislation, penalizing the use and unlawful distribution of dangerous and addictive drugs, including those that mimic the effects of fentanyl. Providing every Tennessee state trooper with naloxone for the emergency treatment of opioid overdose.

Haslam also announced the establishment of the 19-member Commission on Pain and Addiction Medicine Education, which includes medical and healthcare professionals from the state’s public and private medical educational institutions, the Tennessee Department of Health, a broad group of professional associations, and licensed health care practitioners.

“To be clear, this is not us telling medical and health care practitioner schools what their curriculum will be,” Hasalm said. “This is a group of professionals from that field who will come together and design what competencies should be developed around evidence-based pain and addiction management.”
The commission will develop competencies for current and future curricula so that future prescribers receive instruction and training regarding effective treatment for acute and chronic pain, including alternatives to opioids to manage pain; the potential risks and effects of using opioids to treat pain, including physical dependency and addiction, and effective discontinuation of opioids; proper identification of and treatment for patients demonstrating misuse or abuse of opioids; and utilization of the Controlled Substance Monitoring Database.

Other state officials also outlined their part in the plan. Correction Commissioner Tony Parker told said 512 beds at West Tennessee State Prison will be repurposed to deal with opioid addiction issues in the state prison system, doubling the department’s current capacity.
Mental Health and Substance Abuse Commissioner Marie Williams said data indicated some 300,000 Tennesseans “misuse” drugs but aren’t addicted while about 80,000 adults are addicted based on data.

An estimated 7.6 million painkiller prescriptions are active in Tennessee, which exceeds the state’s total population by roughly 1 million.
Williams said her department will also be meeting with private providers to see how to best use the state’s resources for a public-private partnership to fight opioid abuse.

Senate Minority Leader Jeff Yarbro, D-Nashville, said he applauded many of the steps being taken by the Haslam administration under the TN Together plan, but he felt there were parts of the proposal that are lacking.

“This is the time for bold action,” Yarbro said. “I think there’s some things that are included in this proposal that everyone supports. But this is a modest step. Under this plan, we are not sending enough people into medically-assisted treatment. I think personally, the governor feels his hands are tied by the [Republican] majority who hasn’t let him expand Medicaid.”

According to information from the state of Tennessee, the number of opioid-related overdose deaths nationwide, including prescription opioids and heroin, has quadrupled since 1999 with Tennessee remaining one of the top 15 of all states in drug overdose deaths.

Tennesseans are more likely to die of an opioid-related overdose than in a car crash with three people dying of overdoses in the state each day.
More details on the TN Together plan, including help for those suffering from addiction and other resources, can be found at tn.gov/opioids.