Governor Bill Haslam Unveils $30 Million Plan to Combat Opioid Crisis in Tennessee

Educating children, making overdose-reversing drugs available to all state troopers and adding hundreds of prison beds to treat those fighting opioid addiction are part of Gov. Bill Haslam and legislative leaders' comprehensive $30 million proposal to combat the epidemic.

The proposal comes as Tennessee continues to fight the ongoing crisis, which now claims at least three lives a day in Tennessee. More than 1,600 residents died from drug overdoses in 2016.

"It is no secret our country faces a huge challenge in the opioid epidemic," Haslam said at a Monday press conference unveiling the initiative. "Tennessee unfortunately is not an exception to the problem."

The plan — dubbed "TN Together" — will be funded with both federal and state dollars and consist of three main components: prevention, treatment and law enforcement.

The largest component is focused on treatment. The proposal calls for $25 million in state and federal funding to be directed toward paying for treatment and recovery programs for people who cannot afford them.

Tennessee Department of Mental Health and Substance Abuse Services Commissioner Marie Williams said anywhere from 6,000 to 10,000 members of the public could be provided assistance with the new money.

“We are also meeting with private providers to see if we can get them to invest into a public-provide leverage to expand that number,” Williams said, adding the state has also served an additional 5,000 people using federal dollars.

The latest estimates indicate as many as 300,000 Tennesseans are misusing drugs, with 82,000 addicted to drugs, she said.

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The opioid plan also includes adding recovery specialists to emergency rooms and supplying naltrexone, a medication that eases cravings for the drug, to the state's drug recovery courts and county jails.

"The biggest thing we hear is that funding is desperately needed, for treatment programs," said House Speaker Beth Harwell, who last year convened a task force that examined the crisis. "Only a fraction of those people get the treatment they need."

Treatment, she said, costs far less than any other option, including incarceration.

The plan also calls for targeted outreach for women of childbearing age who are chronic opioid users in order to prevent births of children exposed to drugs in utero. The plan includes revisions to the state's health education standards in order to increase prevention education.

The plan also calls for comprehensive changes for law enforcement, including adding new Tennessee Bureau of Investigation agents and equipping all state troopers with naloxone – the drug that reverses or blocks the effects of opioids after an overdose.

Karen Pershing, executive director of the Knoxville-based Metro Drug Coalition, praised the plan’s focus on prevention, treatment and enforcement but noted it has “a lack of true resource investment in primary prevention,” the focus of MDC and other grassroots coalitions around the state.

“While I agree that equipping the Tennessee Highway Patrol officers with naloxone is possibly preventing overdose deaths, the addiction has already taken place,” Pershing said. “It was disappointing to not have any acknowledgement of the role anti-drug coalitions, such as the Metro Drug Coalition, play in local communities. There is currently no state funding designated for substance abuse prevention coalitions in Tennessee.

Pershing applauded the effort to bring treatment into jails and prisons, calling it a relatively inexpensive way to get treatment to a lot of people quickly. But she said the need for more access to evidence-based addiction treatment services in Tennessee is tremendous.

On the prevention side, the proposal includes a plan to limit an initial opioid prescription to a five-day supply, with "appropriate exceptions." Those exceptions would apply to TennCare enrollees as well.

The plan also calls for re-purposing 512 beds in the state's West Tennessee prison to expand drug treatment services. It also calls for the creation of a drug treatment program that would allow inmates who completed it to receive a reduced sentence and add new recovery courts for people convicted of nonviolent crimes who are addicted to drugs.

Judge Duane Sloan, who operates a drug recovery court in northeast Tennessee said the extra treatment options will help all courts. He hopes funding can be made available to create residential recovery units for women going through his courtroom. There are far fewer slots for women than men across the state.

Shelby County Mayor Mark H. Luttrell Jr. noted the impact of the epidemic, which once was centered in east Tennessee but has since become prevalent throughout the state.

Luttrell announced plans two weeks ago for a public awareness campaign led by the Health Department, use of third-party health vendors to monitor prescriptions and continued review of potential litigation against the pharmaceutical industry.

“The opioid issue affects countless people here in Shelby County, which is why the Shelby County Health Department and our many partnering healthcare agencies have launched an aggressive campaign about the dangers of opioids," he said.

The comprehensive proposal comes after months of discussion among state officials, including lawmakers, on how to combat the ongoing crisis.

Last year, a bipartisan legislative task force convened by Harwell, R-Nashville, made a host of recommendations, including:

• Adding 25 agents to the TBI;

• Establishing a commission to combat drug abuse; and

• Creating a consistent approach to determining drug overdose deaths

Not all of the legislative task force's recommendations appear to have made it into the latest proposal. Haslam and other officials declined to say how many TBI agents would be hired.

Tennessee Department of Health Commissioner John Dreyzehner said his agency will continue to work with medical examiners to improvement reporting on drug overdoses.

The opioid plan is among Haslam's top legislative priorities for the session and will likely be prominently featured in the governor's final State of the State speech, which is set for Jan. 29.

Ahead of the news conference, Tennessee Democratic Party chair Mary Mancini said any effort to address the opioid crisis needs to begin with expanding Medicaid under the Affordable Care Act.

Sen. Jeff Yarbro, D-Nashville, and Rep. Mike Stewart, D-Nashville, who were among the dozens of lawmakers present for the announcement, called the $25 million proposed to address treatment needs compared to funds that could be accessed through a Medicaid expansion in the state - a plan that has no Republican support.

Haslam and several of his Republican colleagues scoffed at the criticism.

Rep. Bill Dunn, R-Knoxville, said, "I applaud the governor for coming forward to have a solution. If people want to stand on the side and shoot at him they can but I don't have a whole lot of respect for that."

Calling past efforts to combat the opioid crisis successful, Haslam said the latest proposal is simply a comprehensive plan that takes into account what has already been done in recent years.

Jordan Buie, Kristi Nelson and Wayne Risher contributed to this report.

Reach Joel Ebert at jebert@tennessean.com or 615-772-1681 and on Twitter @joelebert29. Reach Anita Wadhwani at 615-259-8092, awadhwani@tennessean.com or on Twitter @AnitaWadhwani.

https://www.tennessean.com/story/news/politics/2018/01/22/gov-bill-haslams-plan-combat-opioid-crisis-include-boosts-prevention-treatment-and-law-enforcement/1054217001/