As Opioid Deaths Rise, Tennessee Governor Proposes More Money For Treatment, Tighter Prescriptions | Nashville Public Radio

As Opioid Deaths Rise, Tennessee Governor Proposes More Money For Treatment, Tighter Prescriptions

Jan 22, 2018

Creating a 500-bed treatment facility for addicted inmates, limiting the duration of new opioid prescriptions to just a few days, and putting more drug enforcement officers on the streets.

Those are some of the ideas Tennessee Gov. Bill Haslam is pitching to combat the opioid crisis  — which despite past efforts, has continued to worsen.

In a brief presentation at the Tennessee State Capitol on Monday, Haslam unveiled a 10-point plan to fight the spread of opioid abuse. Last year, nearly 1,200 Tennesseans died from opioid overdoses, up from about 700 in 2012.

The proposal spans several government agencies and the courts, and the Haslam administration says it'll cost about $30 million to implement. But it mostly builds on previous ideas — expanding treatment, rolling out more law enforcement, discouraging over-prescription. 

"It's not like we haven't been doing anything. I think if you talk to the Department of Mental Health or the Health Department, they'd say, 'We've made big steps,'" Haslam said. "The steps we've taken in the past have made a dent in it."

What's different now is the scope of the proposals, the governor says.

One key idea is putting a tight limit on how much opioid medication patients receive for routine surgeries and other ailments. In most cases, doctors would be allowed to prescribe only a five-day supply of drugs; each day patients could get no more than the equivalent of 40 milligrams of morphine.

Officials say the proposal is rooted in research that shows so-called "opioid naive patients" are more likely to become addicted the longer their initial prescription for pain medication.

But the tight limit was enough to give some physicians pause. Dr. Jill Gilbert, the president of the Tennessee Oncology Practice Society, says almost any cancer patient she can imagine should not be restricted.  

"No one is going to be relieved in five days of their cancer," she said, "so if they have pain, the pain is going to last longer than that."

The governor's plan does say "appropriate exceptions" will be made for cancer treatment or hospice care for chronic pain. Gilbert says she'd like to see the details to make sure everyone is on the same page.

More money for treatment

The Haslam administration also proposes putting $25 million dollars into treatment programs. That includes a 500-bed intensive program at the West Tennessee State Penitentiary for inmates who are hooked on opioids. Officials say that will reduce recidivism.

The Department of Mental Health and Substance Abuse Services also plans more contracts with private treatment facilities.

Republican leaders in the state legislature and the courts indicated they support the proposal. The speakers of both the state Senate and the state House of Representatives favor Haslam's plan, as does the Chief Justice of the state Supreme Court.

Democrats, however, say it's not ambitious enough. They argue that it would take hundreds of millions of dollars to stamp out opioid abuse — money that could only come from the federal government through programs such as Medicaid.

"I think there are some things in this proposal that everyone supports, but this is a modest step that doesn't do anything close to what we need if we want stop in the tracks this epidemic," said state Sen. Jeff Yarbro, D-Nashville. "I think we need to see a lot more seriousness and a lot more boldness if we're going to turn this country around."