By Tom Wilemon / The Tennessean
COOKEVILLE, TENN. - Tennessee's health
commissioner whittled the data on prescription drug abuse down to the
daily reality occurring in funeral homes and children's hospitals when
he spoke Thursday at a conference on the state's pill problem.
in Tennessee, about three people will die of drug overdoses. About two
babies will be born that are drug-dependent," Dr. John Dreyzehner said.
90 representatives from communities throughout the state spent the day
trying to figure out what to do about the problem. Most were from East
Tennessee, once the land of "hillbilly heroin" until consumption spread.
With maps of the state's counties, Dreyzehner showed the proliferation
of high opioid prescription rates over a five-year span. A few embers
lit up red, grew into hot zones and then turned the state scarlet.
2011, Tennessee had the second-highest per-capita use of controlled
substances of any state in the nation. Dreyzehner attributed the
increase to social acceptance of opioid use, saying that while
prescription addiction is not communicable, it is in a sense
"contagious," as people pick up the habit from others.
has enacted laws to better track and regulate distribution of the drugs.
This week, the Department of Health sent letters to the 50 doctors who
have prescribed the most narcotics, directing them to explain why they
wound up at the top of the list.
But state officials cannot do the
job alone. Conference attendees heard tips on community initiatives
from people in counties where the epidemic began.
"The problem is in the community; the solution is in the community," Dreyzehner said.
This year, 432 newborns in Tennessee - including 20 in Davidson
County - have been diagnosed with neonatal abstinence syndrome,
suffering withdrawal from their mothers' drugs.
Children's Services Commissioner Jim Henry has called prescription drug
abuse one of the agency's biggest challenges, accounting for an
increasing number of reports of abuse and neglect of newborns and older
Last year, 41.2 percent of DCS investigations involved
drug abuse, up nearly 60 percent from 2008. Over the past five years,
there also has been a notable increase in children taken into state
custody because of parental substance abuse, reaching a high of 31.9
percent in 2011.
Henry has instituted a new partnership with the
Tennessee Bureau of Investigation to train DCS investigators on how to
identify drug abuse in families they investigate.
of the Coffee County Prevention Coalition said her community recognized
it had a problem when prescription drugs accounted for 66 percent of
school suspensions related to substance use. Parents initially thought
their children were ordering drugs from the Internet but then faced up
to the fact that the medicine was pilfered from their cabinets - and
sometimes their barns. Her community began giving away free lock boxes
for pain pills, anxiety drugs and animal tranquilizers.
Pershing of the Metropolitan Drug Commission in Knox County said her
organization did that and pitched in free drug testing equipment for
However much teenagers may be tempted to sample their parents' mood
enhancers, prescription addiction is primarily an adult problem.
popping is especially dangerous for the middle aged. Of the 1,062
Tennesseans who died of drug overdoses in 2011, the largest group was
among people aged 45 to 54, followed by those aged 35 to 44.
also is a complication of prescription addiction, said Granger Brown, a
substance abuse counselor with the Tennessee Suicide Prevention
Network. People dependent on painkillers like hydrocodone are nine times
more at risk for suicide, he said, while people addicted to anxiety
drugs such as Valium or Xanax are 45 times more at risk.
state laws to stem the epidemic include the Pain Clinic Act of 2011,
which established tighter regulations for the facilities, and the
Addison Sharp Prescription Regulatory Act of 2013, which limited the
number of pills that can be prescribed at one time, expanded
requirements for patient-specific drug monitoring and enacted tougher
restrictions on pain clinics.
Dr. David Reagan, chief medical officer for the state Health
Department, said new data indicate that doctors are becoming more
careful about prescribing narcotics.
A survey conducted with 72
primary-care physicians in Putnam County revealed that doctors there
really didn't understand the disease of addiction, said Bill Gibson with
the Power of Putnam.
Seventy-six percent said they had received
no training in addiction, and 34 percent checked off that they would
prescribe opioids indefinitely for someone with chronic pain. However,
on the bright side, 95 percent said they would refer patients to a
chronic pain support group if one existed, Gibson said.
are increasingly becoming addiction experts, but experts still don't
fully understand why some drug-exposed babies end up with neonatal
abstinence syndrome while others don't. The percentage afflicted is a
matter of debate, said Dr. Michael Warren, who heads family health and
wellness for the state. Estimates range from 55 percent to 94 percent.
Often it may take four to five days after birth for symptoms to appear,
he said, and by then the baby has gone home from the hospital.
new state law, the Safe Harbor Act of 2013, protects women bearing
drug-dependent newborns from criminal prosecution in some circumstances.
The law is intended to encourage women to seek help.
the Health Department made neonatal abstinence syndrome a reportable
illness - a requirement that is typically limited to communicable
diseases. Previously, the state could not track the problem effectively
because the Health Department would receive a report nine to 18 months
after a diagnosis. Now, doctors and hospital officials must report cases
as soon as they are diagnosed.