TN Together is a multi-faceted initiative that addresses the issue of opioid addiction through legislation, proposed funding in the governor’s 2018-19 budget and executive actions.
The plan focuses on three major components – prevention, treatment and law enforcement – and includes a $30 million investment of state and federal funds to support TN Together.
TN Together is a collective effort and has been designed in partnership with the Tennessee General Assembly through the Ad Hoc Opioid Abuse Task Force established by House Speaker Beth Harwell and chaired by Speaker Pro Tem Curtis Johnson and a working group established by Haslam that includes Harwell and Lt. Gov. Randy McNally’s appointee, Speaker Pro Tem Ferrell Haile.
“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.”
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 exceptions and an emphasis on new patients. Initial prescriptions will be limited to a five-day supply of drugs with daily dosage limits of 40 morphine milligram equivalent.
• limiting coverage for TennCare enrollees to an initial five-day supply with daily dosage limits.
• increasing prevention education in kindergarten through 12th grade through revisions to the state’s health education academic standards.
• an executive order, issued Monday, that established a special commission to formulate current, evidenced-based pain and addiction medicine competencies for adoption by the state’s medical and health care practitioner schools.
• identifying women of childbearing age who are chronic opioid users and providing targeted outreach about risks and treatment to aid in the prevention of neonatal abstinence syndrome births.
• investing more than $25 million for treatment and recovery services for individuals with opioid use disorder. The 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 resources and increasing information about patient and community risks.
• 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, a drug that is up to 100 times more potent than morphine and is linked to an alarming number of overdose deaths.
• providing every Tennessee state trooper with naloxone for the emergency treatment of opioid overdose.
McNally, R-Oak Ridge, said he supports the governor’s plan to fight opioid abuse.
“I am proud to support the comprehensive TN Together plan to attack the opioid crisis in Tennessee. This scourge is breaking up families, ruining lives and killing our people,” said McNally. “The approach Gov. Haslam outlined [Monday] 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. I strongly believe this legislative package will yield results both in the near term and in the long term as we continue to battle this problem in Tennessee.”
The state’s Democrat legislative leaders said the plan is a step in the right direction, but the most effective thing Tennessee lawmakers can do to combat the crisis is to pass Medicaid expansion in the state.
“I applaud the governor for his efforts, however, we all know that he’s hamstrung by the Republican super majority in the state legislature and their continued efforts to serve as a roadblock to his Insure Tennessee plan,” said House Democratic Caucus chair Mike Stewart. “Tennesseans deserve access to the treatment programs that can only happen with expanded coverage.”
“Tennessee is drowning in opioids, and it’s having a generational impact that’s literally changing the trajectory of communities,” said Senate Democratic Caucus chair Jeff Yarbro. “This is no time for a standard-issue, incremental plan. We should treat the opioid epidemic like the public health crisis it is. We’re either going to send people to doctors or dealers. And it seems clear that we’re leaving Medicaid expansion dollars on the table and making some easier political choices at the expense of getting more Tennesseans into the treatment everyone knows is desperately needed.”
U.S. Sen. Lamar Alexander said Haslam and Tennessee’s state and local leaders are providing important leadership in helping combat the opioid crisis, which is tearing Tennessee communities and families apart and posing an enormous challenge to health care providers and law enforcement officials.
“Last year, 1,631 Tennesseans died of a drug overdose – 12 percent more than the year before – and the highest rate of drug overdose deaths in recorded history in Tennessee. Nearly three out of four of the drug overdoses in our state are related to the opioid crisis,” Alexander said. “Earlier this month, I dropped by a meeting at the Tennessee Governor’s Residence in Nashville looking at discouraging the over prescription of opioid painkillers. Gov. Haslam and Tennessee’s state and local leaders have put forward a detailed proposal of steps our state can take to help address this crisis. The antidote to the opioid crisis is strong local communities, and the federal government can be a helping hand to creating an environment in which communities themselves can address the crisis.”
Alexander – as chairman of the Senate Health Committee –held a series of hearings on the opioid crisis, which has taken more Tennesseans’ lives than car accidents in recent years. On Oct. 5, the committee held the first hearing of the series, which focused on the federal response to the opioid crisis. On Nov. 30, the committee heard from witnesses representing states, communities and providers on what they are doing and what, if any, new authorities they need from the federal government to fight the crisis. The committee held a hearing Jan. 9, where Alexander emphasized that the solution to the opioid crisis is a strong community.
“I expect that Congress will provide a significant amount of new funding for the opioid crisis this year – it’s our number one public health issue – that would be used to allow states to provide treatment and implement other strategies to curb opioid abuse,” Alexander said. “I will be holding more hearings in the spring to address this crisis, and I will continue working closely with the Trump administration and my colleagues in Congress to see what additional steps Congress should take to help states, doctors, and families address and solve this tragic problem.”