Dr. Robert Pack
Dr. Angela Hagaman
By Scott Robertson
Anyone looking for the feel good story of the season at the Washington County Commission meeting Monday night left disappointed.
After conducting some relatively routine business (National Surveyors Week was recognized and Commissioner Joe Wise was approved to replace Commissioner Mitch Meredith on the budget committee), commissioners heard from two members of the faculty of the ETSU College of Public Health, Dr. Robert Pack and Dr. Angela Hagaman regarding prescription drug abuse.
“The U.S. is No. 1 in the world for opioids consumed with twice as many opioids consumed than the next closest nation,” said Pack. “We in Tennessee are one-tenth of one percentage point behind Alabama, as the No. 2 state in the No. 1 country. And East Tennessee is the state’s No. 1 area for this problem. This is the epicenter of the problem right now. We are the No. 1 region in the No. 2 state in the No. 1 country.”
The problems range from those caused by dependency to those caused by full-blown addiction to those caused by overdose, Pack said, and all three problems are growing. In Tennessee the number of patients being treated for prescription drug addiction will surpass the number being treated for alcohol addiction in the coming year. That creates a rapidly increasing drain on the economy and the healthcare system, Pack said. “As you can imagine, when a patient comes in with poisoning from prescription drug overdose, a lot of those charges aren’t going to the insurance companies.”
Pack estimated one in 20 Tennesseans has a prescription drug dependency that warrants early intervention or treatment. “That’s on the order of over 200,000 folks who need some sort of care because of their prescription opioid problem. Hydrocodone products are No. 1. Xanax is No. 2. The third one is oxycodone products.”
Pack went on to address the growing problem of babies being born addicted to drugs because their mothers used those drugs while pregnant (neonatal abstinence syndrome or NAS).
James Carson, director of the Washington County Health Department told commissioners that the county is beginning a pilot project with the Johnson City detention center to offer long-acting reversible contraceptive devices to female inmates as their jail terms end. “We feel like instead of trying to get them to stop using drugs, which hasn’t been working, maybe we can address this problem of NAS by at least helping these women keep from getting pregnant.”
Said Pack, “We have the worst problem with this, pretty much, in the state. The rate of babies born with NAS in Sullivan County at 56 per thousand and in the rest of the eight counties of Northeast Tennessee at 36 per thousand are higher than anywhere else in the state for babies born dependent on narcotics.” Compare that to the statewide rate, which in 2010 for Tennessee was just over six per thousand and nationally was just over three per thousand.
Add to that the fact that the drug-related crime rate in Tennessee has doubled in the last seven years, while non-drug-related crime has declined.
“The good news is that we can use evidence-based methods to turn down this trend,” Pack said. Hagaman then explained several different workplace and school-based plans to do just that, ranging from bare bones (drug testing in the workplace) to robust (education-based, with strong elements of team reinforcement). The best programming is done at the fifth and sixth grade level, Pack said, attacking the problem pre-risk.
Commissioner Katie Baker, who is a colleague of Pack and Hagaman at ETSU, told commissioners the presentation was not a prelude to recommending a county-wide plan to address the prescription drug problem during Monday’s commission meeting, but that the Health, Education and Welfare committee is interested in addressing it.
After a bit of fairly routine budget committee work ($10,000 was given to the Johnson City Library for new laptops and $9,141 in new money was earmarked to finish the second floor renovations to the county courthouse), Mayor Dan Eldridge rose to present a sobering report on the county’s labor force, including the fact that the county lost more than 1,400 jobs in 2014. “It’s important we know what we’re dealing with,” Eldridge said, “because we will have specific opportunities to build on our strengths this year. But these numbers are real.”
