By Scott Robertson
One of the most disappointing moments for me last year came when I asked Tennessee’s Commissioner of Economic and Community Development, Bobby Rolfe, how the Volunteer state was faring in comparison to other neighboring states in addressing the opioid crisis, and whether that crisis was affecting our ability to recruit new jobs and investment. Rolfe, in a rare and complete abdication of accountability, said he would prefer to, “set that question aside for now.”
There are two alternatives to explain his non-answer. Either he was unable to respond or he was unwilling to respond. That’s a no-win choice.
It’s not like the question came out of left field. We’ve all known the opioid crisis was growing, yet it seems to have caught Tennessee pols flat-footed. When I asked gubernatorial candidate Bill Lee what surprised him most on the campaign trail, he said he had been taken aback by the number of law enforcement officers who told him opioids were the state’s largest problem.
Monday, Tennessee’s state government, of which Rolfe is a part and which Lee wants to run, finally announced its opioid crisis response. Governor Bill Haslam calls it TN Together. It includes:
• Legislation to address prevention by limiting the supply and the dosage of opioid prescriptions, with reasonable exception and an emphasis on new patients. Initial prescriptions will be limited to a five-day supply of drugs with daily dosage limits of 40 MME (morphine milligram equivalent).
• Limiting coverage for TennCare enrollees to an initial five-day supply with daily dosage limits.
• Increasing prevention education in grades K-12 through revisions to the state’s health education academic standards.
• An executive order, issued today, establishing 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 in order to aid in the prevention of Neonatal Abstinence Syndrome (NAS) births.
• Investing more than $25 million for treatment and recovery services for individuals with opioid use disorder. These 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.
In total, the 2018-2019 budget proposal will include a $30 million investment (using both state and federal funds) to support TN Together.
We can debate the merits of any individual point in the plan, and I assume the members of the Tennessee General Assembly will do so, rather than accepting it without revision. But as Lee told me back in June, “it’s time to address this.”