By Tamarra Kemsley
From Memphis to Bristol, Tennessee’s opioid crisis is increasingly fueled by fentanyl, a drug 50 to 100 times more potent than morphine.1 This is according to multiple reports2,3 put out by the state’s department of health that warned against the misuse of the drug typically used to ease the suffering of patients with advanced cancer pain.
“Fentanyl use is becoming increasingly popular and more accessible,” Department of Safety and Homeland Security Commissioner David W. Purkey said in a statement.4 All told, deaths related to the drug more than doubled from 69 in 2014 to 174 in 2015.5
These numbers have in turn prompted the release of a public health and safety advisory on fentanyl highlighting its dangers.6 In it, the authors note that not all fentanyl consumption is necessarily purposeful. As Tennessee Bureau of Investigation Director Mark Gwyn noted, “Our crime labs across the state routinely analyze pills that look like one thing, but actually contain another. In a growing number of those cases, the pills contain fentanyl, with brings with it the potential for dangerous or deadly consequences.”7 According to the US Drug Enforcement Agency, counterfeit pills not only mimic the shape and colorings, but also the markings of “authentic prescription medications.”8
In addition to pill form, the drug can be delivered as a powder, transdermal patch and nasal spray. When sold via prescription, it is known by the names Actig, Duragesic and Sublimaze.9
Besides a rise in fentanyl misuse, the reports published by Tennessee’s Department of Health show a startling increase in overall death rates related to opioids generally. In 2015, a total of 1,451 people died from overdoses in the state, making it the highest recorded number in the state’s history. Seventy-two percent involved opioids.
“This is a massive, alarming and ongoing rate of preventable death that stays too much in the shadows,” Department of Safety and Homeland Security Commissioner David W. Purkey said. “Our state is struggling with overdose deaths, and we realize the urgency of working even closer with our colleagues on education and treatment in an effort to stop this epidemic. I urge our citizens to be careful and mindful about the risks associated with these dangerous drugs. We’ve got to stop this alarming fatality trend.”10
It’s a rallying cry that has united public officials and ordinary citizens. Earlier this year, Speaker Beth Harwell appointed an opioid task force through the state legislature to research the issue as well as develop any legislation prompted by the group’s findings.
“People around the state are begging for a solution, and we owe it to them to work towards one,” Harwell said in statement.11
Meanwhile, citizens are fighting back with the grassroots movement “Count It! Lock It! Drop It!” Once confined to a single county, the movement designed to encourage those prescribed painkillers to handle them responsibly has spread across the state.12
Researchers, too, are throwing their expertise behind the effort. Led by Danny Winder, professor of molecular physiology and biophysics, Vanderbilt University’s Center for Addiction Research is working to understand what goes on in the brain when a person becomes addicted. Specifically, the group is interested in uncovering the reason people feel compelled to keep using even in the face of all the negative consequences they know result from it. Doing so, Winder told The Oaks at La Paloma, is likely to reveal new treatment options.
However, Winder isn’t just concerned with how addiction works; he wants to change the way it’s perceived.
“We also wish to raise awareness that addiction is a disorder with a biological basis, that it needs to be treated like any other disease from a societal perspective and a medical perspective.”
When asked what advice he would give the opioid task force, he called on them to seek insight from a range of physicians with “a good understanding of empirically-based effective treatment strategies.”
Finally, there is 180 Health Partners, a company developed to aid the youngest and most vulnerable of the epidemic’s victims—newborns. Tennesseans are twice as likely than the average American to know a baby born with Neonatal Abstinence Syndrome (NAS), a condition brought on by exposure to opioids prior to birth.13 180 Health Partners is fighting back by assisting pregnant mothers through the process of medically assisted tapering either to abstinence or a low dose of buprenorphine, “the best alternative medication to opioids while pregnant.”14 Other services include linking women to behavioral and mental health counseling, food, shelter, and transportation, among other things. Headquartered in Nashville, the group expanded to Knoxville in April and expect to be in Memphis this fall.
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