By Jill Penley
It has been determined each day in Tennessee, at least three people die from an opioid-related overdose, which is more than the number of daily traffic fatalities. In 2018, Tennessee passed one of the strictest opioid prescribing laws in the country. But some lawmakers say there have been “unintended consequences,” leading to several updates including a new prescribing provision that went into effect statewide on July 1.
“I think the law is clearly working. It’s just working too well as far as limiting the people getting opiates they need,” state Sen. Shane Reeves said while shepherding HB 843/SB 1810 through the legislature.
Former Gov Bill Haslam announced his “TN Together” plan in Jan 2018 for addressing the state’s opioid abuse epidemic with a three-pronged strategy emphasizing prevention, treatment and law enforcement. Medical professionals spent the ensuing days expressing concerns over specific aspects of the law and the practical implications for doctors and patients.
For example, for patients undergoing major surgery, Tennessee capped opioid prescriptions to 20 days. And even then, patients might not be able to fill them all at once, resulting in repeated trips to the pharmacy. And what about sick elderly patients nearing the end of their lives? Does the current law keep them from accessing legitimate, effective pain management?
State lawmakers made the decision to tweak some parts of the 2018 opioid legislation after many physicians and pharmacists addressed the legislature. The Tennessee Medical Association, which represents doctors, also pushed for some changes to the opioid guidelines, which took effect July 1.
The new law bumps the maximum to 30 days for some surgeries and it also better defines exemptions for patients with cancer or those receiving palliative care; however, most opioid prescriptions will continue to be capped at three days — meaning Tennessee still has one of the strictest prescribing laws in the country.
“Many efforts have been made to curtail the massive quantities of prescribed opioids and there has been success in several areas,” said David Reagan, MD, PhD and former Chief Medical Officer for the Tennessee Department of Health, which include decreases in the amount of opioids prescribed, the number of pain clinics, and the number of doctor shoppers. Unfortunately, however, the number of overdose deaths has continued to increase.
Legislation is one avenue in curbing opioid overprescribing and misuse; however, many other governmental, community and faith based groups can also help. Johnson County’s A.C.T.I.O.N Coalition continually works with other agencies and coalitions to better understand and relate new laws.
“Although Legislation does effectively work to combat the opioid crisis there are other ways for our community to work together to curtail the dangers of opioid misuse and overdose,” said Trish Burchette, Executive Director, A.C.T.I.O.N Coalition. “If the entire community works on the issue cohesively I feel we will see a reduction in opioid misuse and overdose death in Tennessee. The issue is bigger than our lawmakers alone can reverse.”
According to Denise Woods, Prevention Specialist, the A.C.T.I.O.N Coalition has several resources available to the community including medication lock boxes which help keep medications secure and safeguard against access and accidents. They also have counting sheets and timer caps help to keep track of medications, environmentally friendly medication deactivation bags, and info on recovery resources. “Anyone looking for ways to play an active part in reversing the opioid crisis can call or stop by our office at 138 East Main St. Mountain City across from Tri-State Co-op,” said Woods.