Hooked: Tennessee's Opioid Crisis

NASHVILLE, Tenn. (WTVF) - NewsChannel 5 explores the ongoing opioid crisis in Tennessee and tell the stories of some of those impacted by the issue.

State continues focus on prescriptions to combat opioid crisis

 

For many, the reality of the opioid crisis has ripped families apart. 

In total, 1,776 people died of a drug overdose in Tennessee in 2017. Deaths related to opioids counted for nearly 1,300. 

It is a number that continues to rise despite efforts to cut down on the number of opioid prescriptions. Pinpointing the exact cause of the problem can spark debate, but many would not deny that overprescribing painkillers was one of the root issues.

Althea Myles is recovering from nearly a decade-long addiction to opiates at the recovery center Turning Point in Southaven, Mississippi. 

She said it all began when she was prescribed Percocet following a surgery. 

"I can recall going back to my doctor and telling him I have a problem and he proceeded to give me extra drugs," Myles said. "I have to accept I played a part at one point. I did know better but if somebody keeps giving you something and you go to him for advice, you tell your mind it's ok."

Andrea Kirchner is also recovering through a program at Turning Point. She started abusing Percocet four years ago before she turned to heroin because it was cheaper and stronger.

"I was a functioning addict very well. I ran a business and was a successful business but  as my addiction got worse, my business went under within two years," Kirchner explained.

Opioid abuse does not discriminate on race, sex and income. It is evident when you sit in at one of the counseling sessions helping patients learn how to communicate properly again.

Kirchner said she is finally recovering on her own terms, and hopes to get her family back.

"Will I get my family back? I have to show them I'm serious this time and I am because I'm sick and tired of being sick and tired. There's nobody to rush home to. There's nobody. I'm trying to do this for me, finally I'm doing it for me," she said.

To help battle the opioid crisis, Governor Bill Haslam unveiled the $30 million plan TN Together. It focuses on law enforcement, prevention and treatment. Limiting the number of prescriptions is one key component in the plan. 

Under the new law, healthcare practitioners may give an opioid prescription of up to three days with a 180 MME total dosage to patients in need of a small dosage. 

Depending on the condition, they can also prescribe opiates of up to 10 or 20 days but would require extra steps including conducting a thorough evaluation of the patient, document consideration of alternative treatment plans for pain and why an opioid was used and obtained informed consent.

Dr. Chapman Sledge, chief medical officer at Cumberland Heights, said the problem became worse in the early 2000's when standards changed. The medical community then considered pain as a fifth vital sign.

"You would have never dreamed of using opiates to treat chronic non-malignant pain in the early or mid 80's.The medical profession was sold a bill of goods that there's this epidemic of under treated pain and prescriptions skyrocketed after 2001. Things absolutely snowballed," Dr. Sledge said.

Advocates pushed for the use of opioids like OxyContin, while pharmaceutical companies claimed the drugs were less harmful and less addictive.

By 2015, the Centers for Disease Control (CDC) reported there were enough opioids to treat every American around the clock for three weeks. It said more than 11.5 million people reported misuse of prescription pain medicine in 2016.

Earlier this year, Tennessee officials filed a lawsuit again Purdue Pharma, the manufacturer of OxyContin, for fueling the opioid crisis. It claimed the company valued profit over people despite knowledge of the drug's addictive risks over time. 

The state's largest insurance provider Blue Cross Blue Shield of Tennessee has since announced it will no longer cover OxyContin by January 1st. The insurance company will encourage doctors to use two more expensive alternatives, Xtampza and Morphabond, which are more difficult to abuse. Customers will pay the same copay and BlueCross will absorb the additional cost.

There are reports the number of prescriptions nationwide has gone down last year. Health data firm IQVIA's Institute for Human Data Science said actual dispensed opioid prescription decreased 10 percent, while patients receiving high doses declined by 16 percent. 

However, Tennessee still has a high rate of prescribing. 

Hospitals like St. Thomas Midtown have focused on limiting opiates by offering different drug combinations. Dr. Allison Bollinger said it is proving to be helpful.

"There's been recent data that shows that if you take ibuprofen and combine it with Tylenol it's as effective as Lortab for pain," Bollinger said. "It's really important to engage our patients and to have conversations with them in the reasons why we're selecting a non-opioid alternative."

In addition, the hospital is already able to access a database that would allow doctors to search how many painkillers a patient has been prescribed and by how many different providers in the country. It also keeps doctors accountable too.

To receive help like Myles and Kirchner, you can call the Turning Point hotline number at 1-888-614-2251 or visit turningpointtreatment.org.

Fentanyl deaths make opioid crisis rampant

 

While data so far reveals a decline in opioid prescriptions amid a crackdown, the number of deaths continues to spike not just statewide. 

Deaths related to fentanyl passed heroin deaths for the first time in 2017, according to the Tennessee Department of Health. It was associated with 500 deaths, a 70 percent increase since 2016.

Fentanyl is a drug similar to heroin but is more potent, and can be 100 times stronger than morphine. 

T.J. Jordan of the Tennessee Bureau of Investigation said despite countless warnings and advisories, drug users are seeking fentanyl or something even stronger.

With the Chinese government tightening its belt on fentanyl distributed to the U.S., Jordan said it became prime opportunity for drug cartels to infiltrate communities. 

However, pill press machines are being used in home labs to "cut" fentanyl into a counterfeit pill or other substances like heroin. Drug users could unknowingly buy illicit drugs and not realize how potentially deadly it is.

"What happens is you get one pill right out of the gate that has no fetnanyl in it, next may have a sprinkle, next may have some spattering and next mostly high content of fentanyl," Jordan explained.

Jordan said he heard a story at a recent conference regarding heroin laced with arsenic.

"It's a poison that will absolutely kill you and people know it will kill you, but yet the drug user is looking
for that high so bad they're willing to go to the drastic measure of having heroin with arsenic in it to put in their bodies," Jordan said.

However, the problem seems to have no end in sight now that people are using drugs in group settings with a designated person.

Narcan, the brand name for Naloxone, is available to help revive a person who is overdosing. Depending on the strength of the drug or counterfeit substance laced with a typically unknown amount of fentanyl, it may take multiple doses of Narcan to prevent deaths.

"We're starting to see where drug addicts are using together with their colleagues in an attempt that if they crash, there is somebody there to revive them," Jordan added.

Narcan can be administered through a nasal spray or intravenously.  Law enforcement and emergency departments like the Rutherford County EMS has been equipped with Narcan for years.

The county used Narcan 123 times in 2013 but it spike last year to 415. 

As the need for Narcan grows, so does the price. The Nashville Fire Department saw the cost nearly triple in the last seven years. 

To help respond to scenes even faster, Rutherford County EMS has been using what's called power units. They are crews already roaming around waiting to respond to any emergency.

“They go out into the neighborhoods and they’re high visibility on the streets, so when a call for service comes in, they're the first ones that get the call,” paramedic Brandon Smith said. 

Officials said it's making a difference. An average response time in Rutherford County is about eight minutes.

The deputy director of EMS said with the power units, it’s able to go down to 7.5 or 7.2 minutes. It's a slight change, but when it comes to emergencies, every second matters.

But with recent opioid laws, there are also concerns the use of fentanyl abuse or heroin will increase especially from the pain community, potentially increasing the amount of deaths.

Chronic pain patients like Chantal Burke who rely and function on opioids say recent regulations may force others to seek drugs on the streets that are easier and cheaper to get.    

The Tennessee Pain Society says doctors have opted out of treating patients or prescribing opioids in general because of stricter rules. There is also fear of legal consequences.

As a result, existing pain clinics have been swarmed

"Some of the practices I understand are actually no longer accepting any more patients because they're just saturated," Dr. John Schneider of the Tennessee Pain Society said. 

In 2015, there were more than 350 pain management providers in the state. The number has now dwindled to less than half. 

Over the summer, Comprehensive Pain Specialist abruptly closed its clinics in the state amid Medicare fraud allegations. It left thousands of chronic pain patients fearful and scrambling to find another provider who'd accept their insurance.

Many fear it would push patients to commit suicide if drugs they have relied on to treat their excruciating pain aren't easily accessible. 

Tennessee children left behind by opioid crisis

 

Sitting on her grandmother’s couch inside a tiny apartment on Nashville’s West Side, Sandrell Newsome is twirling the ends of her braided black hair between two fingers, she is 11-years-old and has been left behind by Tennessee’s growing opioid crisis.

Sandrell was seven-years-old when both her mother and father were arrested for selling opioids. With both of her parents in jail, Sandrell along with her five brothers and sisters were forced to move in with their grandmother Sherl Cox. Sandrell’s youngest sister is four-years-old, her oldest brother is 17, all of them are crammed into this two-bedroom brick apartment that is in desperate need of being renovated. It smells of cigarette smoke and dog food.

With her feet tucked beneath her, Sandrell glances off in the distance as she talked about her mom and dad, “It’s hard because they’re our parents and most people expect kids to live with their parents.”

This sixth grader is one of the lucky ones in this nationwide epidemic that is leaving behind broken families and broken hearts. Sandrell’s mother Sharon wasn’t using drugs when she was pregnant with any of her kids so none of them were born addicted. Theirs though is the reality hundreds of thousands of families across the country are facing right now. By some estimates more than 1 million children are living with their grandparents because their parents are addicted to opioids.

Sandrell is shy but her grandmother gently coaxes her to talk more about what’s happened to their family, “I’ve learned that drugs are not the answer to anyone’s problem.”

A bit of a nervous smile appeared on Sandrell’s face as she continued talking about the life her and brothers and sister have been forced into, “It creates a mess for everyone.”

The “mess” the opioid epidemic has created is multifaceted and complicated. Not just emotionally but financially as well. At least twice a month Sherl Cox, known in this quickly gentrifying neighborhood as “Mama Sherl,” is forced to go to a nearby food bank because she regularly runs out of food to feed all six kids she has taken custody of.

“I’m barely making it living here. I pay $800 a month and I work at Burger King, so I’m barely living,” Sherl says, her voice cracking a bit.

On the day we met Sherl and Sandrell their kitchen was filled with only a few loaves of white bread, some peanut butter and instant noodles. Sherl makes every dollar she spends on these six kids last as long as possible.

“We just have to make it day by day. We do our best. We survive,” Sherl said.

This struggling family thought the opioid crisis had already taken enough from them. But in August it delivered another devastating blow after the children’s father, Mandrell Newsome died of a heroin overdose.

He was 36-years-old.

“It’s killing them every day, every day. Every day someone is dying of an overdose,” Sherl says raising her voice with passion.

Sandrell though is not quite as animated when she talks about her dad, the young girl’s tone got quieter as she described how her father died, “He had taken some drugs and there was poison in them. He was in the hospital for a couple of weeks and they just had to let him go.”

Like so many others addicted to opioids, Sandrell’s father turned to heroin because he couldn’t afford the prescription pain pills he was craving. Doctors believe the final dose of heroin that killed Mandrell Newsome was likely laced with the drug fentanyl. According to the National Institute on Drug Abuse more than 115 people die each day from overdosing on heroin. Every three weeks as many people die of an overdose and they did on September 11th.

It’s a reality Sandrell struggles to comprehend.

“It’s very sad and lonely,” she said.

“It hurts, just to know what they have to deal with living without a father in their life so it’s hard,” her grandmother adds.

None of Mandrell Newsome’s children have been to visit her father’s grave. It sits on the edge of a tiny family cemetery in Kingston Springs, Tennessee about 20 minutes west of Nashville.

His family still hasn’t been able to afford to buy him a headstone. Only some wilting flowers and a white name placard indicate where Mandrell is buried. Another victim of a crisis that seemingly has no end and another family left behind to deal with the aftermath.

Sherl is able to help her grandchildren through the Family & Children's Services. The Davidson County Relative Caregiver Program provides emotional and practical supports for children and the non-parental relatives who care for them. 

Recovery navigators help addicts find treatment

 

Fighting opioid abuse is getting a boost of support from people who have overcome the same dark addiction in the past.

As of this month, a program under the TN Together plan will get to pair people who were revived from a drug overdose with so-called recovery navigators in Nashville.

Recovery navigators are people who have been in recovery for at least two years and completed the Certified Peer Recovery Specialist Program.

Their goal is to connect with patients at the hospital and get them much needed help and support.

"Once they're able to give consent, the doctor will ask them if they would like to speak to someone and want help. Then they will call one of us, and we respond. We give them resources, share a little bit of our story of how we've been there and what we've been through, and just that there is hope and this is not the end," Coon explained.

Coon recovered from her opioid addiction four years ago at Buffalo Valley. She admitted herself to the treatment center after she overdosed on heroin laced with fentanyl.

"I remember praying for God to please let me wake up, and I wouldn't do this again," she said. "I knew at that point I did not want to live like that anymore."

Since then she went from being a client to an employee. She jumped on the opportunity to become a recovery navigator because she knows the importance of making a connection.

"Doctors, counselors, and psychiatrists tried to get me sober for a long time until I got my counselor, and she had been through the same thing I've been through. That makes a difference, so I know it makes a difference," Coon said.

Currently, there are 11 recovery navigators across the state. Four of them are in the Mid-State.

Under TN Together, $25 million focuses on providing treatment to drug users. Part of it includes the expansion of peer recovery specialists in targeted, high-need emergency departments.

The program first started in upper East Tennessee and made its way to Memphis and then Nashville. Chattanooga and Knoxville are next on the list.

St. Thomas and TriStar Skyline Medical Center are two hospitals who are a part of the program. The state hopes to include more hospitals in the future.

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