State of Recovery
By MELANIE KILGORE-HILL
Tennessee Addresses Prevention, Treatment amid Growing Concerns
More than 400,000 Tennesseans suffer from substance abuse disorders. That's a number the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) is taking seriously, particularly amid a nationwide increase in addiction and overdose deaths.
"We've created resources and a continuum of evidence-based best practices for those with little or no other access to care," said TDMHSAS Commissioner Marie Williams. "Our mission is to create collaborative pathways to resiliency, recovery and independence to help Tennesseans thrive."
Of the 438,000 Tennesseans with a substance use disorder, more than 52,000 are uninsured or underinsured. In 2018, the Department was responsible for treatment of 8,832 people with opioid addiction, 6,829 struggling with alcohol and 6,747 addicted to marijuana. They also operate four regional mental health institutes and provide behavioral health services to approximately 300,000 Tennesseans annually - services in increasing demand in 2020, as 40 to 50 percent of Tennesseans have admitted to feelings of pandemic-related depression or anxiety, often turning to drugs or alcohol to cope.
Addressing those struggles often begins in the ER with Tennessee Recovery Navigators - individuals in long-term recovery who help connect those who have overdosed with treatment and recovery services. As of June 30, 2020, certified navigators have worked with 3,776 patients throughout the state. "Someone is at their lowest point after overdosing, and we have people who say: 'We're here and a witness to what recovery and treatment can do,'" Williams noted.
Regional Overdose Prevention Specialists are employed throughout the state, and officials estimate more than 150,000 lives have been saved since October 2017 through statewide distribution of naloxone kits, intended to reverse effects of overdose. They're also partnering with 635 certified recovery congregations - a faith-based initiative to create respites for those coming out of treatment.
In rural communities, intervention often is initiated by the Lifeline Peer Project, which helps launch support groups and connect individuals with resources. Meanwhile, state officials have partnered with Vanderbilt University Medical Center to create an ECHO Hub to offer opioid use disorder training to providers.
Anthony Jackson Jr., TDMHSAS director of Prevention and Early Intervention Services, said recent data shows a 20 percent increase in overdoses during COVID. But, he added, the trend has been leveling off in recent weeks.
In 2019, the Department launched the Tennessee Recovery App to help connect patients and providers, track recovery and milestones, and provide positive messaging. "We also use it to share information about perception and risk and educate on substance use topics," Jackson said. "It's another mechanism to help our providers and patients stay connected." The app is currently utilized by 1,500 people and growing each month thanks to ongoing surveys and user input.
TDMHSAS, in partnership with the Tennessee Department of Environment and Conservation, also has placed more than 330 prescription drug take-back boxes across the state reaching all 95 Tennessee counties. During the October 2019 prescription drug take-back day, Tennesseans securely disposed of 26,263 pounds of medications.
Jackson also oversees the Tennessee REDLINE (800-889-9789) a 24/7/365 resource for substance abuse treatment referrals. "Our goal is to engage people before they start using, and we can't lose those opportunities," he said. "So much of what we do is in the community ... and when COVID hit, we could no longer convene as a group, so we're looking for ways to outreach and provide information and insight to make them feel better and keep them engaged."
Those efforts include social media and TikTok challenges, along with virtual training for clinicians and volunteers. "Many people in my group have lived the experience," Jackson said. "They want to help those with substance use disorders and are ready to do this."
Operating under a $432,003,600 total budget for FY2020-2021, TDMHSAS has received $192 million in federal grant applications since FY2011. "Our team goes above and beyond; they don't just sit back and take what the state gives us," Williams said. "We go out of our way to go after state and federal funds to augment needs in our communities."
The Department also receives funding from the federal substance Abuse Prevention and Treatment Block Grant. "We have a continuum of clinical treatment - from outpatient to detox - thanks to 35 providers working multiple sites across the state," said Linda McCorkle, director of Treatment and Recovery Services, who oversee the block grant program.
That work includes medication assisted treatment programs and funding for specific treatment for adolescents and women, including three residential programs for expectant mothers created to address common barriers like childcare, transportation and housing. The Department also is developing a women's residential recovery court in Nashville, designed to offer services to 70 to 80 women.
TDMHSAS Assistant Commissioner for Substance Abuse Services Taryn Sloss said social distancing mandates and PPE have redefined the way care is provided, but she added that clinicians are stepping up. "We have provider calls daily, and they talk to each other about challenges and compare experiences as a group," she said. "They've became a big family during this time, and we can see that telehealth has been very positive, especially for patients in rural areas or with transportation issues."
From drive-through court sessions to treatment graduation, partners are finding innovative ways to work with patients and stay connected. "COVID has changed the way we do business, but we are just so proud of our agencies," Sloss said. "They've stepped up and decided they're going to remain open and do whatever it takes to be sure individuals with disorders receive the services they need."