Opioid Wars: A Johnson City Press Special Report

Johnson City Press • Aug 4, 2016 at 9:24 AM

While epidemic prescription drug abuse has long been a concern in Northeast Tennessee, the issue took the spotlight this year when Mountain States Health Alliance and East Tennessee State University proposed to establish a substance abuse clinic in Gray. The proposal generated tremendous concern among Gray residents about safety issues associated with methadone treatment. With state and local authorization pending, the Johnson City Press has developed a five-day series of articles discussing the proposal, the challenges of opioid addiction, legal implications and treatment options. Follow links below.

Appalachian addiction: Man says buprenorphine treatment saved his life
Misty Smith clearly remembers the moment she walked into a buprenorphine clinic, fell to her knees and begged doctors to admit her husband, Darrell Smith, into treatment.

Methadone: Medicine or another addictive drug?
A fine line separates methadone’s treatment attributes and its deadly nature.

Why not the Med-Tech Corridor?
There is an argument being made that if an opioid addiction treatment center were to open in Washington County, it would work best if located in Johnson City’s Med-Tech Corridor.

Drug addicted newborns: Our most vulnerable victims of narcotics abuse
Amid the conversations about methadone clinics and a rising drug abuse epidemic, the region’s most vulnerable population has become tangled in the complex web of opioid addiction.

Opioid addiction is costly to our community
Opioid drug abuse has become a pervasive and costly epidemic in Tennessee. Authorities say this state ranks third in the nation for prescription drug abuse and 12th in the nation for deaths resulting from drug overdose.

Region's history not favorable to methadone clinics
A topic of discussion for more than a decade, proposed methadone clinics in Northeast Tennessee have frequently faced opposition from residents and officials. Now, Mountain States Health Alliance and East Tennessee State University are facing the same challenges to their own proposed facility.

Once addicted, local doctor is Tennessee director for substance abuse services
Dr. Stephen Loyd was certain July 8, 2004, would be the worst day of his life.

Clinic will be project of Mountain States, ETSU with staff from Frontier Health
A proposed opioid addiction treatment clinic will be managed and housed by Johnson City’s hospital system, but is designed to lock into East Tennessee State University’s new over-arching center to fight prescription drug abuse, a multi-pronged approach health officials say is rare.

Pill ring: Federal officials hard on opioid crimes
A former Jonesborough pizza parlor owner was sentenced to more than six years in federal prison last week for his part in a prescription drug ring he apparently used to feed his own addiction.

Recovery Court sees good results in its infancy
Nobody said it would be easy, but as the saying goes, nothing worth having is ever easy.

Law enforcement efforts to battle impact of opioids on community
Arrests, legislation, prescribing guidelines, prosecution, drug court are all components used to attack a drug  epidemic that has the nation, including Tennessee and specifically Upper East Tennessee, in its tight and deadly grip.

State laws contributed to decrease in total number of pain clinics in Tennessee

In 2014, there were about 333 pain clinics in Tennessee. Now there are about 237. Officials believe that decrease marks a step forward in the state’s fight against prescription opioid abuse.

Looking beyond medication: Could multi-modal pain treatment be a model for the future?

Patients who visit Pain Medicine Associates in Johnson City oftentimes lead lives saddled by persistent, invisible discomfort.

Area pharmacists recognize role in opiate addiction, help search for solutions

In the past few years, Tennessee has taken a strong top-down statewide approach to curbing chronic pain prescriptions.

TennCare's lack of coverage for methadone treatment slowing opioid addiction response, advocates say

Addiction treatment advocates complain TennCare’s lack of coverage of methadone clinic services for opioid addicted beneficiaries is slowing the state’s response to a public health epidemic and unequally impacting the well-being of low income residents.

CON hearing scheduled for Aug. 24 for Gray addiction treatment clinic

East Tennessee State University and Mountain States Health Alliance are pursuing a late February 2017 date for their proposed addiction treatment clinic at Gray Commons Circle to be completed.

Making a decision: Opioid or non-opioid treatment

As opioid overdose deaths rise, a growing stigma can obscure the medicinal benefits of the pain medication.

Impact of addiction far reaching, multigenerational

For the region’s human service agencies, the impact of the opioid addiction epidemic is multigenerational — and dramatically adding to the need for almost every emergency service the agencies provide.


What are opioids?

Opioids are natural or synthetic chemicals that reduce feelings of pain. Common prescription opioid pain relievers include: 

• Hydrocodone (Vicodin)

• Oxycodone (OxyContin)

• Oxymorphone (Opana)

• Methadone

• Fentanyl

Are opioids safe? 

Prescription opioids can help with some types of pain in the short term but have serious risks.They can be an important part of treatment in some circumstances and can effectively relieve suffering for patients with active cancer or others in hospice or palliative care, but studies are not available to indicate whether opioids control chronic pain well when used long-term. Before taking opioid medication for your chronic pain: 

• Discuss pain treatment options, including ones that do not involve prescription drugs.

• Tell your doctor about past or current drug and alcohol use.

• Discuss all of the risks and benefits of taking prescription opioids.

What are the risks from opioids?

Patients taking prescription opioids are at risk for unintentional overdose or death and can become addicted. From 1999 to 2014, more than 165,000 persons died from overdose related to prescription opioids in the United States.1 Up to 1 out of 4 people receiving long-term opioid therapy in a primary care setting struggles with addiction.2,3,4

In addition to the serious risks of addiction and overdose, the use of prescription opioid pain relievers can have a number of side effects, even when taken as directed:

• Tolerance—meaning you might need to take more of the medication for the same pain relief

• Physical dependence—meaning you have symptoms of withdrawal when the medication is stoppe 

• Increased sensitivity to pain

• Constipation 

• Nausea, vomiting, and dry mouth

• Sleepiness and dizziness

• Confusion 

• Depression

• Low levels of testosterone that can result in lower sex drive, energy, and strength

• Itching and sweating

Remember, your doctor is a partner in your pain treatment plan. It’s important to talk about any and all side effects and concerns to make sure you’re getting the safest and most effective care.


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