OPIOID CRISIS: EXPERTS CITE STIGMA, OPPOSITION AS LETHAL BARRIERS TO TREATMENT IN TENNESSEE – WHERE MEDICAL CURE PRESCRIPTIONS DOUBLED TO NEAR HIGHEST IN U.S.
Tennessee opioid deaths remain among the highest while prescriptions of expert gold standard medical cures doubled, becoming among highest dispensed among all states.
by Clark Miller
Published January 31, 2025
Let’s just get to the facts.
From Nashville’s local NPR affiliate,
People in Tennessee die of overdoses at a higher rate than almost anywhere in the country. But one of the evidence backed-tools that could stem that tide gets a lot of blowback.
More than 3,000 Tennesseans died of opioid overdoses in 2022, according to state data. Only West Virginia and Washington, D.C. had higher death rates that year. In the same period, more than 10,000 Tennesseans sought care for a non-lethal overdose — on average, 27 people a day.
But there’s stigma attached to MAT, and that is having a concrete effect on patients in Tennessee. It’s driving opposition to new clinics, such as a methadone clinic Cedar Recovery proposed outside of Cookeville. The 12-county Upper Cumberland area doesn’t have one, so patients have to drive an average of 100 miles each way for the outpatient appointments.
So, that’s it. By expert assurance Tennessee’s status as a lethal outlier for opioid related deaths is tied to barriers that keep compulsive, high-risk opioid users from access to the established gold standard proven cures buprenorphine and methadone. Who could doubt that? There must be some explanation just like that! Because by unified, locked-down medical/media consensus over decades of the crisis, if there’s anything we can be sure of, it’s that those medications are “proven“, are effective. We’ll come back to that.
In 2023, Nashville was second only to Baltimore in U.S. per capita rate of opioid overdose deaths, that distinction moderated this year (2024) with a decrease attributed (and here) to as in other locales an intensive, community based naloxone campaign, like that described here.
The seemingly anomalously high rates of fatal opioid overdose deaths continued into 2023 per reports and available evidence.
Described recently, September 2024, behind a paywall by The Tennessean, with headline:
From state and other reports, OD deaths attributed to “all opioids” were 3,073 in 2022 and in 2023 were 2,989, an apparent drop of 84 deaths, or decrease of 2.7 percent, a small drop compared to figures for decreased opioid deaths comparing the same years for the U.S. (17 percent) and other states, with some drops as high as 8 and 10 percent for Minnesota and Florida, respectively.
Supporting that evidence, from this report, among states, Tennessee remained at the highest end for per capita opioid OD death rates in 2023.
With that grim picture, it’s a really good thing that experts and media are identifying the barriers to reducing deaths in Tennessee: stigma and opposition to expanded use of the gold standard proven medical opioid cures, the substitute opioids methadone and buprenorphine (Suboxone).
But there is a problem with that rationalization. It’s that, as in the lethal consensus and mystification protecting those experts and America’s medical/media collusion from exposure of truths about their worsening crisis, that rationalization is a demonstrable lie
From use of the interactive map, it’s apparent that Tennessee was at that status from as early as 2019. That is, in addition to fatal opioid overdoses, Tennessee has been at the highest end of states for dispensing of buprenorphine – “bupe” established as functioning as the street currency for fentanyl and as enabling illicit opioid use in other ways, established for years as fueling the lethal crisis rather than providing benefit.
And this from the American Medical Association (AMA) –
Expanding that image reveals that in Tennessee dispensing of buprenorphine –
– Was in 2012 third greatest of all states at 494,953 prescriptions
– Nearly doubled by 2018 to 927,895 prescriptions
– Remained third greatest of all states in 2023 with 828,676 prescriptions
Now we actually do understand. As could have been predicted, the severity of opioid high-risk use, of overdoses, and of fatal overdoses worsened with increased dispensing – including under COVID and post-COVID relaxation of safety standards – of the doctor-prescribed opioids whose abuse and enabling role in street economies of high-risk illicit drug use have fueled the worsening crisis.
Those effects are moderated, as consistently in all other locations examined, by recent, intensive campaigns of distribution training, and use of naloxone (Narcan) as harm reduction to reverse ODs and reduce fatal overdoses. For Tennessee, that’s described here, here, and here, efforts surging dramatically in 2022 with extra settlement funding of $6 million devoted to Narcan campaigns.
As described here –
Regional Overdose Prevention Specialists (ROPS) are located throughout the state of Tennessee as a point of contact for training and education on opioid overdose and for overdose prevention through the distribution of naloxone. From October 2017 through June 2024, the ROPS distributed more than 854,000 units of naloxone, and TDMHSAS has documented at least 103,000 lives saved because of naloxone distributed during that time. Because of stigma and other factors, the department believes the actual number of lives saved is much higher.
[emphasis added]
Many more than the undercounted 103,000 otherwise fatal opioid overdoses reversed, prevented, over the past few years with increasing dispersing of naloxone. That’s a lot.
That, in fact, is more than enough to account for the very recent decreases in fatal opioid ODs in Tennessee. Actually many, many times more than enough. Leaving no reduced opioid deaths to attribute to American Medicine’s proven gold standard cures.
Those other locales where consistently the evidence paints the same lethal picture?
Chicago – upcoming post
Nevada – upcoming post
New Hampshire – upcoming post
Louisiana – upcoming post
and Maryland
Once we turned to face the evidence, we could make perfect sense of the lethal decades-long public health debacle in Tennessee and elsewhere. That wasn’t so difficult, was it.
Forbidden, and almost easy. Only requiring a bit of curiosity, and a lack of cowardice.
