Tennessee s Opioid Addiction Crisis: Public & Private Efforts to Affect Change
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1 Tennessee s Opioid Addiction Crisis: Public & Private Efforts to Affect Change August 2018 TCPS Regional Meetings Mike Dietrich, VP Member Services, THA
2 Opioid Abuse in Tennessee 2016 opioid use disorder prevalence estimates for ages 12+ (includes use of heroin and misuse of opioid pain relievers) Sources: National Survey on Drug Use and Health , 2014, ; 2016 U.S. Census 12+ Tennessee population.
3 Source: Lyndsey Rolheiser, Jack Cordes and S.V. Subramanian, Opioid prescribing rates by congressional district, United States, 2016, American Journal of Public Health POLITICO Pro DataPoint
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7 The Substance Abuse Treatment Gap ¹ ¹ ² ¹ Han B, Hedden SL, Lipari R, Copello EA, Kroutil LA ² SAMHSA, Center for Behavioral Health Statistics & Quality
8 TDMHSAS Treatment and Recovery CURES Act: $13.8M Federal in 2018 and 2019 for State Targeted Response
9 TN Opioid STR Prevention OUD Activities: Establish 10 new FTE Regional Overdose Prevention Specialist (ROPs) 18 ROPs hired Train professionals and key stakeholders on opioid overdose disorders 784 training sessions; more than 13,000 individuals trained Naloxone Distribution 8,916 units purchased for Community Coalitions to distribute to lay people and individuals leaving treatment or deemed high risk of overdose 9,528 units purchased for Law enforcement utilizing Justice Assistance Grant funds
10 TN Opioid STR Prevention OUD Activities Continued: Media Campaign: Television impressions in FY 18 13,713,000 Implement Opioid Overdose Rapid Response System Partnership with the TN Dept of Health Prescription drug monitoring data from CSMD Hospital discharge and vital statistics data Hospital non-fatal overdose reports Data on deaths Law enforcement data Mental health information, including substance abuse tx Identify hotspots for action
11 TN Opioid STR Estimated number of individuals to receive treatment and recovery support services in year 1: 3,408 More than 4,200 individuals (unduplicated) received Treatment and Recovery support services Pregnant Women: 35 Addiction Recovery Program : 1,855 Tele-treatment : 120 Buprenorphine: 142 Naltrexone: 141 Continuum of Care: 2,899 Year 2 STR Award Period: May 1, 2018 April 30, 2019
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13 TN Together Tennessee s FY budget includes more than $15M in new money to help combat the opioid epidemic
14 TN Together Media Campaign Statewide Digital Websites Streaming Video Social (YouTube, Facebook, Instagram, etc.) Television in Nashville Market 40 Tennessee Counties, 2.5 Million People age 12+ Print in East and Middle regions 68 Newspapers through TN Press Association 14
15 TN Together Media Campaign Statewide Digital Almost 2 million people reached More than 10 million impressions Facebook Video: 6.5 M impressions Almost 1 M actions (likes, shares, clicks, etc.) Targeted Video: 1.9 M impressions YouTube Video Ads: 1.1 M impressions 15
16 TN Together Media Campaign Broadcast Television (Nashville Market) 21.7 Million impressions age 12+ Covering 93% of the market More than 10 exposures on average 16
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18 Local Newspapers (Middle & East TN) 68 Total Newspapers Quarter page ad per week for 5 weeks About 700,000 readership each week Estimated total 3.5 M impressions 18
19 TN Together Media Campaign Expanding broadcast TV buy Radio during football season All media campaign assets collected on one page: 19
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26 TDMHSAS Treatment and Recovery DMHSAS, THA and other stakeholders No Wrong Door or PPP statewide treatment collaborative Established in Governor s opioid plan Priorities for the group include: Urgent admissions from the ED TennCare authorization and reimbursement changes for medication-assisted treatment (MAT) and detox Workforce development Recovery housing and transportation enhancements for SUD ED protocols for administration of MAT and/or Narcan at discharge
27 TDMHSAS Treatment and Recovery Other major initiatives Tennessee REDLINE /7 centralized referral system to connect people in need with a treatment provider Permanent, recurring state funding began in July Historically for the uninsured but can now also help the insured Wait list is 500 people for each of the state s 21 residential detox programs Certified peer recovery specialists ( Lifeliners or TN Recovery Navigators )
28 TDMHSAS Treatment and Recovery Other major initiatives TN Recovery Navigators Meet patients in the ED who have recently overdosed Use lived experience to connect with individuals A resource for ED teams to navigate the treatment & recovery continuum Faith-Based Recovery 275 certified recovery congregations statewide
29 TN HealthLink Program TennCare program to coordinate health care services for members with the highest behavioral health needs Many patients have co-occurring needs (mental health AND substance abuse) Supported via the THA Admissions, Discharges and Transfers (ADT) project
30 TN Pre-Arrest Diversion Observation, respite, crisis stabilization, medicallymonitored detox, and short term residential beds and spaces for people with mental health and substance abuse needs Collaborative community projects designed to keep lowlevel offenders out of hospital EDs and the criminal justice system 7 Sites supported with $15M non-recurring state funds Davidson, Hamilton, Knox, Hamblen, Madison, Putnam, Shelby
31 THA Training and Education Workplace violence De-escalation techniques Statewide Crisis Intervention Training (CIT) taskforce CDC funding Naloxone for 1 st responders Acute opioid outbreak response plan Public outbreak in rural areas
32 TN Together Tennessee Department of Mental Health and Substance Abuse Services Fast Facts Website Resources Tennessee Department of Health Data Dashboard
33 Questions? Need help? Mike Dietrich Tennessee Hospital Association
34 Tennessee Opioid Light ED Pilot
35 Opioid Light ED Pilot Enlist interested facilities in reducing opioids used to treat patients in Emergency Department Six month pilot Aim to reduce opioids use in the ED by 30% Multi-disciplinary hospital teams (physicians, pharmacists, nurses)
36 Opioid Light ED Pilot Utilize Pain Pathways by Indication 1.) Headache/Migraine 2.) Musculoskeletal Pain 3.) Renal Colic 4.) Chronic Abdominal Pain 5.) Extremity Fracture/Joint Dislocation Allows for improved communication between staff and patients with tiered approach to pain
37 Opioid Light ED Pilot Baptist Memorial Hospital Memphis as local expert faculty Collect and report to THA measure data on Morphine millequivalents (MMEs) per 100 patient visits Promote use of Tennessee College of Emergency Physicians Tennessee Emergency Department Opioid Prescribing Guidelines
38 Opioid Light ED Pilot Total MMEs per 100 adult patient visits reported per month Numerator = total number of MMEs (Morphine millequivalents) administered to adult patients, ages 18 or older, while in the Emergency Department Denominator = total number of adult, ages 18 or older, patient visits in the Emergency Department per month
39 Opioid Light ED Pilot Percentage of adult Emergency Department patients who received any opioid medication Numerator = total number of adult patients, ages 18 or older, who received any opioid while in the Emergency Department Denominator = total number of adult, ages 18 or older, patient visits in the Emergency Department per month
40 Opioid Light ED Pilot Participants CHI Memorial Healthcare CHI Memorial Hixson Henry County Medical Center Maury Regional Medical Center Methodist Germantown Hospital Methodist North Hospital Methodist Olive Branch Hospital Methodist South Hospital Methodist University Hospital NorthCrest Medical Center Parkridge East Medical Center Parkridge Medical Center Parkridge West Medical Center Regional One Health Saint Thomas Midtown Southern Tennessee Regional Health System Lawrenceburg Starr Regional Medical Center - Athens Starr Regional Medical Center - Etowah Sumner Regional Medical Center TriStar Ashland City Medical Center TriStar Centennial Medical Center TriStar Hendersonville Medical Center TriStar Horizon Medical Center TriStar Skyline Medical Center TriStar Southern Hills Medical Center TriStar Stonecrest Medical Center TriStar Summit Medical Center Vanderbilt University Medical Center
41 For additional information, contact Jackie Moreland at
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