Knoxville News Sentinel: Alexander: Push on prescription epidemic partly rooted in Tennessee

Posted on October 22, 2015

President Barack Obama may have picked West Virginia as the place to bring up the country’s prescription drug and heroin abuse epidemic, but U.S. Sen. Lamar Alexander said the president’s address Wednesday was a direct result of concerns that came up in Knoxville last month.

In September, Alexander, along with Centers for Disease Control and Prevention Director Tom Frieden and Tennessee Department of Health Chief Medical Officer David Reagan, led a roundtable discussion in Knoxville on opiate abuse, on the heels of a CDC announcement that Tennessee would get a four-year, $3.4 million grant to fight it.

Out of that meeting, Alexander said, came concerns from doctors, police and community leaders that a Medicare patient satisfaction survey might have contributed to the overprescribing of painkillers.

The Maryville Republican said he talked to U.S. Secretary of Health and Human Services Sylvia Burwell, who said she would look into it. The president mentioned the issue in his address.

Alexander said state Rep. Bill Dunn, R-Knoxville, and others at the roundtable told him the survey encouraged doctors to prescribe painkillers because hospital reimbursements are tied to how patients score doctors. If doctors don’t get a high score, Alexander said, their Medicare reimbursement is reduced.

Tennessee ranks third in the nation for prescription drug abuse and 12th for drug overdoses. But in 2014, Knox County had 133 of the state’s 1,263 drug overdose deaths — more than any other county in Tennessee, including both larger metropolitan areas.

“We are in the midst of an opiate epidemic in eastern Tennessee,” said Dr. Kelly Cooper, assistant public health officer for Knox County Health Department.

The health department has several initiatives to combat drug overdose as well as the number of babies born withdrawing from drugs — more than 1,000 last year, statewide. It’s partnering with methadone clinics, agencies offering treatment and support to addicted women, and the jail system to offer education (and, in some cases, contraception) to women struggling with addiction.

It’s also working to increase the accessibility of naloxone, a drug that can reverse the effects of drug overdose, buying time for a patient to get medical treatment. Emergency responders in Tennessee gave injectable naloxone 45 times last year, and in September Knoxville police officers began carrying nasal naloxone.

In addition, CVS has made the drug available at its pharmacies, and Knox County Health Department Director Dr. Martha Buchanan said the Health Department has reached an agreement with area Kroger pharmacies to provide naloxone — and to educate and offer it to customers who fill a certain number of opiate prescriptions monthly.

“In states and cities where they’ve done that, lives have been saved,” Buchanan said. “It’s such a simple thing — we want to increase access wherever we can.

“These are totally preventable deaths.”