August 31st, communities around the world will host a variety of activities in support of International Overdose Awareness Day. Inspired by annual community events hosted in Melbourne, Australia, International Overdose Awareness Day was brought to the global stage in 2012 as nations like the United States and Australia were beginning to understand the magnitude of the opioid crisis. Since 2012, IOAD has maintained it’s original purpose to raise awareness, reduce stigma of drug-related death and commemorate those who have been lost to drug overdose.
All drugs can cause an overdose, including medications prescribed by a doctor or purchased over the counter. However, not all overdoses are fatal. In Tennessee, 74 % of fatal overdoses involved an opioid despite the opioid overdose reversal medication, Naloxone, being available.
An opioid is a class of drugs that include the illegal drug heroin as well as powerful pain relieves available legally by prescription. An opioid overdose can occur when a opioid is taken in excess amounts or in combination with other drugs. This is because opioids affect the brain’s regulation of breathing. During an overdose, opioids can slow breathing until it eventually stops, resulting in death. Most opioid overdoses are slow and occur one to three hours after using the drug.
Together, Tennessee recognizes that these numbers matter.
Every number is a story, and every story is a person.
The Tennessee Department of Health (TDH) is taking a data-driven approach to understanding this evolving epidemic. Through state support and federal funding the Office of Informatics and Analytics (OIA) is able to support a comprehensive and multi-faceted data-driven response to the opioid crisis in TN.
We use mortality (fatal), morbidity (non-fatal), and prescription data and rigorous public health surveillance and epidemiologic methods to provide accurate and timely information to understand the epidemic. OIA strongly supports dissemination of data through a variety of reports, data-briefs, projects, and collaborative statewide efforts including a data dashboard.
One of the biggest barriers to preventing overdose deaths is the perceived stigma surrounding overdose and addiction.
When an individual is stigmatized, others view the person as the problem rather than viewing the condition as the problem. This leads the individual to feeling shame and isolation, making it even harder to ask for or accept help.
Person-first language is proven to reduce stigma and improve treatment.
It’s not about being sensitive or politically correct. It’s about access to quality treatment and care. Person-first language is nonjudgemental, neutral, and the diagnosis is purely clinical.
Knowing the right words to stay can be tricky as language is ever evolving. The Shatterproof Language Guide is a tool to understanding more compassionate language. Click below to visit Shatterproof and learn more!
Naloxone, often known by it’s nasal spray application brand name Narcan, is a proven tool in the battle against drug misuse and overdose death. When too much of an opioid medication is taken, it can slow breathing to a dangerously low rate. If breathing slows too much, overdose death can occur. Naloxone can reverse this potentially fatal situation by allowing the person to breath normally again.
Anytime an overdose is suspected call 911 immediately. Stay with the person until first-responders arrive. Give Naloxone if you have access and are trained. Sometimes multiple doses of Naloxone are needed if potent opioids, such as Fentanyl, are consumed. Start rescue breaths by pinching the person’s nose and breathing into their mouth every five seconds until first-responders arrive or the person becomes alert. If you cannot wait for first-responders, place the person in the recovery position (on their side supported by a bent knee).
Since 2017, Tennessee’s Save A Life project has funded regional overdose prevention specialists throughout the state. These ROPS serve as a point of contact for training and education on opioid overdose and for overdose prevention through the distribution of naloxone. Currently, the Tennessee Department of Mental Health and Substance Abuse Services has a total of 20 ROPS operating in 13 regional divisions across the state.
Harm Reduction is a public philosophy and set of practical strategies that seeks to reduce the negative consequences associated with substance use. In Tennessee, there are numerous organizations and state sponsored activities that actively practice the principles of harm reduction – some of which have already been mentioned.
This section will highlight some programs and services important to Harm Reduction: Syringe Service Programs (SSPs), Medication Assisted Treatment (MAT), and End the Syndemic Tennessee- all of which serve a meaningful role in Tennessee communities.
Syringe Service Programs (SSPs) are community-based prevention programs that can provide a range of services, including:
More than 30 years of research show that SSPs protect communities by reducing syringe litter, increasing access to recovery services, and reducing transmission of HIV, hepatitis C and other infectious diseases. Click the graphic below to learn more about how SSPs benefit communities
Medication-assisted treatment (MAT) is the use of medications with counseling and behavioral therapies, to provide a “whole -patient” approach to treatment of substance use disorders.
MAT is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers that contain opiates. The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative effects of the misused drug.
While MAT may be a viable option for some patients, it is simply a tool in the toolkit when treating substance use disorders, and appropriate therapy should be chosen in consultation with a licensed healthcare provider.
Buprenorphine is a Schedule III opioid narcotic that can be used in an Opioid Treatment Program setting. It can also be prescribed by specially-trained physicians and filled at a pharmacy. Buprenorphine is a “partial opioid agonist.”
This means that it works similarly to methadone, but it does not cause a full opioid response in the body. This should not be confused with potency, however. Buprenorphine is a strong medicine and should only be used for patients with known history of opioid use.
Methadone is a long-acting opioid used to treat addiction in Opioid Treatment Programs.
The aim of methadone treatment is to prevent withdrawal symptoms and to reduce cravings for opioid drugs. Methadone is a Schedule II opioid narcotic with potency that varies from patient to patient. Due to risk of overdose, doctors prescribe a low dose to begin treatment and observe patients closely.
The Division of Alcohol and Drug Substance Abuse Services is responsible for oversight of Tennessee’s opioid treatment programs also known as medication-assisted treatment programs. The State Opioid Treatment Authority within the Department of Mental Health and Substance Abuse Services is responsible for program oversight and clinical assistance. Specifically, the State Opioid Treatment Authority is responsible for providing administrative, medical, and pharmaceutical oversight to certified opioid treatment programs, including, but not limited to planning, developing, educating, and implementing policies and procedures to ensure that opioid addiction treatment is provided at an optimal level.
Naltrexone comes as a tablet or long-acting injection. It is not a controlled substance.
Naltrexone is an “opioid antagonist” which means its effects are opposite of narcotic drugs. Naltrexone has been shown to be effective at encouraging sobriety and reducing substance abuse.
Naltrexone may be available through your regular doctor’s office.
Disulfiram is a medication that treats chronic alcoholism. It is most effective in people who have already gone through detoxification or are in the intitial stage of abstinence.
This drug is offered in tablet form and is taken once a day. Disulfiram should never be taken when intoxicated and it should not be taken for at least 12 hours after drinking alcohol.
Unpleasant side effects (nausea, headache, vomiting, chest pains, difficulty breathing) can occur as soon as ten minutes after drinking even a small amount of alcohol and can last for an hour or more.
Acamprosate is a medication for people in recovery who have already stopped drinking alcohol and want to avoid drinking. It works to prevent people from drinking alcohol, but it does not prevent withdrawal symptoms after people drink alcohol.
It has not been shown to work in people who continue drinking alcohol, consume illicit drugs, and/or engage in prescription drug misuse.
The use of Acamprosate typically begins on the fifth day of abstinence, reaching full effectiveness in five to eight days. It is offered in tablet from and taken three times a day, preferably at the same time every day.
The medication side effects may include diarrhea, upset stomach, appetite loss, anxiety, dizziness, and difficulty sleeping.
When used as a treatment for alcohol dependency, naltrexone blocks the euphoric effects and feelings of intoxication.
This allows people with alcohol addiction to reduce their drinking behaviors enough to remain motivated to stay in treatment, avoid relapses, and take medications.
TENNESSEE REDLINE: 1.800.889.9789
CALL or TEXT (Toll Free 24/7)
The Tennessee REDLINE is a toll-free information and referral line that provides accurate, up-to-date alcohol, drug, problem gambling, and other addiction information and referrals to all citizens of Tennessee at their request.
The REDLINE provides referrals for co-occurring alcohol and drug disorders that arise along with mental health disorders.
The Tennessee Suicide Prevention Network (TSPN) is a statewide organization working tirelessly to eliminate the stigma of suicide.
Staff and volunteers are often counselors, mental health professionals, physicians, clergy, journalists, social workers, law enforcement personnel as well as survivors of suicide and suicide attempts. Suicide does not discriminate against age, race, means, or profession. We would like our volunteers to be just as diverse in background as the people we strive to reach.
The Tennessee Statewide Crisis Line is available toll-free 24/7 hours a day 365 days a year.
This is a resource for anyone experiencing a mental health crisis. All calls are routed to a trained crisis counselor in your area, who will provide you support and guidance, and work to connect you with appropriate community supports.
There is no “typical” demographic of a person who is at risk for suicide. No age group, ethnicity, or background is immune. Fortunately, many troubled individuals display behaviors deliberately or inadvertently signal thier suicidal intent. Recognizing the warning signs and learning what to do next may help save a life.
If you or a loved one is experiencing suicidal thoughts or tendencies call the National Suicide Prevention Helpline.
Call 1-800-273-8255 or Text 741741
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The Tennessee department of Mental health and Substance Abuse Services is proud to offer the TNRecover app.
This app is designed for people in recovery from substance use disorder or for people looking to get more information on preventing addiction. The TN recover app is available for download in the Apple Store for iOS devices or the Google Play Store for Android devices.
Text SAVE to 30678 to download the free TN Recover app.