What's Up in Tennessee? Addiction Doctor. Posted on Mar 2. 3, 2. Charlie Supernatural Season 4 here. Tennessee, like the rest of the country, is having an opioid epidemic. But they have it on steroids (pardon the pun). Neonatal abstinence syndrome is up 1.

More Tennesseans die annually from prescription drug overdose than from any other cause, including motor vehicle accidents. If you wonder why, the cause is probably encompassed by another fact. Tennessee physicians lead the nation in prescribing full opioid agonists, such as hydrocodone and oxycodone. In fact, in Tennessee, there are 1.

Now, you’d think that such facts as these would get the attention of those who legislate in Tennessee. You’d be right. They’ve introduced the Addiction Treatment Act of 2. Senate Bill 8. 29. Well, that’s good. Or not. Senate Bill 8. Certificates of Need if you’re going to open a clinic to treat opioid dependence.

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That’s what I’d do if someone wanted to treat the number one killer in my state, put up a road block. The problem here is that Senators Yager and Mc. Nally, as well as the nine senators (Briggs, Crowe, Hensley, Jackson, Massey, Mc. Watch Credo Youtube there. Nally, Overbey, Watson, Yarbro) that passed this bill unanimously in the Health and Welfare Committee can’t tell the difference between a full opioid agonist that is the focus of active addiction and a partial agonist useful in its treatment. Even thinking beyond the NIMBY aspects of this legislation and its pandering to voters who feel they have no addiction in their neighborhood, the logic behind this bill would smack of a knee- jerk reaction if I didn’t know that the senators in question had ample opportunity to get expert advice. They didn’t listen.

So how about the other bill, the well titled Addiction Treatment Act of 2. I mean who wouldn’t vote for that? Sounds great. Sponsored by Senators Dickerson and Yager (he must really have an interest), this bill, among some good things, has a provision that will have very serious negative consequences. The bill, as written, will require that all doctors prescribing buprenorphine will use their special DEA X number that the Federal Government only requires when treating addiction. It further requires doctors not use it off label for chronic pain control. You may see the logic here.

They want to prevent anyone from treating opioid dependent people by calling them “pain patients” and then being able to go beyond the 1. Who doesn’t want to stop a cheater? And if my state didn’t have about 1. I’d probably agree. Rather than stop pain doctors from using buprenorphine, these senators should be reading the medical literature that shows that treating chronic pain with buprenorphine is much safer and more effective than full opioid agonists. Or maybe they shouldn’t be reading the literature. Leave that, and the practice of medicine, to the doctors.

Here’s my prediction. This legislation will pass. The limit will go into effect.

In order not to run afoul of it, no one will use buprenorphine for pain. There will be more full opioid agonists used, not less, and the problem will get worse. This could be an example of a self- negating prophecy. You read this, call Tennessee, tell them not to make this mistake, and maybe they prove me wrong by changing the bill before it becomes law. Let me say, I understand their fear. I remember when a government official told me that she was worried when buprenorphine came out over ten years ago. What if the pain doctors get a hold of it.

Everyone will be on it.” I said, “You wish they’d use buprenorphine, but they won’t, and there will be a lot of dead people because they won’t.” It’s ten years later and numbers have borne out my opinion, except in Tennessee, I guess. I’m just glad it’s not Louisiana at the top of the list this time.