NASHVILLE, Tenn. – Opioid prescriptions in Tennessee dropped by about one-third between 2013 and 2018, according to new data released by the Tennessee Medical Association.
The figures show a steady decrease in the numbers of opioid prescriptions filled statewide – from more than 8.5 million in 2013, to almost 5.7 million last year.
Dr. Elise Denneny, president of the Tennessee Medical Association, says while the reduction is a step in the right direction, state health professionals and lawmakers should be focusing on the bigger picture.
"Opioid use disorder is just a symptom of what plagues our society,” she states. “We still have a problem with alcohol in our nation, and it's even greater."
In 2017, Tennessee legislators passed some of the most restrictive opioid supply laws in the country.
Senate Bill 2257 put restrictions on dosages, and requires dispensers to check the state's Controlled Substance Monitoring Database prior to handing out opioids the first time a patient fills a prescription.
The database is used to spot over-prescribing and make it harder for patients to "doctor shop" for drugs.
Denneny points out that many physicians are beginning to advocate for approaches to pain treatment that don't involve highly addictive drugs.
"Physicians definitely have treatment of pain on the radar,” she states. “There's not just one way to treat pain, because not all pain is the same kind of pain. So, multi-modality approaches for management of pain is really important."
Some doctors say they feel pressured to give in to patients' demands for immediate pain relief.
However, one study published earlier this year found that U.S. doctors who received direct payments from opioid manufacturers were more likely to prescribe opioids than doctors who did not.
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March Madness is in full swing, and depending on where you live, you might be able to place a bet on a college basketball tournament game. Wisconsin hasn't fully embraced the movement, but experts still advise people to avoid unhealthy habits.
A 2018 U.S. Supreme Court ruling paved the way for states to decide if they want to legalize sports betting. That helped fuel the presence of online platforms where people can place wagers through their smartphones. Wisconsin limits live bets to tribal casinos. But bettors can flock to some neighboring states for online access.
Rose Blozinski, executive director of the Wisconsin Council on Problem Gambling, said they're neutral on these laws but still have concerns.
"We know that more people are going to do it, and we also know that more people are going to become addicted to gambling," she said.
Since the legalization wave, Connecticut officials havehave reported a 200% increase in calls to gambling addiction hotlines.
To protect yourself from falling into traps, prevention experts recommend only betting what you can afford. If troubling patterns emerge, they suggest things like deleting betting apps and switching to flip phones. Nearly 40 states allow some form of sports betting, but some do have restrictions for college games.
The financial impacts of problem gambling can be obvious, but Blozinski noted that compulsive gamblers also have a higher suicide rate. And with mobile betting marketed toward young adults, she said this demographic should be considered high-risk.
"They're at a time where they're high risk-takers to start, and gambling fits right in with that, especially the sports betting. It makes them feel important; if you're winning, you can brag to all your friends," she added.
She said a big problem in helping young adults falling into addiction is that Gamblers Anonymous resources are outdated in the age groups they cater to. Industry leaders note their ads come with disclosures about problem gambling and where to seek help. But prevention experts say they're not easy to understand, and called for broader funding to carry out assistance programs.
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Communities across the Commonwealth want to minimize traumatic experiences for the state's youngest residents - as a way to help stem the drug epidemic, and prevent future generations from struggling with substance-use disorders.
According to Kentucky Youth Advocates, at least one in five Kentucky kids has had at least two Adverse Childhood Experiences or 'ACEs.'
These include physical, sexual and emotional abuse, neglect, having family members with a substance-use disorder, witnessing domestic violence, and parental incarceration.
Dr. Connie White, deputy commissioner for clinical affairs with the Kentucky Department for Public Health, said research shows ACEs can increase risky behaviors and the development of chronic diseases - and even lead to a shorter lifespan.
"All of these things contribute as that child's neural pathways are developing," said White, "as they're learning how to make choices - healthy choices, unhealthy choices - as they're chronically stressed and their cortisol levels are chronically elevated."
White added that it's becoming clear that interventions promoting safe, stable environments for kids can strengthen the building blocks for healthy coping mechanisms - and reduce their likelihood of dependence on alcohol or drugs in adolescence or adulthood.
Barry Allen is president and CEO of the Gheens Foundation. It's a member of BLOOM Kentucky, a statewide coalition pushing for policy changes to prevent ACEs.
He said increasingly, communities are recognizing the correlation between addiction and childhood trauma.
"And so, a small group of us grantmakers proceeded to seek an audience with then-Attorney General Daniel Cameron," said Allen, "to plead the case to apply at least half of the opioid abatement settlement dollars - over $400 million - to apply those to prevention."
This legislative session, Bloom Kentucky says it's advocating for sustained funding for school-based mental health providers to improve access to services, for establishing a process to automatically expunge an eviction from a family's record after a reasonable amount of time, and to prohibit minors from being named in eviction filings.
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Celebrating the holiday season can be complicated for households with a loved one dealing with an addiction.
A South Dakota expert said there are steps the individual and their family can take to avoid major problems.
Matt Walz, representative for the Keystone Treatment Center, said because alcohol is often provided at holiday gatherings, it is important for the host to provide different beverage options. The person in recovery can also plan ahead by getting a sense of the best time to leave if other guests are likely to be drinking more.
Walz stressed the approach is not "one-size-fits-all," and advised avoiding rash decisions.
"Some things that families like to try to do at family gatherings, in good faith, is they try to do, you know, guilting or shaming -- or just ignoring or doing the 'ostrich,' head in the sand -- it kind of runs the gamut," Walz explained.
He pointed out you can help the person feel supported and recognize they are dealing with an issue which can improve over time. For individuals going through a 12-step recovery process, Walz recommended talking with their sponsor before a party to determine the best approach, or whether it is appropriate to attend. He noted maintaining sobriety is more important than missing a gathering.
If a person's addiction is brought up at a holiday party, Walz suggested avoiding conversations with a large group of people. He said one-on-one chats are more manageable.
"Just asking, 'Well, how's it going? How's that working for you? Is there anything I can do to help?'" Walz recommended.
Walz added praising the person in their recovery is often viewed as an effective strategy. But he noted the stress from holiday planning might also trigger someone to drink excessively. Experts recommend taking walks or other exploring other, healthy coping mechanisms to minimize stress.
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