Confronting the Opioid Epidemic in East Tennessee

Last week I discussed how the opioid epidemic affects our citizens, our economy, and our schools. This week I’ll chat on what we can do about it.

 First, we need to recognize that we can’t simply get rid of opiates. People with chronic pain who have been on narcotic pain medications for years cannot just be suddenly cut off. As a community, we cannot embrace heartless solutions that make patients suffer even more. Those who want to change their pain management regimen and who are addicted need access to affordable and appropriate addiction treatment.

 Second, we need to be sure that new patients being considered for long-term narcotics have exhausted all other reasonable options and are aware of the risk of addiction. It is also important to monitor pain treatment and to make sure that  patients actually require all the medication that is prescribed.

 Third, we need teamwork. Confronting the opioid epidemic is going to require input from multiple organizations, including insurance companies, healthcare systems, law enforcement organizations, public health experts, faith-based programs, and others. Obviously, some of these groups are independent, while others report to local or state authorities, not federal authorities. As your Congressman, I pledge to use the influence of my office to bring together all groups capable of contribution to the successful management of opioid addiction.

 Fourth, in our region especially we need to pay close attention to the use of Suboxone.

Suboxone is a form of Medication Assisted Therapy (MAT) for drug addiction. MAT allows patients to get on with their lives and not have to spend every day wondering where they are going to get their next opioid dose. Suboxone can literally be a lifesaving medication for people addicted to opioids. But, ironically, Suboxone itself can be abused. It must be properly prescribed, carefully monitored, and not over-used.

 Unfortunately, we know something is very wrong when several of the nationally top-ten-ranked prescribers of Suboxone are located right here in Tennessee’s First Congressional District.

 Local for-profit Suboxone clinics usually cost a patient about $100 per week, or over $5000 per year. This is out-of-pocket cash, because for-profit clinics often do not accept insurance. When the price is unaffordable, some desperate patients illegally sell a portion of their prescribed medication to pay their medical bills. This kind of self-defeating pattern has become a serious problem and is something we just should not tolerate. Sadly, Suboxone (street name “Box”) has become the most abused addictive prescription drug in most areas of the District. Some of my patients have told me that Suboxone is the only drug they have ever abused. This means that, for them, Suboxone was an “entry drug.” These patients were never addicted to opiates and never needed Suboxone to begin with, but they encountered it in the community and developed a drug problem that could not have occurred unless someone else sold or diverted a prescription.

 We need a health care system that lives up to its responsibility to treat drug abuse like other medical conditions. In such a system, patients won’t have to sell their medications to afford medical therapy, and supplies of Suboxone available for street sales will decline. Of course, fewer prescriptions for Suboxone will cut into the profits of drug companies, and they may try to keep their money flowing by lobbying and donating to sympathetic politicians. Unlike my incumbent opponent, I will not be a Congressman who opens the door to that kind of donor influence.

 Communities affected by the opiate epidemic are in a dark hole. The first rule of holes is that when you’re in one, stop digging. Stopping the growth of the opioid epidemic begins by decreasing the number of new people who become addicted. Then we need to treat those already addicted in the same fashion we treat other medical problems. However, there is no quick fix. It is going to take us decades to address the problems for our region caused by the opioid epidemic. While the recently passed U.S. Senate bill is a start, it will be important to evaluate its effectiveness and to take additional steps based on what is learned as we go forward. As a physician, I have first-hand practical experience with treating opiate addiction. I anticipate I’ll be the only member of Congress who has actually helped patients end their drug addictions. As your Congressman I will bring all of my knowledge to bear on helping our families and our communities put this mess behind us.