Companies that made, distributed or sold opioid painkillers faced lawsuits that led to a $26 billion settlement. In 2022, local governments across the country — including in Tennessee — signed on to the settlement agreement, and now it’s up to the affected communities to decide how they will best mitigate the damage those companies caused.
In 2023, more than 700 Nashvillians died from a drug overdose.
In March of this year, the Tennessee Opioid Abatement Council announced $81 million in grant awards statewide, with millions set to hit Nashville organizations’ bank accounts starting in July.
There are a few common threads in the program strategies. Medication-assisted treatment with buprenorphine and methadone curbs opioid cravings. It is used to treat opioid use disorder (shortened to OUD) and substance use disorder (SUD), a broader term. Naloxone, commonly known by the brand name Narcan, can reverse an overdose, but not if xylazine, an adulterant often found in illicit drugs, is involved. Many organizations will operate under the harm-reduction ethos, which acknowledges that people will not typically be ready to quit using drugs altogether, but when provided with clean syringes, wound care and naloxone, they can more likely live to one day access treatment.
Below, find more details on how Nashville’s top five awardees plan to spend the opioid-abatement money.
Vanderbilt University Medical Center
Vanderbilt University Medical Center: $2.8 million
VUMC’s funding will focus on treatment for mothers with substance use disorder and their babies, bolstering the organization’s 2011-founded Firefly program.
They’ll use the opioid-abatement money to expand services to rural areas. Patients travel to VUMC representing 26 different counties, says Jessica Young, medical director for Firefly. The organization’s goal is to get pregnant mothers into treatment so Firefly can minimize the effect on the fetus, provide specialized anesthesia during birth and continue to support patients postpartum.
The opioid-abatement money will also be used to employ more peer recovery specialists with the hope of growing the profession, Young says.
“We have found adding peer recovery specialists to our team has really increased engagement,” Young says. “We have fewer people who are disengaged from care. For people who do relapse, I think it makes it easier for them to re-engage.”
REACH pilot program releases Q3 results, Partners in Care to expand to all police precincts
Mental Health Coop: $2.3 million
Mental Health Coop, with 12 locations statewide, currently has a small grant that allows them to serve a handful of uninsured individuals per month. With the additional funding, the organization will be able to serve more of them in medication-assisted treatment, outpatient treatment and detox offerings. Detox offerings are difficult to find in the region, and are a barrier to other forms of treatment.
“To make sure people are prepared to have outpatient treatment means sometimes they need to go through detox first,” says chief operating officer Andrea Westerfield. “Not many of those services exist across the state, and our goal would be to use our 24/7 crisis services here in Davidson County to be able to also complete detox on site and have a safe place to do that.”
Meharry Medical College: $2.6 million
Dr. Lyle Cooper, director of the Meharry Addiction Clinic, finds that very few people with substance use disorder actually come into the clinic. Because of this, much of the organization’s opioid-abatement money will go toward establishing a mobile clinic in Memphis, to mirror the one in Nashville.
HOPE Clinic (Helping Our People Effectively) started as a mobile syringe exchange program, and thanks to the funding, will now include fentanyl test strips, xylazine test strips, naloxone, wound treatment, HIV and hepatitis-C testing and treatment, plus prescriptions for medication-assisted treatment.
Though the smallest subset of the cash (just over $429,000) is going to research called Tennessee Harm Reduction Efforts for Advanced Data (THREAD), it’s the part Cooper is possibly most excited about. THREAD will include a point-in-time survey, and create an advisory board to allow people with substance use disorder to participate in research studies.
“We know how many people go to treatment every year,” Cooper says. “We have some idea of what the outcomes are in treatment and how many people overdose, and we know some things about those folks — whether it’s fatal, or it’s nonfatal. The space where we just don’t know much of anything is people who are actively using drugs.”
Belmont University: $2.9 million
Belmont University is entering the opioid landscape for the first time with a harm-reduction program called BU Trains. The program is twofold, offering training for students and current physicians, as well as a mobile unit that will provide care similar to Meharry’s model, along existing routes for the city’s outreach workers.
With Belmont’s medical college set to welcome students this fall, the timing is ripe. BU Trains will also serve as a teaching opportunity for the students.
“We don’t want to reinvent the wheel, that’s for sure,” says Tracy Frame, an associate professor of pharmacy and medicine at Belmont’s future medical college. “We want to partner with organizations and really help everyone flourish.”
“We’re growing,” says pharmacology professor Amy Henneman. “There’s a sense of ‘Where can we be helpful to Nashville?’ We want to be an integral part of the community.”
Metro Nashville Public Health Department: $2.1 million
Metro Nashville Public Health Department will use the money to expand its opioid pilot program, for which it is set to announce the awardee in May, once approved by the Metro Council.
The program will implement an opioid care process that employs a care coordinator to guide the person through treatment, including housing and transportation resources where needed. Referrals will come from the city’s REACH program, the emergency room and incarceration reentry, as well as self-referrals from the department’s clinics.
