Limits on pain medication, more law enforcement officers and expanded use of a drug that blocks the brain's ability to get high are some of the recommendations a team of Tennessee lawmakers has come up with to combat opioid abuse after nine months studying the issue. But no one has figured out yet how much their solutions will cost, and it could be next year before there's a final price tag.
The state House of Representatives' seven-member Opioid Task Force released its recommendations Wednesday. Appointed by House Speaker Beth Harwell, its goal was to come up with new ideas to address the epidemic of painkiller abuse.
Their wishlist ranges from teaching schoolchildren about the dangers of drug use to diverting more addicts into treatment, instead of jail.
State Rep. Cameron Sexton, R-Crossville, describes it as smarter spending. He notes the state already puts about $1 billion a year into fighting opioids — money that could go into prevention.
"The amount of money it's costing the state of Tennessee — it's either we can fund this on the front end and save money and save lives, or we can continue spending the billion dollars on Department of Corrections and everywhere else and just watch the numbers explode," he says.
The plan calls for hiring 25 more TBI agents to fight the opioid trade and expanding the use of naltrexone, a drug meant to block the brain's receptors to opioids. Naltrexone, also known by the brand name Vivitrol, has been controversial in other states because its maker has heavily marketed to public officials and law enforcement.
State Rep. William Lamberth, R-Cottontown, says the goal is not to promote naltrexone over other opioid treatment drugs, such as buprenorphine.
"I think that's an example of one drug that could be useful to law enforcement," he says. "But I think my recommendation is that they should use that or anything else that they find helpful to try to combat this."
Other ideas include capping painkiller prescriptions at just one week and requiring insurers to sign off before a second refill.
Meanwhile, pain clinics could be barred from treating walk-in patients.
Such new rules could require legislation. And the price tag for more treatment and investigators might not be known until early next year.
State Sen. Jeff Yarbro, D-Nashville, says that's the plan's biggest flaw. He's again calling on the state legislature to expand Medicaid — noting that some states, including Kentucky and West Virginia, are using those dollars to fight opioid abuse.
"One of the first things a judge should do is tell people to get to a doctor, and they can't," he says. "I think all you have to do is look at the overlap of the childless adults that don't have medical care in our state and the opiate population, and you would know that this is a critical piece of taking this problem seriously."