Overdose Fatality Review, or OFR, is a fairly new and yet already proven strategy for identifying gaps in recovery ecosystems. In other words, you bring together people from healthcare, law enforcement, criminal justice, harm reduction services and more to jointly examine cases of fatal overdoses and find out how these people fell through the cracks.

Lauren Savitskas works for the Institute for Intergovernmental Research on behalf of the Bureau of Justice Assistance to provide technical assistance for the implementation of OFR teams across the country. Trevor Henderson, SMART’s Middle Tennessee Substance Use Response Consultant, joins Lauren as well as Sharena Cathey of the Knox County Health Department and Denise Martin of the Rutherford County Medical Examiner’s Office to provide perspective on how OFR teams have been implemented in Tennessee, showcasing how varied and dynamic this strategy can be.  

In this conversation, we explore why this strategy breaks down data silos, identifies actionable solutions, and leads to long term relationships, including opportunities for further innovation.

Learn more:
OFR Toolkits: www.ofrtools.org
OFR Fact Sheet (LAPPA): https://legislativeanalysis.org/wp-content/uploads/2022/05/OFR-Fact-Sheet-FINAL-1.pdf 
Model OFR Legislation (LAPPA): https://legislativeanalysis.org/wp-content/uploads/2021/03/LAPPA-Model-Overdose-Fatality-Review-Teams-Act.pdf 
SMART: www.smart.tennessee.edu 

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

Finding Opportunities to Save Lives With Overdose Fatality Review Teams

Despite significant changes at the federal and state level, the rate of opioid prescriptions remains startlingly high. The most recent data shows that Tennessee is still hovering around 60 prescriptions for every 100 people in the state.  And again, that’s prescriptions, not pills.  As such, many patients are still facing the same on-ramp to opioid medications that got stuck in the opioid crisis in the first place. 

My guests this month are Brand Newland and Michael Doty of Goldfinch Health, Melissa Armstead of Southern Tennessee Health System, and Kathy Federico of Lifepoint Health. In 2024, Goldfinch received a grant to implement a primary prevention program focused on non-opioid pain treatment in surgical settings, and they partnered with a hospital in Lawrenceburg, TN, located in the rural, south central portion of our state.

The early success of the Billion Pill Pledge in Lawrenceburg genuinely surprised me. I worked in rural emergency departments from 2014-2018, during the rise of fentanyl, and so I know first hand how significant it is to so dramatically reduce visits to the ED for pain control. 

In this conversation, we talk about the program, how it works, how it rolled out in Lawrenceburg, and what the future of non-opioid pain treatment may look like, at both the clinical, the scientific, and the policy levels. 

Learn more:
Goldfinch Health - The Billion Pill Pledge: https://www.goldfinchhealth.com/billion-pill-pledge/ 
Southern Tennessee Regional Health System, Lawrenceburg: https://www.southerntnlawrenceburg.com/ 
Lifepoint Health: https://www.lifepointhealth.net/ 
SMART: www.smart.tennessee.edu/

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

Changing Healthcare Culture: The Billion Pill Pledge and Non-Opioid Pain Treatment

The group of people that are dying of overdoses at the highest rate, by far, are men in their 30s-50s. This group is also statistically less likely than others to ask for help. This is one of the biggest reasons why it can be difficult to implement effective prevention strategies targeting working age men. 

My guest this month is Dr. Monty Burks, Deputy Director of the Tennessee Governor’s Faith-Based and Community Initiative, which seeks to empower community resources to tackle the biggest challenges of our time, including overdose, addiction, and recidivism. Monty is also a certified peer recovery specialist with years of experience engaging people with substance use disorder and meeting them where they are, so I could think of no better person with which I wanted to discuss one of the main consequences of these deaths: the impact on their families. 

After all, many of these men were fathers, as are many of those men still in the throes of active addiction. What can we do to reach this surprisingly vulnerable population and help them become the best versions of themselves? 

In this conversation, we talk about the ways that we the people of Tennessee can step up to help, from foster care to peer recovery to even just listening to someone who needs to be heard.

Learn more:
Governor’s Faith-Based and Community Initiative: https://governorsinitiative.org/
SMART: http://www.smart.tennessee.edu/

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM


Fathers Lost in the Overdose Crisis: Prevention, Mentorship, & Rebuilding Families

Small business owners, industry leaders, law enforcement officers, teachers, and even other elected offices like city councilperson - these are some of the most common professions that people have before becoming a county mayor in Tennessee.  But it may surprise you that a fair number of our county executives were EMTs, paramedics, or first responders before seeking public office. 

On the one hand, a path like this makes a lot of sense – if one is drawn to the kind of leadership that responding to literal fires, injuries and disasters requires, surely that mindset could be put to good use in a mayor’s or county executive’s office. On top of that, as far as the opioid crisis is concerned, we at SMART have found that few people are more aware of the complexities of the overdose crisis than EMTs and paramedics, and that degree of expertise goes a long way towards making effective decisions on allocating the opioid settlements. 

My guests this month are Montgomery County Mayor Wes Golden and Jefferson County Mayor Mark Potts, two Tennessee leaders that have dedicated their careers to public safety and now hold elected office. In this conversation, we talk about how their past experiences prepared them for mayoral life, the benefits of a career in public safety, and why a career in public service is life-changing. 


Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas.

Learn more:
Montgomery County’s Youth Engagement Coalition: https://montgomerytn.gov/juvenile/youth-coalition 
Brighter Tennessee article on Jefferson County’s award winning opioid settlement allocation process: https://indd.adobe.com/view/9bd5aac3-0955-491b-995f-0c5f4101f319 
Portable Spectrometers Brief: https://smart.ips.tennessee.edu/drug-policy-analysis/portable-spectrometers 
SMART: www.smart.tennessee.edu

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

First on Scene, Still on Duty: How These EMTs-Turned-Mayors Tackle the Opioid Crisis

Cannabis, cannabinoids, and cannabimimetics like Delta-8 and THC-P and more are increasingly common across America, including in the state of Tennessee, where we have passed numerous regulations on the industry in recent years. And in states where cannabis has been fully legalized, some products containing Delta-9 THC, the psychoactive ingredient of what is defined in Tennessee state law as marijuana, the concentrations have grown to historically unprecedented levels, with some products boasting 90-95% potency. 

Despite the widespread availability of high-THC cannabis products, however, it seems the general conversation around the safety and efficacy of these substances remains grounded in a lot of misunderstandings. Not to mention a lack of awareness about the concerning side effects of these high-potency synthetically manipulated products, which are not at all like the cannabis of the ‘90s or earlier. 

My guest this month is Dr. Kristen Gilliland, Director of Outreach and Advocacy Programs and Assistant Professor of Research at the Warren Center for Neuroscience Drug Discovery at Vanderbilt University. On top of an extensive career in the field, Dr. Gilliland tragically lost her son to a drug overdose in 2019, a couple of years after he had been diagnosed with schizophrenia. Now, Dr. Gilliland works to provide innovative, evidence-based, and compassionate prevention education to teens about the reality of the modern cannabis market, which has been significantly changed since it became a legal, corporatized, and multibillion dollar industry. 

Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas.

Learn more:
Speaking Through Me: https://speakingthroughme.squarespace.com/home
Dr. Kristen Gilliland: https://speakingthroughme.squarespace.com/kristen 
SMART: www.smart.tennessee.edu

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

Speaking Through Me: Using Compassion and Science to Talk to Teens About  Cannabis, Social Media, and Brain Health

If you’ve ever worked in the field of recovery in East Tennessee, there’s a strong chance you’ve met Trent Coffey, executive director of the Schools Together Allowing No Drugs, or STAND, Coalition in Scott County, TN. 

And if are connected to Appalachia and use Instagram, TikTok or YouTube, there’s an equally strong chance you’ve encountered his cousin, Andi Marie Tillman, a comedian, actor and musician who is known for her wide array of relatable characters. 

As it happens, Andi Marie is a person in recovery, and knows first hand what it feels like to need help from the medical system in Tennessee - and how difficult it can be to get that help. 

In this special episode, we talk about Andi Marie’s recovery journey, Trent’s extensive career in drug prevention, the opioid crisis in rural Appalachia, how culture plays a role, opioid settlements, federal funding cuts, and as always, policies that might make this battle against addiction a little easier. We even dive into some Coffey family lore. 

We also filmed this episode, and will soon be releasing the video version on our soon-to-launch YouTube channel, so stay tuned for that release. 

Finally, we decided to include some content that we normally wouldn’t. Consider it behind-the-scenes or bloopers. These two are just too funny to not share that with you - and plus, it shows the real Appalachia you don’t typically see on TV. As always, any views and opinions expressed in this episode do not reflect those of UT. 


Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas.

Learn more:
STAND Coalition: https://www.standcoalition.com/about
Andi Marie’s Instagram: @andimarietillman
Andi Marie’s YouTube: @andimarie7554
Scott County Opioid Abatement: https://scottcounty.com/opioid-settlement-funding/ 
SMART: www.smart.tennessee.edu

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

Family, Recovery, and the Real Appalachia: A Conversation with Andi Marie Tillman & Trent Coffey

When it comes to any large government program targeting health, social, and cultural issues, there are always concerns that the money won’t be spent well. The opioid settlements are no exception.  

So when a program involves multiple community partners, a transparent and collaborative decision-making process, and is based on the local data, the rate of success tends to be high.  

This is what makes Sumner County’s approach so remarkable. After finding out that Highpoint Health hospital alone received over 50% of all overdoses brought in by EMS, they hired a Substance Use & Recovery Navigator to join the emergency department and help connect overdose survivors with local resources and treatment. The program also includes funding to get people help at Volunteer Behavioral Health - located right across the street from the hospital - and a “Box of Hope” containing naloxone, an up-to-date local recovery resource guide, and other tools provided by the Sumner County Prevention Coalition.  And this is just a part of the county’s overall overdose response plan that they are funding with opioid settlement dollars. 

My guests this month are Justin Werlick, Substance Use & Recovery Navigator, Dr. Geoffrey Lifferth, Chief Medical Officer for Highpoint Health with Ascension Saint Thomas, Haylee Mcphearson-Bush, VP of Operations of the Middle/West regions for Volunteer Behavioral Health, Meagan Griffith, Director of the Sumner County Prevention Coalition, Charlotte Hollis of the Sumner County Health Department, and Dr. Dustin Owens, Grant Accountant for the Sumner County Budget Committee.  

In this episode we talk about how all of these vital partners were brought together, how concerns were addressed - including the fear of duplication or supplantation of existing services - and why they are working to make naloxone more available to the community than ever before. We also discuss the larger barriers that people needing recovery face, including not only the lack of connection between existing resources, but the gaps in healthcare coverage that keep people from getting the help they need. 

Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas.

Learn more:
Highpoint Health Announcement: https://www.highpointhealthsystem.com/news/coalition-receives-grant-to-support-opioid-overdose-crisis-interventions
Sumner County Opioid Abatement Committee: https://sumnercountytn.gov/opioid-abatement/ 
Volunteer Behavioral Health: https://volunteerbehavioralhealth.org/ 
Sumner County Prevention Coalition: https://sumnercoalition.org/ 
SMART: www.smart.tennessee.edu

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

The Recovery Navigator: Connecting ER Patients to Hope in Sumner County

West Virginia has been often described as “ground zero” of the opioid epidemic, largely because of the explicit targeting of the state by Purdue Pharma for its aggressive marketing of OxyContin.

First Responder Jan Rader, long-time champion in the fight against the overdose crisis and the first woman to serve as Fire Chief in West Virginia, disagrees. At the 2025 Syndemic Summit held in Huntington, she said to the crowd “we were just the first to talk about it.”

In this conversation, we discuss why naloxone remains important even as new drugs like medetomidine are found across the country, how the importance of mental health for first responders is growing exponentially, and the policy issues that keep us from adapting to shifting drug trends, among other topics, like how even though we have been saving lives with naloxone, there are people surviving with anoxic brain injuries and we are underestimating this impact as part of the disease process of substance use disorder. 


Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas. 
Books mentioned in this episode:
Chasing the Scream by Johann Hari
Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference by Stephen Trzeciak and Anthony Mazzarelli

Learn more:
Jan Rader’s TED Talk: https://www.ted.com/talks/jan_rader_in_the_opioid_crisis_here_s_what_it_takes_to_save_a_life
Jan Rader in TIME Magazine: https://time.com/collection/most-influential-people-2018/5238151/jan-rader/ 
Syndemic Summit: https://communityeducationgroup.org/syndemic-summit/ 
SMART: www.smart.tennessee.edu

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

Listen to the Front Lines: Why Drug Policy Needs to be Bold and Flexible

It is increasingly well understood that the criminal justice system is one of the most significant and valuable intervention points for getting people into recovery. When people are given access to the services they need to enter and maintain recovery, the success stories are common. 

But providing those resources in jails can be tough, especially in small, rural counties. For one, there are a number of policies and laws that jails have to consider when seeking funding for resources. 

And worse, when addiction goes unaddressed - whether due to cost, or lack of local services, or more, recidivism tends to be higher, which makes the problem even more expensive, and even tougher for counties to solve. 

Our guest this month is Libby Jones, Associate Vice President of the Overdose Prevention Initiative. Her organization is currently working with the U.S. Congress on three bipartisan federal bills that seek to improve this situation: the Re-Entry Act, the Due Process Continuity of Care Act, and the Peer Support Act. In this conversation, we talk about what these bills seek to do and how they could potentially benefit county governments, the ongoing history of bipartisanship at the federal level when it comes to fighting the overdose crisis, how Tennessee legislators have been leaders in this fight, and finally, how the best policies come from the local level. 

As always, this episode is intended to be educational, and is not to be taken as an endorsement or rejection of any legislation. Any opinions or views or specific language presented in this episode does not reflect the opinion of the University of Tennessee.

Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas. 
Learn more:
Overdose Prevention Initiative: https://www.advocacyincubator.org/program-areas/injury-prevention/overdose-prevention
The Re-Entry Act: https://www.congress.gov/bill/119th-congress/house-bill/2586
Due Process Continuity of Care Act: https://www.congress.gov/bill/119th-congress/house-bill/1510
Peer Support Act: https://www.congress.gov/bill/119th-congress/house-bill/2741/text 
SMART: www.smart.tennessee.edu

Related reading: Critical Issues in Policing 2025: Opioid Deaths Fall as Law Enforcement and Public Health Find Common Ground (https://perf.memberclicks.net/assets/Opioids2025.pdf) 

LISTEN HERE: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

Funding Recovery Behind Bars: Bipartisan Solutions for Jail-Based Treatment

This is the kind of dilemma that faces many people in Tennessee: staying in recovery while trying to rebuild a life, but resources are limited and local public transportation is not reliable or readily available.  This has been identified in dozens of needs assessments across the state as a major barrier to recovery.  

This is where many people believe that church can have a massive impact.  Andi and Tanner Clements of Uplift Appalachia think so too.  For a few years now, their church and others they have mentored have provided transportation to courts, recovery meetings, job trainings and more, with the goal of helping people not only survive, but thrive. 

Uplift Appalachia provides education, training, consulting, and connecting to churches and organizations, motivating and equipping them to love and serve those living with addictions, mental health, and other life challenges on their journey to flourishing. They also have a three year grant to cross-train faith, health, and social service communities about addiction and trauma.  

As always, this episode is intended to be educational. Any opinions or views or specific language presented in this episode does not reflect the opinion of the University of Tennessee.

Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas. 

Learn more:

Uplift Appalachia (including Intrinsically Motivated podcast): https://upliftappalachia.org/ 

Clements, A. D. (2023). The Trauma Informed Church: Walking with Others Toward Flourishing: 2nd Edition with Study Guide. Uplift. ISBN: 979-8-9870371-1-9.

Clements, A. D., Clements, T., & Hedrick, M. J. (2025). Interpersonal connection and medication for opioid use disorder (MOUD): Does the endogenous opioid system inform the etiology and treatment of addiction? Available at SSRN: https://ssrn.com/abstract=5363291 or http://dx.doi.org/10.2139/ssrn.5363291 

Clements, A. D., Cyphers, N. A., Whittaker, D. L., Hamilton, B., & McCarty, B. (2021). Using trauma informed principles in health communication: Improving faith/science/clinical collaboration to address addiction. Frontiers in Psychology: Health Psychology, 12, Article 781484 https://doi.org/10.3389/fpsyg.2021.781484 

Clements, A. D., Cyphers, N. A., Whittaker, D. L., & McCarty, B. (2021). Initial validation and findings from the willing/ready subscale of the Church Addiction Response Scale (CARS). Frontiers in Psychology: Health Psychology, 12, Article 733913. https://doi.org/10.3389/fpsyg.2021.733913

Listen on Apple: https://podcasts.apple.com/us/podcast/smart-policy-podcast/id1642539321
Listen on Spotify: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM

Lastly, the SMART Initiative empowers communities to overcome the overdose crisis and build a healthier Tennessee where individuals impacted by substance use can thrive. Our annual Week of Giving is December 15th-19th, wherein we will be accepting charitable donations that are matched up to $15,000. Your gift would support ongoing zero-cost training and technical assistance to local governments and community partners to implement evidence-based opioid abatement strategies, continued development of interactive mapping of recovery resources across the state, and research, analysis, education and outreach on substance use prevention, mitigation, and other health initiatives. Visit giving.tennessee.edu/smart today to donate, or contact Kristen Davis at 865-974-9609 or at kristen.davis@tennessee.edu. Thank you for your consideration and support!

Finding Opportunities to Save Lives With Overdose Fatality Review Teams

SMART Initiative

Related tracks