Telehealth, broadband internet, criminal justice reform, harm reduction...a lot has been changing lately to expand access to treatment for substance use disorder.  But how well are these changes being implemented in rural areas, where the need is greatest?  And what about prevention?

I spoke with Trent Coffey, Executive Director of STAND, a coalition of Scott County businesses, organizations and community leaders focused on the health and well-being of youth.  

Rural areas have a lot of unique challenges, and my biggest takeaway from this conversation is that in order to make changes that last, we’re going to have to listen to the people who actually live there.

SMART Policy Podcast

Rural Areas and the Importance of Prevention

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


Rural Areas and the Importance of Prevention

SMART Initiative