Election 2018 Issues and Answers: Opioid crisis and public safety

Abuse of opioids such as the oxycodone-acetaminophen pictured have led to a second straight year of life expectancy in the United States to be lowered.

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Next monthRural development and distressed counties. Like most of America, Tennessee’s metropolitan areas have prospered during the last eight years while the rural areas have lagged in almost every measure. The state has 19 of its 95 counties classified as “distressed.” What can and should we do to give every Tennessean a chance to succeed?

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Resources› Think Tennesseehttp://thinktennessee.org› The Beacon Center of Tennesseehttp://www.beacontn.org› White House Opioid Summithttps://www.whitehouse.gov/briefings-statements/president-donald-j-trump-combatting-opioid-crisis/› Tennessee Department of Healthhttps://www.tn.gov/health/health-program-areas/pdo.html› Advisory on Fentanylhttps://www.tn.gov/content/dam/tn/health/healthprofboards/Fentanyl_Public_Health_Advisory.pdf› Tennessee Traffic Fatalitieshttps://www.tn.gov/content/dam/tn/safety/documents/FatalityRate1950-2016.pdf

Issues and Answers

In the months leading up to the Aug. 2 state primary elections, the Times Free Press is running an "Election 2018: Issues and Answers" feature, produced by the Tennessee Press Association, as part of an effort to educate readers and voters about key issues facing Tennessee and what candidates for governor and U.S. Senate have to say about them. This is the second installment; future installments will cover rural development and distressed counties, health care and well-being, and education.


Opioid crisis and public safety

The spread of opioid abuse claimed more than 1,600 lives in Tennessee in 2016, and it is getting worse. Methamphetamine abuse, while not getting the headlines, has increased. Gun violence is increasing. What proposals do our candidates have to help Tennesseans address these public safety issues? Each of the major candidates for governor and U.S. Senate were asked to tell our readers about their views on the opioid crisis and public safety.



Diane Black

photo Rep. Diane Black, R-Tenn., speaks at the Susan B. Anthony List and Life Institute Luncheon Tuesday, Feb. 27, 2018, in Nashville, Tenn. (AP Photo/Mark Humphrey)


The opioid epidemic is a scourge on our society, and I firmly believe the next governor will be judged by how she handles this crisis.

As I've traveled the state, I've sought input from the boots on the ground combating this epidemic. Working with the attorneys general and sheriffs on my Law and Order Coalition, we have developed a plan to go after the root cause of the crisis.

We can significantly reduce the destructive impact of addiction if we: 1) prosecute pill mills; 2) sue manufacturers who mislead providers about the addictive nature of their drugs; 3) provide more resources to district attorneys, local law enforcement and the TBI; 4) regulate prescriptions using a real-time Controlled Substance Monitoring Database without adding administrative burdens to providers and; 5) protect patients by encouraging pharmacies and manufacturers to include emetics in their formulas.

We can't just stop at addiction. We have to broaden our view and look at crime as a whole.

As governor, I will be dedicated to giving law enforcement and schools the resources they need to be successful. I will work with school districts to provide a safe and secure environment, including armed school resource officers in every school and increased mental health screenings.

As governor, I will get tough on repeat offenders, especially drug trafficking and domestic violence offenders. We can't keep letting repeat offenders walk the streets with our kids.

Randy Boyd

photo Businessman Randy Boyd speaks to reporters after a gubernatorial forum hosted by the Tennessee Business Roundtable in Nashville, Tenn., on Tuesday, Sept. 12, 2017. (AP Photo/Erik Schelzig)


Opioids are decimating our communities, and this is a crisis that requires bold and decisive action. As I've traveled to all 95 counties, I've met countless people who talk about loved ones lost. Last September I published a 10 Point Plan, which can be summarized into three strategies: mobilize, prevent, recover.

We must mobilize all state resources to end this scourge; that begins with declaring a state of emergency to call this epidemic what it is. We will then appoint a chief epidemic officer to marshal resources and prioritize this battle.

We must also prevent more people from getting addicted; this means addressing the over-prescription of opioids. There is no excuse for prescribing twice the national average and being one of the top states in the country for dispensing these deadly pills. Educating doctors, patients, parents and children about the danger of these drugs is a key component in prevention.

Finally, we must do a better job of helping with recovery. The place we send most addicts for recovery today is jail. We can't incarcerate our way out of this problem. The good news: Providing proper treatment in addiction and mental health facilities is more effective, better for the addict and cheaper than jail.

Tennessee needs to step up in a big way, not just for addiction, but for mental health in general. Over the last 50 years, the number of beds for treatment has been reduced by nearly 95 percent. The people didn't go away, they just ended up on the streets and in the jails. We can do better, we must do better, and as your governor, we will do better.

Beth Harwell

photo State House Speaker Beth Harwell, R-Nashville, is sponsoring a bill that seeks a federal waiver that would mandate work requirements for able-bodied, working-age TennCare recipients.


As speaker of the House, I appointed a task force in early 2017 to take an in-depth look at the opioid crisis in our state and make recommendations as to what should be done. I appreciate Gov. Haslam incorporating several of the recommendations into the legislation he presented this year, and I am supportive of these efforts.

As governor, I would continue the work we have started this year. We cannot incarcerate our way out of this crisis, so I would prioritize treatment and funding for treatment to ensure people have access to the help they need to get clean. I would also step up our prevention efforts because educating the public about this issue is part of the battle as well. And finally, we have to support our law enforcement professionals as they fight this, and keep these drugs off the street.

Another public safety issue I have worked on is human trafficking. We often discuss it, but seeing it firsthand absolutely cemented my belief that we must continue working to implement policies that will assist our law enforcement throughout the state in these operations.

The TBI has partnered with local enforcement and other agencies and nonprofits to tackle this problem. In addition, End Slavery Tennessee - a wonderful organization - works with these agencies and the community at large to raise awareness about this issue and to provide long-term, comprehensive, specialized services. This is a perfect example of a public-private partnership that attacks a problem from multiple angles. We are leading the nation as a state in our response to trafficking, but I've seen just how much work there is left to do. As governor, I will support and continue those efforts.

Bill Lee

photo Businessman Bill Lee, left, participates in a gubernatorial candidate forum on health care Friday, Jan. 19, 2018, in Nashville, Tenn. (AP Photo/Mark Humphrey)


Over the last 10 years, a collective failure by government, pharmaceutical companies, and some in the medical community have left us with an opioid crisis that is crippling our state. There's no quick fix, and the solution will require shared responsibility from state and local institutions, our medical providers, and faith and community leaders.

The state is currently taking several common-sense first steps that we can build upon. For instance, restricting the use of addictive opioids, particularly in TennCare, is an important preventative step. Lowering the overall rate of prescriptions is an important first step to solving this crisis.

Another step is to increase funding and support for law enforcement drug interdiction efforts, which is critical to combat the flow of drugs from China and Mexico and the new threat of fentanyl.

On rehabilitation, we need to look at the entire continuity of recovery by bringing addicts back into the community with meaningful connections and skills to start a new life. I am heavily involved in prison ministry and I know that the window for rehabilitation must happen months, if not years before an offender's release from prison. Our next governor has an opportunity to lead the Department of Corrections into a new strategy for healing offenders before their release.

Finally, we must address our mental health support system by acknowledging the shortfalls in addiction treatment and supporting those working in mental health. For families in crisis, navigating the mental health system is often frustrating and complex, and we have to do better. As governor, I'll bring a comprehensive approach to overcoming our opioid crisis.


Karl Dean

photo Former Nashville Mayor Karl Dean, a Democrat, speaks at a gubernatorial forum hosted by the Tennessee Business Roundtable in Nashville, Tenn., on Tuesday, Sept. 12, 2017. (AP Photo/Erik Schelzig)


I have seen, as I'm sure many others have, the human toll the opioid crisis is having on our state. As governor, I would take a four-pronged approach:

' Educating the public about the dangers of opioids;

' Ensuring that people addicted to opioids get the treatment they need;

' Supporting law enforcement to arrest those who are profiting;

' Eliminating over-prescription of narcotics.

As mayor of Nashville, public safety was one of my top priorities, and that was reflected in the city's operating budget. Even when other departments were being cut due to the recession, we protected funding for public safety. Over my eight years in office, we increased the Metro Nashville Police Department's budget. We also invested millions in building new precincts and our city's own crime lab. We also increased the number of police officers. In return, overall major crime was down when I left office from when my first term began, including record low homicide numbers in 2013 and 2014.

Our government's No. 1 job is to keep people safe, and so as governor, public safety would be a priority. I would be willing to have tough conversations across party lines to see what we can agree on in this state as it relates to gun safety and move from there to help keep our children and families safe. We should be working to keep guns out of the hands of dangerous people. Additionally, I would be in support of a ban on bump fire stocks, and we need to look at the age limit for purchasing an assault weapon.

Craig Fitzhugh

photo State Rep. Craig Fitzhugh, D-Ripley, speaks on the opening day of the legislative session Tuesday, Jan. 9, 2018, in Nashville, Tenn. (AP Photo/Mark Humphrey)


The opioid and methamphetamine crisis is tearing up our state, especially our rural areas. There has been a push in the legislature this year to address this crisis, and while I back those efforts, I do not believe that they go far enough. The governor proposed a plan, committing $30 million to combating opioids. Less than half of that money comes from state funds. There are individual hospitals that have committed more funding to opioids. If our state had expanded Medicaid, we would have additional funds for opioids and methamphetamine issues, especially in the aforementioned rural areas. Tennessee has had more per capita hospital closures than any other state, almost all in our rural counties. Open hospitals offer more opportunities for treatment for opioid addiction.

Methamphetamine is a problem not just from its use but also from its creation. It can be created from just a few ingredients that can be easily found, and it ruins the homes it is created in and is very harmful to children. Education and prevention are key. We have slowed the growth of meth somewhat with roadblocks at our pharmacies, but more must be done, as law enforcement is being overwhelmed.

Gun violence is increasing. Not only are mass shootings on the rise - which have driven our children into the streets in protest - but the numbers of gun crimes occurring in our state have increased as well. According to the Tennessee Bureau of Investigation, gun crimes have increased 25 percent in the past four years. More firearms are being stolen, and those guns are being used to commit crimes. We are also seeing an increase in gun crimes being committed by and against our young people. As governor I will work with law enforcement to make sure illegal, unlicensed guns are off our streets.



Marsha Blackburn

photo Rep. Marsha Blackburn


Public safety is one of government's foremost responsibilities, and it requires federal, state and local government to work hand in hand. In Tennessee, we are blessed with an exceptional law enforcement community. In listening to them, they expressed their concern not only with opioids but also with the resurgence of meth, heroin and cocaine in our communities.

I am gravely concerned about the opioid crisis. In Tennessee alone, at least three people die from an opioid-related overdose each day, and that does not include the Tennesseans who have had their lives destroyed by addiction.

I have long worked to fight the opioid epidemic and other drug abuse, including the rise of methamphetamine use. In the state Senate, I fought for drug courts and treatment programs and partnered with law enforcement and prosecutors to ensure they had the necessary tools. In Congress, I supported the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act; both bills took major steps to combat the opioid epidemic by supporting prevention, treatment and recovery programs that proved effective.

Last month, I introduced the Comprehensive Addiction and Recovery Act 2.0 to further strengthen the federal government's response by increasing civil and criminal penalties for bad actors and authorizing vital funding.

Additionally, we are working to prevent horrific attacks involving gun violence. I know we can protect our citizens in public spaces, while safeguarding our Second Amendment rights, and I am committed to that goal.


Philip Bredesen

photo FILE - In this Jan. 29, 2013, file photo, former Democratic Gov. Phil Bredesen speaks on a panel about reducing the federal debt at Lipscomb University in Nashville, Tenn. Democrat James Mackler says he's dropping out of the U.S. Senate race in Tennessee to replace Sen. Bob Corker, a move that appears to clear the path to the Democratic nomination for Bredesen. (AP Photo/Erik Schelzig, File)


It's no secret that we have an opioid crisis in Tennessee, and there is no shortage of recommendations to address it. Most of them include the word "billions": billions of dollars for research, billions for mental health services, billions for law enforcement.

But there's another approach that costs little and is far more humane: Demand more personal responsibility from everyone involved in getting these pills into Tennessee medicine cabinets.

America is an outlier among nations in the volume of opioids that are legally prescribed: We consume legal opioids at 30 times the rate that the Japanese do, for example. Tennessee is an outlier in America: We have the third highest legal opioid use of any state.

Every one of these pills was manufactured by a legal, regulated pharmaceutical laboratory. And every one of them was prescribed by a physician.

We should of course demand responsibility from pharmaceutical companies who manufacture and push these drugs.

But remember that Tennesseans don't get a bottle of pills until a physician writes a prescription. Tennessee's physicians need to take some personal responsibility if we are ever going to beat this. Patients don't know the ups and downs of these powerful drugs. There are evidence-based standards for when and in what quantities opioid prescriptions are appropriate. If a physician regularly prescribes outside of these standards, and patients become addicted, shouldn't that physician bear a part of the responsibility?

Congress can, and probably will, spend billions on this. The truth of the matter, though, is that change will only come when everyone involved in getting these drugs into our medicine cabinets is forced to take some personal responsibility for what happens.