Tennessee Ranks 3rd in Opioid Use in US

Fentanyl recently seized by TBI officials. Photo TBI Facebook.

In a recent study by wallethub.com, Tennessee came in 11th overall for drug use problems, and 3rd in Opioid Overuse, Overdose Deaths and Drug Arrests per Capita. Illicit drug use is an issue the country has been fighting since the 1970s, but the war on drugs is a never-ending battle. New drugs like fentanyl are simply the newest killing machines developed by the enemy. 

Wallet Hub’s report, “Drug Use by State: 2023 Problem Areas” offers an attempt to locate problem states by comparing all 50 states and the District of Columbia “across 20 key metrics, ranging from arrest and overdose rates to opioid prescriptions and employee drug testing laws.” Tennessee is one of those problem states. 

There were more than 100,000 deaths attributed to an overdose in 2022 in the United States. According to White House figures released in January 2023, 148,594 pounds of illicit drugs were confiscated by law enforcement in the third quarter of 2022 alone, with a street value of more than $2 billion.

 According to the State of Tennessee, the biggest problem the state is currently facing is an influx of heroin laced with fentanyl. The Tennessee Bureau of Investigation (TBI) website notes, “Fentanyl is a synthetic opioid used for severe pain, and is exponentially more potent than heroin. Pure fentanyl is so deadly it can prove fatal if simply absorbed through the skin. The effects of and overdose can range from breathing problems to death. Fentanyl now makes the seizing of illicit drugs and lab analysis of them deadly for law enforcement.”

 A disturbing new discovery is compounding the problem of fighting drugs in Tennessee, according to the TBI. “Law enforcement agents recently recovered what appeared to be oxycodone pills during a traffic stop, with the same size, appearance and stamp of oxycodone. But a lab analysis determined these pills were counterfeit. They did not contain oxycodone, but instead contained fentanyl. The safety concern of this discovery is so great that the TBI issued a warning about this potentially dangerous drug recovery. 

Fake oxycodone is a big problem, because of the state having such a high level of prescription opioid abuse. When abusers can no longer get a prescription from a doctor or from a friend or relative, they take to the streets to fill their need.

Wallet Hub’s expert, Dan Arendt, Pharm.D., BCPS, Assistant Professor – Pain Stewardship, The James L. Winkle College of Pharmacy – University of Cincinnati and University of Cincinnati Health, explained in their report that “Despite [a] decline in opioid prescribing, opioid overdose deaths have continued to rise; last year was the deadliest year we have ever seen regarding opioid overdoses in the United States. This juxtaposition may seem strange, based on how the opioid epidemic is usually discussed, but the fact of the matter is that the current stage of the opioid overdose epidemic is now more directly related to the nature of the illicit drug market than it is to opioid prescribing. Over the last few years, we have seen a dramatic increase in the presence of illicitly manufactured fentanyl within the underground drug supply. In large part this is because fentanyl is significantly more potent than morphine, as well as heroin. With the increased attention on opioids, it has become riskier and riskier for drug smugglers to transport large quantities of opioids. Fentanyl, being more potent, can cause the same effects as morphine or heroin, but requires a smaller amount of drug to do so. Ultimately, smugglers are then able to transport the same “quality” in terms of how much effect it will have, while transporting less physical substance. Fentanyl is found on its own in the drug supply, partially for this reason, but it is sometimes also used to cut heroin, etc. because it will provide similar effects with less drug…[W]e [are] even seeing fentanyl show up as contamination within the supply of other, non-opioid drugs that are being purchased on the market, mainly cocaine and methamphetamine. All of this, combined with the fact that there is less and less opioid prescribing, has meant that the illicit market is the de facto route for most illicit use of opioids currently. Drug users, however, and even their dealers, do not know what is in the supply that they are using, they, therefore, do not know what dose to use, and unfortunately, fentanyl is so quick acting that there is not a grace period after it is used where users can recognize ‘oh that was fentanyl, I might need naloxone.’”

The TBI is asking the public to help law enforcement in their vigilant fight against these new substance combinations by understanding the increased dangers associated with illicit drug use. These new drug combinations are now not only a threat to those using them, but also to those fighting their use. They are also driving up the rate of overdose deaths, hospital costs and emergency room visits, the number of children being placed in state custody, and the number of incarcerations for drug-related crimes. 

William Eggerton, PharmD – Assistant Professor – Binghamton University School of Pharmacy and Pharmaceutical Sciences and Clinical Toxicologist – SUNY Upstate Medical University, another of the experts who commented on the WalletHub study, stated “The best thing you can do if you are concerned about a family member or friend who has a drug abuse problem is to offer support and listen without judgment. If they want help getting treatment, you can contact the National Helpline (1-800-662-4357) or reach out to a local healthcare provider.”

To find out where to gain access to naloxone, used to prevent opioid overdose, click here.

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