Substance Abuse: A Growing Public Health Crisis in Middle Tennessee

Substance abuse is a growing public health crisis in Middle Tennessee, with nearly 400,000 residents struggling with addiction to alcohol, illicit drugs, prescription drugs, or a combination of substances. Addiction is a chronic brain disease, like mental illness, and it can be treated. However, only one in ten Tennesseans who need substance abuse treatment get it. This analysis examines data on mental health and substance use disorder in all states and the ability to meet with residents, as well as the effects of substance abuse on public health in Middle Tennessee.

It is widely accepted that addiction is a compulsion, not a choice. People who suffer from substance use disorders will prioritize the substance of addiction above all else and despite negative consequences. Those who are truly addicted would rather satisfy their craving than eat or pay bills. Over time, substance abuse causes changes in the brain.

Most drugs work by flooding the brain's reward system with dopamine, a neurotransmitter that regulates movement, thinking, motivation, emotions, and pleasure. Brain changes associated with addiction can be treated and reversed through therapy, medications, exercise, and other treatments. Effective treatments replace everything the drug did for the addicted person and provide them with ways to relieve stress, cope with challenges, and create new rewards. Binge drinking is defined as five or more days a month of excessive alcohol consumption, which consists of drinking too much alcohol for a short period of time to become intoxicated.

Heroin is an opioid that is most commonly used as a recreational drug because of its euphoric effects. As prescription painkillers become more difficult to obtain, addicts often turn to heroin. Used for severe pain, pure fentanyl is so strong that vets use it to reassure elephants that it can be deadly if simply absorbed through the skin. Methamphetamine is a stimulant drug that causes serious and irreversible damage to the body.

Methamphetamine use in Tennessee has stabilized in recent years but there are still 800 meth laboratories operating at all times in the state. Factors that influence addiction risk include biology, age, and the environment. Many risk factors for substance use disorder begin in childhood. Protective factors that reduce the likelihood of abuse include strong family ties, rules that are consistently enforced, and success in school.

Negative risk factors include a chaotic home environment, aggressive behavior in the classroom, easy access to medications, and life in poverty. When children experience prolonged adversity at home, toxic stress is created. These adverse childhood experiences (ACEs) disrupt brain development making these children more likely to struggle with challenges such as addiction as adults. Women's bodies process medications differently than men and they experience a higher incidence of depression and anxiety which can lead to substance abuse.

Addiction, mental illness, and trauma often feed on each other. Many people struggling with addiction face comorbid conditions such as hepatitis and other chronic medical problems. Tennessee ranks third in the country for prescription drug abuse among all demographic groups. More than 70% of people who use prescription drugs for non-medical reasons get them from friends or family.

More than 1,000 babies in Tennessee are born dependent on drugs each year. Neonatal abstinence syndrome (NAS) causes low birth weight, seizures, and social and health problems later in life. Approximately 38,000 Tennessee teens (7.4%) report using illicit drugs. Excessive substance use stalls mental development which can lead to serious problems in adulthood such as difficulty holding down a job or being a parent.

Drug abuse among Tennesseans ages 18 to 25 is increasing and they are using prescription opioids at a rate 30% higher than the national average. Incarceration can also contribute to the cycle of addiction; during incarceration medications may be available and few resources are available once released which can lead to relapse for those struggling with addiction. Overwhelmingly Tennesseans aren't getting the treatment they need; however first responders have had notable success using naloxone nasal spray which counteracts overdoses with incredible effects - Tennessee police have been 100% successful with those saved with Narcan. In addition to supporting charitable programs that benefit all Tennesseans BlueCross has programs to support members affected by substance use disorder; TNAChieves and its volunteer mentors are helping more students get a college education. The department operates four regional mental health institutes in Nashville Memphis Chattanooga and Bolivar and contracts for emergency psychiatric admissions at three private hospitals in East Tennessee. After having been a legislative liaison in the governor's administration and in numerous lobbying and public policy functions in the private sector Brenda understands all facets of effective promotion and organization from developing popular support to taking advantage of popular outreach. To help policy makers decide how to use new federal funding for substance abuse treatment it's important to understand how addiction affects public health in Middle Tennessee so that effective solutions can be implemented.

Herbert Denbow
Herbert Denbow

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