Public Defender Richard Hughes outlines 'wow factors' of opioid crisis

Posted 8/2/18

Public Defender Richard Hughes is well aware of the impact of the ongoing opioid epidemic on individuals and families in the 10th Judicial District and beyond. Hughes shared the enormity of the …

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Public Defender Richard Hughes outlines 'wow factors' of opioid crisis


Public Defender Richard Hughes is well aware of the impact of the ongoing opioid epidemic on individuals and families in the 10th Judicial District and beyond. 

Hughes shared the enormity of the epidemic with his fellow Cleveland Kiwanis Club members Thursday, at the club's weekly luncheon in the downtown Elks Lodge.

Among statistics provided by Hughes were what he describes as "wow factors."

One of those is the fact health professionals in Tennessee, in 2015, wrote more than 7.8 million opioid prescriptions, or 1.18 prescriptions for every man, woman, and child. This was when the state was grappling with a surge of painkiller addictions and abuse.

He emphasized this is 118 prescriptions for every 100 Tennessee residents, while the national average is only 75 per 100.

A second "wow factor" is  in the same year, white Tennesseans made up 89.5 percent of the 839 people treated for heroin addiction, and 95 percent of 4,071 who were treated for prescription opioids.

These percentages were released by the Tennessee Department of Mental Health and Substance Abuse Services, Hughes said.

Tennessee is second to Alabama in the number of prescriptions written per capita, at 1.18 per person. Alabama leads at 1.2. Other Southern states include West Virginia (1.13), Arkansas (1.11), and Mississippi (1.07).

"This is the worst epidemic in the nation's history," Hughes said. 

The epidemic began in the 1990s, the speaker said, when OxyContin was controversial and heavily prescribed for pain.

"You don't see it anymore, but they've gone to other drugs."

Hughes passed out a brochure listing the different life-threatening drugs, including today's No. 1 opioid risk — fentanyl. 

The information sheet notes fentanyl is an overprescribed synthetic morphine and is deadly, at 100 percent more powerful than morphine.

Hughes noted opioids are nothing new, having been prescribed by doctors for years with different morphine equivalency. But through abuse the drugs have gained a popular, if deadly, foothold.

But, the number of  overdose deaths this century has risen from around 5,000 to 30,000. 

Hughes said he feels the relationship between a doctor and patient is one key to the problem.

"I believe monitoring of the patient's progress (on opioids), should be a legal duty (of the doctor)." 

He said he is not against pain medication, and emphasized   it is an extreme need for many patients, such as those in recovery from surgery, or sports injuries.  He noted it is often these very patients who become addicted.

He said 15 percent of those addicted become so through the doctor/patient connection. 

"But, the biggest problem is the diversion of the opioids, where people give them (or sell them) to family members, friends, or acquaintances," he added. "There are just too many pills, and they're too easy to divert" from legitimate medical use.

"I hear from a lot of people who are in pain who feel we're taking relief away from them" by trying to crack down on abuse.

Hughes said he feels there is a place for legal pain clinics, but asserts the need for proper monitoring.

He also praised Gov. Bill Haslam, and the state Legislature, for progress in the matter. "We have some of the strongest criminal opioid legislation in the country," he said.

The state's legislation focuses on prevention and treatment, and limits the duration and dosage of opioid prescriptions for new patients to a three-day supply, with medically approved exceptions.

The comprehensive plan also addresses the enforcement component, and creates incentives for offenders to complete substance abuse treatment programs while incarcerated.

Haslam's 2018-19 budget includes more than $16 million in the addiction fight.

Hughes said  he's "a big proponent of intervention with children. ... We also need the lower courts to do more."

• The Cleveland Kiwanis Club will not meet this week. Members will be involved in the club's annual golf tournament fundraiser at Chatata Valley Golf Club, Kiwanis' biggest event of the year.


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