The 2017 Tennessee Opioid Summary by the National Institute on Drug Abuse found the state had the third highest prescribing rate for opioids in the nation in 2017 with 94.4 opioid prescriptions written per 100 people. While still 1.5 times higher than the national average, the report noted the 2017 prescribing rate represented a 25 percent decline since 2013, according to statistics from the Centers for Disease Control and Prevention.
A more recent report released this summer by IQVIA tracked a 13.3 percent decrease in opioid prescriptions in Tennessee between 2017 and 2018, and a 32.3 percent drop in the five-year period since 2013.
Additional state-by-state data from the American Medical Association Opioid Task Force also showed a dramatic increase in the number of queries to Tennessee's Controlled Substance Monitoring Database (CSMD), rising from 8.6 million in 2017 to 11.4 million in 2018. The CSMD is used to identify and address overprescribing and prevent patients from "doctor shopping" for prescriptions.
According to the AMA report, CSMD queries in Tennessee have increased every year since 2014, when state officials reported 5 million queries. Nearly 51,000 physicians and other healthcare providers are now registered to use the Tennessee CSMD, up from about 39,000 in 2014.
"Our focus in the Tennessee medical community for the past several years has been - and continues to be - controlling what we can control with opioid prescribing and getting better at non-opioid pain management," said Elise C. Denneny, MD, a Knoxville otolaryngologist and president of the Tennessee Medical Association. "We continue to focus on appropriate opioid reduction while creating best team-led practices to address pain. This data affirms that we are moving the needle in the right direction and progressing in areas where physicians can make a real difference fighting the epidemic."
TMA, which helped lead the way in changing the prescribing educational requirements for Tennessee physicians, offers a number of proprietary opioid and pain management resources for doctors and other prescribers at tnmed.org/opioids.
While working to decrease excess prescribing practices, the physician organization has also advocated for balance in laws and corporate regulations that might limit access to opioids for patients in need. Most recently, TMA has challenged the controlled substance policy at Walmart and Sam's Club, sending a letter to the company's compliance department and lodging a complaint with the Tennessee Board of Pharmacy after hearing from several physician members that opioid prescriptions were being denied. TMA maintains Walmart's policy to restrict initial acute opioid prescriptions shouldn't be applied to certified pain management specialists treating chronic pain with controlled drug prescriptions, as long as those specialists remain in compliance with applicable state and federal laws.
AMA Stats on Prescription Monitoring Database Usage
Tennessee Controlled Substance Monitoring Database Program