Digital Commons Network^™

What Is The Risk Of “Captagon” And Other Pill-Pressed Stimulants In Tennessee?, Jeremy C. Kourvelas Mph

SMART Policy Briefs

• The U.S. is the world’s largest market for amphetamine-type stimulants. While “ice” methamphetamine is the predominant type seized in Tennessee, amphetamine powder, cocaine, designer stimulants like MDMA, and diverted pharmaceuticals are also encountered. In fact, non-medical use of pharmaceutical amphetamines is the most predominant type of amphetamine use in the U.S.

• The ongoing shortage of prescription stimulants like Adderall puts college-aged youth and other vulnerable populations at particular risk of encountering counterfeit prescription stimulants. Fentanyl-laced counterfeit Adderall has already been discovered on college campuses, for example.

• One potential threat is “Captagon,” which was banned in the 1980s but has since …

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The Effect Of Focused Client Education On Case Management & Readmission Rates In Homeless Individuals With Co-Occurring Disorders Admitted To A Jail Diversion Program, Pallavi Rao, Mary Johnson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Individuals with both mental illness(es) (MI) and substance use disorder (SUD) occurring simultaneously are known as having co-occurring disorders (COD). The rates of COD found among homeless individuals (H-COD) are higher than in the general population. The presence of both conditions prevents H-COD individuals from overcoming their hardships and places them at a higher risk of being involved in the criminal justice system.

Local Problem: Jail diversion programs (JDPs) admit a high rate of H-COD clients nationally and locally at the project site in Knoxville (JDP-K). The Office on Homelessness reported about 80% of those admitted to JDP-K are …

Prior Authorizations And Addiction Treatment, Channie Cretsinger Mph, Jeremy C. Kourvelas Mph, Jennifer G. Tourville Dnp

SMART Policy Briefs

Key Points

• Concerns about prior authorizations have grown given research demonstrating inconsistent coverage and review policies across insurers, interruptions to care, high provider burden and higher healthcare costs.
• Tennessee policymakers and insurers have recently taken appropriate measures to ease the concerns and minizine unnecessary barriers. TennCare changed their policy on buprenorphine allowances in May 2023, essentially removing the prior authorization barrier for buprenorphine/naloxone preferred products.
• This is a significant step for Tennesseans given that the research shows that once the prior authorization process was removed for medications for opioid use disorder (MOUD), patients with opioid use disorder …

Increasing Nurse Awareness Of A Breastfeeding And Substance Use Disorder Guideline To Improve Rates Of Breast Milk And Skin To Skin Usage: A Quality Improvement Initiative​, Makenna R. Black, Alexandria L. Tasket, Megan L. Young, Tracy L. Brewer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Neonatal opioid withdrawal syndrome (NOWS) is related to opioid exposure in utero, and cases of NOWS have been increasing. In Tennessee in 2020, 824 newborns were born with NOWS. NOWS treatment involves pharmacological and nonpharmacological treatment. Breastfeeding, a nonpharmacological treatment, decreases the need and length for pharmacological treatment, the length of stay, and NOWS symptoms. Skin-to-skin may also reduce symptoms of NOWS. This quality improvement (QI) project involved implementing an Opioid Use Disorder Toolkit from the Tennessee Initiative for Perinatal Quality Care (TIPQC) and specifically educating staff nurses in a Women and Infant’s Department in a regional medical center on …

Reducing The Stigma Of Nurses In Recovery: Substance Use Disorder And Alternative-To-Discipline Program Education For Nurses, Daniel Paul Del Toro, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Decades of previous studies suggest that approximately 10-15% of all actively licensed nurses in the United States may be impaired by or in recovery from alcohol or other drug addiction. As a result of the COVID-19 pandemic, medical professionals are experiencing unprecedented amounts of stress, fatigue and emotional distress that when coupled with poor coping mechanisms and easily accessible addictive substances may result in an increased risk for developing substance use disorder. By providing education to nurses regarding substance use disorder (SUD) and alternative to discipline programs (ADP), previous studies have shown that the risk of nurses developing SUD can …

Opioid Overdose Deaths In Tennessee, Jeremy C. Kourvelas, Erin Gwydir, Jennifer G. Tourville Dnp, Karen Pershing

SMART Policy Briefs

Opioid overdose deaths (ODD) are best understood as three phases: first due to prescription opioid misuse, followed by a rise in heroin use, and currently due to contamination by synthetic opioids such as fentanyl. Each phase has posed unique policy challenges. ● Numerous policies and practices have successfully reduced prescription opioid and heroin ODD, but ODD due to fentanyl and other synthetic opioids continue to rise, especially since the COVID-19 pandemic began. ● Fentanyl test strips, syringe service programs, greater naloxone (Narcan, Kloxxado) availability and other harm reduction approaches have been implemented in recent years with positive results, but synthetic …

Utilization Of A Drug Use Screening Assessment: A Quantitative Study To Reduce Benzodiazepines In Inpatient Detoxification, Malerie Lazar Bolinsky, Mary Johnson, Sarah Devault

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

The use of benzodiazepines in the inpatient psychiatric setting is common for patients undergoing drug and alcohol detoxification but does not come without risks. Too high of a dose of benzodiazepines are often administered during detoxification when patients are not adequately assessed on admission. Current literature supports utilization of a screening tool for drug use can reduce unnecessary benzodiazepine use. This study implemented the Drug Use Screening Tool in a drug and alcohol detoxification unit of inpatient psychiatric hospital to evaluate severity of drug use on admission and established a statistically significant reduction in the use of as-needed benzodiazepines prescribe.

The Cost Of Stigma, Jeremy Kourvelas, Carole R. Myers Dr., Katie Cahill, Karen J. Derefinko Phd, Robert Pack Phd, Kelly E. Moore Phd, Jennifer Tourville

SMART Policy Briefs

Key Points

• Substance Use Disorder (SUD), formerly known as addiction or substance abuse, is a treatable medical condition, but fewer than 1 in 10 Tennesseans with SUD receive treatment.
• Stigma can lead to a view of those with SUD as weak-willed, unmotivated, and unlikely to recover. However, the reality is that about 60% of people with SUD experience full remission.
• Treatment is also fiscally sound: every $1 spent on evidence-based treatment for SUD saves $12 in healthcare and criminal justice costs.
• How we talk about SUD is the beginning of reducing stigma. Using person-first language such as …

Substance Misuse And Incarceration In Tennessee, Katie Cahill, Duane Slone, Jason R. Trautwein, Ricki Dierenfeldt Phd, Kelly E. Moore Phd, James M. Hart, Jennifer G. Tourville Dnp

SMART Policy Briefs

Key Points

• Corrections in Tennessee cost over $1 billion annually due to a rising incarceration rate.
• The State’s increasing incarceration rate is related to the growth in substance misuse which on its own costs Tennessee $2 billion each year and leads to over $1 billion in lost income from a shrinking work force.
• Prioritizing evidence-based treatment that targets the underlying medical and behavioral issues driving addictive habits for justice-involved individuals could simultaneously address rising recidivism, reincarceration, and growing substance misuse.

See report attached, and for additional information, visit https://smart.tennessee.edu/policy-briefs/substance-misuse-incarceration-tn/ .

Better Broadband For Better Health, Jeremy Kourvelas, Katie Cahill, Carole Myers Phd, Jennifer Tourville, Sreedhar Upendram

SMART Policy Briefs

No abstract provided.

Telehealth Improves Access To Treatment For Substance Use Disorder, Jeremy Kourvelas, Carole Myers Phd, Katie Cahill Phd, Stephen Loyd Md, Jennifer Tourville Dnp

SMART Policy Briefs

No abstract provided.

Addressing Substance Abuse And Violence In Substance Use Disorder Treatment And Batterer Intervention Programs, Christine Timko, Helen Valenstein, Patricia Y. Lin, Rudolph H. Moos, Gregory Lyal Stuart, Ruth C. Cronkite

Psychology Publications and Other Works

Background

Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems.

Methods

We surveyed directors of a sample of substance use disorder treatment programs (SUDPs; N=241) and batterer intervention programs (BIPs; N=235) in California (70% response rate) to examine the extent to which SUDPs address IPV, and BIPs address substance abuse.

Results

Generally, SUDPs were not addressing co-occurring IPV perpetration in a formal and comprehensive way. Few had a policy requiring assessment of potential clients, or monitoring of admitted clients, for violence perpetration; almost one-quarter did not admit potential clients who had perpetrated IPV, …