Addiction Problems & Community-based Recovery Solutions in Chattanooga, Tennessee
I can afford
To board a Chattanooga choo choo
I’ve got my fare
And just a trifle to spare
~ “Chattanooga Choo Choo” by Mack Gordon and Harry Warren 1941
A listen to this old treasure, one of the Glenn Miller Orchestra’s greatest hits during World War II, seems to hark back to a happier time. But in fact America was at war, many necessities of life were rationed, and families were glued to the radio anxiously listening for news from the parts of Europe where their sons and brothers were posted. Hearing a cheery little ditty like “Chattanooga Choo-Choo” would certainly have lightened the emotional burden of families back home, and may well have put a few smiles on the faces of those sons of Chattanooga who served as soldiers.
Chattanooga could use another ditty like that right about now—to combat the gloomy news as regards deaths to drug overdose.
What It Is
Chattanooga is the county seat of Hamilton County, Tennessee and a major transit hub in southern Appalachia. The population is estimated to be around 167,000. Education levels are close to national average. With a median annual income of at least $10,000 annually below national average annual salary of $55, 322 it’s not surprising that 21% live below the poverty line as compared to national average of 12.7%.
This may be a contributing factor in the fact that many of Chattanooga’s denizens choose crime as a way of supporting themselves. A definite contributing factor is the rise in addictions.
The state of Tennessee has had a rough ride through the opioid epidemic. From 2010 until 2015 more than 6,000 people in the state of Tennessee were reported to have died of a drug overdose. In 2015 alone Tennessee generated more opioid prescriptions than the total population, and the state reported at least 1400 drug overdoses, adding that no one really knew the true number as so many overdose cases don’t get reported as such.
Unreported Cause of Death
An investigation carried out by a USA Today Network found a number of glaring errors in the way deaths are investigated and reported in Tennessee. The study found inconsistencies in the ways medical examiners, law enforcement, and hospitals identified causes of death. In addition there wasn’t room in most county budgets to fund autopsies to determine the cause of death for certain. The cost of an autopsie is usually between $1,600 and $2,000, but some counties are switching to a new payment model—a flat rate based on their population—that allows medical examiners to conduct autopsies whenever an overdose is suspected. In Tennessee autopsies are recommended but not required for deaths where overdose is suspected
The information written in death certificates was often mistaken or incomplete. Many rural areas don’t have access to forensic pathologists who could conduct reliable investigations.
Dr. Adele Lewis, Deputy State Chief Examiner, medical examiners are only part of a big puzzle—a chain of communication beginning with the person who first reports the death, and errors can be made at every stage.
Another drawback is that Tennessee still uses a paper reporting system, whereas most states now use an electronic death registration system that obliges examiners to enter detailed information. State officials are working toward implementing an electronic system in the near future.
But even when autopsies are undertaken, examiners are sometimes at a loss to identify which toxin caused the deaths. Because of an influx of synthetic drugs from China for which no known test has been developed, overdose deaths must sometimes be reported as “toxic substance secondary to addiction.”
A Complex Problem with Deep Roots
According to the U.S. Centers for Disease Control and Prevention for every death there are at least 851 people in various stages of drug abuse and treatment. According to their estimate one in six Tennesseans is either misusing or abusing drugs or in treatment for drug abuse.
Much of the problem can be blamed on an irresponsible pharmaceutical industry and the doctors who carelessly overprescribed the powerful new painkillers. This is how the pills entered the state but many people without prescriptions got the pills from well-meaning frinds and family or simply lifted them from medicine cabinets. When the supply was restricted or simply when prescription holders could no longer afford to pay, they would turn to heroin.
Tennessee has the second highest prescription rate in the country behind West Virginia.
According to the state’s controlled substance monitoring database the following are the most often prescribed:
Prescriptions are now being given in 30-day batches with no refills in order to reduce the overuse. Every time a patient wants more pills they have to return to the doctor for a reassessment. Also people left with medications they no longer need can take them to police stations and some pharmacies for safe disposal. Only 17% of prescription opioid users actually have prescriptions.
The irony of the flood of powerful new piankillers is not simply the trageides left in their wake but alos that in spite of the rampant use and misuse of opioids most patients report that they’re not satisfied with their pain control.
Grave Chemical Dangers
Fentanyl, a prescription drug used to treat intense pain, is now one of biggest dangers on Tennessee streets. The drug is highly addicted and even a tiny amount can be enough to kill, and the drug can even be lethal if absorbed through the skin.
The prevalence of heroin, which entered the gap created by curbing opioid prescriptions, is doubly alarming because of the presence of fentanyl on the streets. Many drug dealers lace heroin with fentanyl and promote the mixture as a great high. Unfortunately it’s often a lethal mix. Fentanyl is also sold as oxycodone when it’s really just a cheap substitute.
A Plethora of Meth Labs
It’s believed that approximately 800 meth labs are operating in Tennessee at one one time, this despite a crackdown by law enforcement and the availability of the drug smuggled in from Mexico. It may be economic need that is compelling people to seek ways of producing enough to feed their own habits as well as support their families.
And the List Goes on...
Cocaine also continues to be a problem.
Even more alarming is the degree to which drugs are mixed, as certain combinations can be lethal.
Heroin is a bigger problem in urban areas and prescription drug abuse more common in rural areas. The increasing number of crimes involving heroin may be in part due to the in surge of the drug when opioid availability was restricted.
Drug Related Crime in Chattanooga
The Tennessee Bureau of Investigation reports that 80% of crimes committed in Tennessee are drug-related.
Gang violence in Chattanooga has been a problem for quite some time, something else that might be attributed to economic difficulties in some quarters and the need of the addict to somehow, legal or not, acquire the funds to feed the habit. The Chattanooga Police Intelligence Unit has stepped up its skills and taken more often to the streets in an effort to track down gang memebrs and curtail their activities. Police are also trying to understand what conditions compel young people to join gangs and to build gang culture, even across generations, through active recruitment.
So What Are They Doing About It?
Hamilton County is has been designated a HIDTA (High Intensity Drug Trafficking Area), which puts it in line to receive special law enforcement funding and other resources from the federal government.
The state government is tackling the problem from a number of directions, including:
- Improving the quality and availability of addiction treatments to reduce the demand for contraband drugs
- Continuing to reduce the number of opioids prescribed
- Facilitating safe disposal of unused drugs
- The Tennessee Prescription Safety Act requires that patients who ask for prescription medications be checked against a database to ensure that patient hasn’t been “doctor-shopping,” i.e. going to several different doctors to be prescribed the same or similar painkillers
- The Tennessee Alliance for Drug Endangered Children (TADEC) began operating in 2006 in response to a number of meth labs running where children were living. With time the number of meth labs in Tennessee was reduced, after which TADEC enlarged its mandate to include serving and protecting children placed in danger by any illegal drug use.
The following are several organizations that serve Chattanooga among other areas in the state to combat drug crimes and addiction:
- The Tennessee Bureau of Investigation (TBI) is an umbrella for the Tennessee Methamphetamine and Pharmaceutical Task Force, which fights the illegal production and distribution of methamphetamine and rescues children from the harmful environments associated with illegal drug manufacturing.
- Project Lazarus began in North Carolinian 2007 as a response to the sharp rise in overdose deaths there. This non-profit created its own model to prevent deaths by rallying and educating communities, enabling them to take responsibility for their health.
- The Hamilton County Sheriff’s Office in Chattanooga uses an array of investigative resources and strategies to battle the drug trade, reduce harm, and educate the public. They work hard to develop productive partnerships with other law enforcement agencies and community organizations. Its Narcotics & Special Operations Division (NSO) has developed an used a program to prevent prescription fraud, targeting every step along the chain that has the power to illegally divert prescription drugs, from manufacturers to pharmacies to health care professionals to fraudulent patients.
The goal of harm reduction initiatives strive is to keep addicts alive and as healthy as possible until they can get the help they need. These programs are controversial because they are seen, at least on the surface, to enable drug use. But it usually only takes having a dear friend or family member die from an overdose to convince a caring citizen that harm reduction may be the only way to keep an addict alive long enough for them to kick the habit.
Naloxone is a drug to be administered in heroin overdose emergencies. This drug effectively blocks the neural receptors that heroin acts on, this preventing the drug from destroying the brain. Chattanooga police and health care professionals are now equipped with this drug to administer during overdose emergencies and are instructing community members on how to use the drug in case they know anyone who may be at risk
The supply of sterile syringes to drug addicts greatly reduces the spread of HIV and AIDS.
Disposing safely of unused medications and used syringes is necessary to public health both to reduce the opportunity to steal opioids and preventing the spread of HIV and AIDS via used needles. Chattanooga police departments and pharmacies provide many opportunities to dispose of these items with no questions asked.
Marijuana in Tennessee
The state of Tennessee takes a hard line on marijuana cultivation, law enforcement long taking strong action to removing all plants for within its borders, with a marked degree of success.
Tennessee has passed legislation allowing the cultivation, sale, and use of marijuana for medical reasons, but only to a limited degree; in fact the state has among the strictest marijuana laws and enforcement practices in the cointry. But a small shop called Grass Roots has just opened in Chattanooga that sells cannabis-based products for healing purposes. Proprietor Elisha Millan was moved to open the business after she lost four friends to opioids and learned that their lives might have been saved had they been able to treat their medical conditions with non-mind-altering cannabidiol (CBD), one of the two main compounds in marijuana (the other is THC, or tetrahydrocannabinol, which causes the psycho active effects).
Drug courts have proven a highly successful alternative to jail time for addicts. If it’s a first offense and a nonviolent drug-related crime the offender may opt to go for addiction treatment. On successful completion of a residential treatment program all charges can be dropped. Hamilton County has a drug court in Chattanooga. Participants are given a handbook explaining the rules and regulations and encouraging them to make every effort to succeed in the hopes that graduating from the program will be the first step in a healthy, addiction-free life. Participants must, for example, submit to routine drug and hair testing to ensure that they’re not still secretly using drugs. They must attend a 12-Step group, find a same sex sponsor, finish GED if they haven’t already, and find honest gainful employment. The program provides participants with any resource necessary to help them become clean and sober for life.
What Can I Expect From Treatment?
First of all, contact us! We’ll be glad to help you find the supports and resources most appropriate to your specific needs.
Recovery involves a number of essential stages. Although each stage my look different in different settings, each recovery facility will need to assess your needs. You will need to go through detox and then a lengthy period of counselling, peer support, and education to help you avoid relapse and live drug-free.
Usually assessment is done by a medical doctor while symptoms of drug abuse are still manifesting, so don’t think you have to get clean to undergo treatment; the doctor needs to see you just as you are in order to determine the extent of your drug abuse and to question you about your health, possible underlying psychological issues, and your history of drug use. This can take up to an hour. The doctor may then send you for a more detailed assessment with another medical professional. You must be seen to be physically stable and of sufficiently sound mind to undergo treatment.
Once you’ve agreed to enter the program or once an intervention has been decided upon you’ll be briefed as to what you can and can’t bring into the favility. You’ll be given constructive life goals. The program will be explained to you in detail.
If you haven’t already gone through detox (detoxification to rid your body of the harmful substances) you’ll need to go through it now, as detox is the essential first steop in the recovery process. No program of treatment can work if drugs are still in your system and you continue to use.
Detox can take anywhere from a few days to a whole month. Some of this is on an inpatient basis but sometimes the latter part is outpatient for those unable to take a break from their responsibilities. The first part of detox involves going through withdrawal under the supervision of a medical professional, sometimes with the help of drugs to ease the withdrawal symptoms, and the second part involves counseling, education, and peer support.
Inpatient treatments come in many forms, from hospital detoxes to long-term healing in residential treatment centers (RTCs). More information on inpatient treatment HERE.
Outpatient treatment refers to treatment programs that don’t require living in the facility 24 hours a day. Intensive outpatient (IOP) treatment is sometimes given to patients who don’t require medical supervision for the withdrawal phase but only a strong network of support with frequent counselling sessions and peer group support.
Outpatient treatment is also used for those who’ve successfully gone through withdrawal from drugs and/or alcohol but still require aid in the form of peer and individual counselling and education. In some cases, and especially if the participant has been in trouble with the law, this also involves routine drug testing.
Aftercare for sober living
Once you’ve lived through an addiction you must remain vigilant against relapse for the rest of your life. But many former addicts report that they feel lucky to have gone through the recovery process in order to find so much meaning in life.
A sober living house is a home you reside in for a period of time in between rehab and going home. You live in a house with other people who are recovering from addiction just like you. You get to socialize with people who aren’t abusing a substance, so you develop the ability to socialize without drinking or abusing a substance. It’s an ideal solution after treatment if you feel too vulnerable to return home. If you don’t have a home to return to, you can live at the sober house and get your life back together. You’re able to work while living at the house and will only have a curfew at first. You have an opportunity to regain your independence with help before setting out on your own again.
Is This You?
IF you or a loved one is tangled up in an addiction that’s destroying or threatening to destroy their body, mind, and relationships, give us a call and we’ll talk about what can be done. Chattanooga has many resources to help addicts recover.
Our greatest glory is, not in never falling, but in rising every time we fall. ~Oliver Goldsmith