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Fentanyl crisis needs 'all hands on deck' approach in Tennessee

Tennessee has struggled with an opioid and drug crisis since 1995 when the FDA first approved Oxycontin for prescription use. About 70% of the 46,000 overdose-related deaths in 2022 involved opioids. This epidemic started because of the Oxycontin and Purdue Pharma scandal in 2016, which resulted in Purdue admitting to marketing opioid drugs that it knew were being diverted to abusers. Some six million Tennesseans became addicted to prescription opioids, and drug distributors began opening a door for illegal drug distribution.

Fentanyl has recently become a dangerous extension of the opioid crisis, causing 463 deaths in Knox County alone in 2022.

“[Distributors] got this new drug called fentanyl, and it's 10 to 50 times more powerful than morphine and heroin,” said Mike Brown, global director for counter-narcotics technology at Rigaku Analytical Devices. “They started selling people fake pills, so people started buying what they thought was a fake Oxycontin, and it was actually a fentanyl pill. Then they became addicted to fentanyl.”

Fentanyl is an extremely addictive synthetic substance. Brown said because Fentanyl is cheaper to make than semi-synthetic substances, distributors of the drugs are “force transitioning” users to this drug for profit. A force transition is when a distributor purposely sells a new drug without disclosing that it's not the user's intended drug.

“They're businessmen. Selling narcotics is a business and that business is done to make millions of dollars," Brown said. "They can invest maybe three or $4,000 in purchasing chemicals and the equipment and can make three or $400,000 in fentanyl profit.”

Brown, formerly with the Drug Enforcement Agency, said drug organizations purchase the powder from drug cartels and press it into pills to sell. They are then able to sell Fentanyl to the Knoxville area. These organizations have grown through East Tennessee, and law enforcement has not been able to keep up.

“As their territory increases, more fentanyl will be sold…so then [TBI] investigative capabilities have to expand. [Do they] have the manpower, the money, the capabilities to do that? As a DEA agent, we’re always lagging behind the drug traffickers because they have the money and capability to expand and evolve faster than law enforcement.”

Brown says parents, medical professionals and government officials need to collaborate.

“This is an all hands on deck situation. Of course law enforcement needs to be involved, but we need harm prevention programs, we need the city health administration, we need parents, and we need the citizens to all get involved. It’s affecting every aspect of our society. Sixty years ago it was people on Skid Row.. now it’s in your neighborhood.”

Campuses like the University of Tennessee are particularly vulnerable.

“Students take Adderall, they take Xanax, they take Percocet, students are on prescription drugs,” he said. “There need to be prevention programs in place that can help students.” According to the Tennessee Department of Mental Health, there were 201 fatal overdoses for people aged 15-24 in 2021 alone. On campus, University of Tennessee Police cites 39 unlawful drug paraphernalia incidents in the last 60 days.

Tennessee Commissioner of Mental Health and Substance Abuse Services Marie Williams said there has been a 40% increase in individuals struggling with drug use in Tennessee since the COVID-19 pandemic. Since 2016, the TBI has collected and disposed of over half-a-million pounds of prescription drugs through the Dangerous Drug Task Force.

“We can all do something to help. Even if addiction isn't your issue, it's probably an issue for someone you know and you love,” said TBI Director David Rausch at a news conference in November. “A problem like this one will take all of us working together.”

Among the TBI’s resources are two Pill Take Back Locations in Knox County, the police station and the University of Tennessee. The Tennessee Department of Health also introduced programs for treatment, harm reduction and social services in East Tennessee. The CDC awarded Tennessee $5.4 million dollars to expand education and resources concerning drug usage in the state.

The Tennessee Opioid Abatement Fund, a settlement fund for those impacted by opioid addiction, will also help address the crisis. Tennessee is set to receive $31.4 million in the first settlement from drugmakers including Johnson & Johnson, Amerisource Bergen and others.

“There isn’t a county in Tennessee that hasn’t been touched by the opioid crisis,” said Stephen Loyd, chairman of the Opioid Abatement Council. “The funding going to these counties will have an immediate and much-needed impact.”

If you or someone you know struggles with opioid addiction, the TBI advises that you call or text REDLINE at 1-800-889-9789.

(This story was co-produced with students from the University of Tennessee's Department of Journalism and Media.)