Tennessee Together Opioid Bill (HB1831) becomes law on July 1, 2018, and seeks to combat the opioid epidemic by limiting the supply and the dosage of opioid prescriptions for new patients, with reasonable exceptions.


Yesterday, during a bill signing ceremony in Maryville, Tenn., Tennessee Gov. Bill Haslam signed into law House Bill #1831 which seeks to combat the opioid epidemic by limiting the supply and the dosage of opioid prescriptions for new patients, with reasonable exceptions. The bill, which becomes law on July 1, 2018, is a direct result of Tennessee Together, a comprehensive plan to end the opioid crisis in Tennessee.


According to the Tennessee Together website, Tennessee Together is a “multi-faceted plan, comprised of legislation, more than $30 million (state and federal funds) through Gov. Haslam’s 2018-19 budget and other executive actions to attack the state’s opioid epidemic through three major components: 1.) Prevention, 2.) Treatment and 3.) Law Enforcement.”


Dr. Stephanie Vanterpool, Director of Comprehensive Pain Services for The University of Tennessee Medical Center (UTMC), Assistant Professor of Anesthesiology at the UT Graduate School of Medicine and the Medical Director for the University Center for Pain Management, serves as one of 19 members across Tennessee selected to serve on Gov. Haslam’s Commission on Pain and Addiction Medicine Education. Vanterpool joined Gov. Haslam today as he signed the Tennessee Together Opioid Bill (HB1831) into law.


Vanterpool explains the Commission on Pain and Addiction Medicine Education was charged with developing competencies to be adopted by all higher learning healthcare institutions in the state to facilitate appropriate understanding, assessment, diagnosis, and treatment of pain and addiction. Vanterpool also collaborated with the TN Department of Health, TN Medical Association, and the TN Pain Society on several initiatives aimed at addressing the opioid crisis, such as the determination of appropriate criteria and measurements for spine and spine surgery episodes of care and the language in the Tennessee Together Opioid Bill (HB1831).


“This new law appropriately limits the initial dose and duration of opioids prescribed for acute pain and for pain after surgery, while still allowing the prescriber to use medical judgment and appropriate documentation to prescribe additional opioids when necessary,” said Vanterpool.


According to Vanterpool, it is important for patients and prescribers to remember that opioids do not target the cause of pain, and therefore, they are not the best medications to use for pain treatment.


“Opioids do, however, have a role in treating certain types of severe or acute pain, particularly when used in combination with other treatments targeted at the cause of the pain,” said Vanterpool.


Vanterpool explains that these duration and dose limits are important because data from the Centers for Disease Control and Prevention (CDC) shows that if a person’s initial exposure to opioids is longer than five days, there is a drastic increase in the chance that the person will still be using opioids one year later.


Vanterpool says that educating prescribers and patients on proper treatment specific to pain management is a critical next step in the practical implementation of the TN Together Opioid Bill, and UTMC has already been proactive in that regard.


“UTMC has been proactive in educating their prescribers on the best ways to fully comply with the new law,” said Vanterpool. “In addition, the medical center continues to champion the movement towards more targeted treatment of pain, both in its acute pain and chronic pain management services.”


Vanterpool recommends that opioids should only be used in combination with other treatments targeted at the identified cause of the pain.


“For too long, the healthcare system and patients have focused on treating a pain score, not the sources,” said Vanterpool. “It’s time to change that focus.”


Vanterpool says that with this new law in place, it will be even more important for prescribers to focus on “treating the source, not the score” when it comes to pain management.


“Educating prescribers and patients on the importance of Targeted Pain Treatment – accurately diagnosing the cause of the pain, and then targeting the treatment to the cause – will be critical in effectively treating pain and improving function and quality of life for our patients,” said Vanterpool.


As part of its continued educational efforts specific to pain management assessment and treatment, Vanterpool says UTMC will be offering a Targeted Pain Treatment Conference on February 1, 2019, in Knoxville. Open to all healthcare professionals in the region, the conference will provide evidence-based sessions on practical steps for identifying and diagnosing causes of pain, medical decision making for prescribing opioids, and other targeted pain treatment initiatives.