By Jerry Vagnier


Overlooked amid the understandable focus on the coronavirus over the past year has been the alarming rise in opioid use and, tragically, deaths from overdoses. Here in East Tennessee, we are witnessing what the CDC tells us is happening across the country: opioids are exacting a devastating toll on our communities.


The numbers are stark. After the pandemic hit in March 2020, overdose deaths spiked to record levels, and then gathered even more momentum. Between February and May of last year, monthly overdose deaths grew by 50 percent to more than 9,000, driven by opioid-related fatalities. As a perspective, prior to 2020, overdose-related deaths in the country had never topped 6,300 per month. The final national death toll for the year could approach 100,000.


The rate of overall drug-related deaths in Tennessee (not just from opioids) – 22 deaths for every 100,000 residents – has almost doubled in the past dozen years, according to America’s Health Rankings.


The McNabb Center staff at The University of Tennessee Medical Center see the faces behind such numbers. Within our emergency rooms, we encounter our friends, neighbors and loved ones whose addiction to painkillers has put their lives at risk. Opioids know no zip code and can indiscriminately grip anyone. The people whom we see struggling to confront their conditions are the same ones that you see at church or on the sidelines of your child’s ballgame or behind you in line at the post office. Addictions can start innocently enough from a doctor or dentist visit and quickly descend to the point where the drugs consume every part of a person’s life.


There are significant challenges in treating opioid addiction, and what we have learned over time is that the most effective treatment does not begin with medical intervention. Before we can introduce the idea of a path to recovery, first must come the forging of a relationship with the patient, a relationship that must be built on trust. Only then can we begin to make real progress in a healthier direction.


Understanding this reality is the premise behind a pioneering program at the McNabb Center that is setting new standards in the treatment of opioid addiction. We have introduced readily available peer support specialists, a team of onsite counselors whose own first-hand experiences and specialized training help to construct trusted bonds with patients struggling with addiction. The program is being supported by a $1.05 million grant to the McNabb Center from the United Health Foundation.


Past medical efforts to engage with emergency room patients continually met with frustration.  Historically, most opioid-addicted patients are reluctant to consider any treatment that does not involve the continued administration of opioids, despite their attendant risks. Remember, what these patients know to be true is that opioids provide desperate relief to their chronic pain, even though these very drugs had just landed them in the hospital and put their life in jeopardy. It is the very definition of addiction.


But peer support specialists have been able to break through to these patients, time and time again.  Often applying the realities of their own personal experiences with addiction, peer support specialists have the expertise and ability to engage patients at the bedside, and these interventions have been met with unprecedented, groundbreaking success, exceeding all expectations. In fact, we are seeing levels of patient response in one month what we had anticipated seeing in an entire year. Over the next year, we expect to engage with some 250 patients, with as many as 100 of them transitioning to an outpatient or residential treatment program.


We call this patient engagement program Hope United, reflecting the collaborative approach toward giving patients a renewed outlook for the future. And the initiative is not confined to the emergency room setting. Hospital staff and peer support specialists maintain follow-up contact with patients, helping to assure they are moving toward a path to recovery and providing assistance in navigating the often-complex network of services. We also are actively working through our programs in several East Tennessee counties to help people before they reach crisis – to provide mental health and substance abuse counseling, social and victim services.


The program serves people struggling with addiction, but also works to build relationships among community partners and reduce the stigma often associated with substance use disorders. Because of the strong partnership between the McNabb Center and UTMC, we are able to help more people in need. This relationship is integral in the success of the Hope United and will help thousands of East Tennessee residents and their families take advantage of some of the nation’s most effective and compassionate treatments for drug addiction.


As too many people continue struggling with opioid addiction in our community and country, more organizations must consider incorporating peer support specialists in interventions and treatment plans. The experience and empathy peers bring makes recovery seem more attainable, and perhaps most importantly, inspires hope.



Jerry Vagnier is a Licensed Clinical Social Worker and CEO of the McNabb Center. Vagnier joined the McNabb Center in 1988 as a children and youth therapist and has served in multiple roles for the organization. Vagnier can be reached at