CSMD Impacts Prescription Opioid Challenges in Tennessee
(from the Tennessee Department of Health)
Thursday, September 1, 2016

Section: Spotlight Articles, August 2016

It happens thousands of times every day in Tennessee. Healthcare providers securely access critical information to know if a person may be at risk for an overdose, an adverse drug interaction or treatment for a substance use disorder. The information they’re reviewing is within Tennessee’s Controlled Substance Monitoring Database, an online resource that is literally changing lives across the state.

In 2012, with the support of Tennessee's healthcare community, the Tennessee General Assembly passed the Prescription Safety Act of 2012. Its provisions included an effective database of information about prescriptions written for powerful drugs and convenient online access to empower clinicians in their prescribing decisions. The act was proposed by Governor Bill Haslam's public safety sub-cabinet and went fully live in April of 2013. After three years, the act was to sunset if it had not demonstrated success.

"It has proved to be remarkably helpful in our state’s efforts to address our opioid challenges that the nation has now clearly recognized as a national epidemic, resulting in the Act being re-authorized and strengthened in 2016,” said Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH. “Timely, accurate information about our patients is a critical tool for clinicians, and in surveys of healthcare providers about how it is used, we know it has helped provide better and safer care."

Among the significant benefits recorded during the last three years of CSMD usage in Tennessee are:

  • One third of the state’s clinicians report they are now more likely to refer a patient for substance abuse treatment after checking the CSMD.
  • The number of “doctor shoppers” – those who go to multiple healthcare providers seeking a prescription for certain narcotics – has decreased more than 50 percent.
  • The average amount of opioid pain relievers prescribed to those receiving them has decreased by 28 percent.
  • In the last three years, there has been a reduction of more than two billion morphine milligram equivalents prescribed across the state – and every county in the state has recorded a decrease from the 2013 prescribed amounts.

“The CSMD is a great tool to help clinicians and patients make the best decisions when considering treatment options,” said TDH Chief Medical Officer David Reagan, MD, PhD. “After reviewing a patient’s history and knowing what has been previously prescribed, a clinician may recognize a need to consider other treatment options. For many patients, simply prescribing more opioid pain medicine will do more harm than good, and other approaches need to be considered, such as using several types of therapy, including physical therapy, lifestyle adjustments, behavioral therapy, and non-opioid medicines. Sometimes it is best to refer the patient to a pain medicine specialist for further evaluation. The CSMD helps the patient and the prescriber to make good decisions about the wisdom of using powerful but risky opioid pain medications.”

“The CSMD has certainly made a positive difference in how healthcare providers now work with patients requesting pain relief,” said Tennessee Department of Mental Health and Substance Abuse Services Commissioner E. Doug Varney. “It’s helping more people live healthier lives, free from the unintended dependence on opioid pain medicines. We encourage all Tennesseans to have conversations with their healthcare providers about alternatives to opioids.”

The Tennessee Department of Mental Health and Substance Abuse Services funds a toll-free information and referral line for those seeking assistance with addictions. Administered by the Tennessee Association of Alcohol, Drug and other Addiction Services, the Tennessee REDLINE -- 1-800-889-9789 – provides guidance and encouragement to people in all counties of the state.

To learn more about the Tennessee Redline, visit 

To learn more about Tennessee’s Controlled Substance Monitoring Database, visit http://tn.gov/health/article/CSMD-about

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