Blake Farmer

Candidates to be Tennessee's next governor agree on the seriousness of the opioid epidemic and that the state needs a more aggressive response. But there is some conflict on how to attack a pervasive drug problem.

This week, Tennessee's Medicaid program began enforcing a limit on first-time opioid prescriptions. TennCare patients can only get enough pills for five days. Legislative leaders say similar restrictions are in the works to regulate painkiller prescribing for all Tennesseans.

A program to assist desperate parents in rural Tennessee is expanding to DeKalb and half a dozen other counties. The initiative, which is already operating in Putnam and Coffee counties, establishes a two-person support team — a care coordinator and a family support specialist, who is often the parent of a child with a mental health diagnosis.

Medication used to treat opioid addiction has now been blamed as a factor in dozens of overdose deaths in Tennessee. According to data released by the state health department, toxicology reports found buprenorphine played a role in 67 of the 1,600 overdose deaths in 2016.

Tennessee's reluctance to expand Medicaid under the Affordable Care Act is still being blamed for the high number of hospital closures in the state — the most in the U.S. outside of Texas. And this week brings one more. The Decatur County Commission decided to close its only hospital this week, citing the increased taxpayer subsidies.

Tennessee Sen. Lamar Alexander has backed off his demands to add health insurance subsidies for low-income Americans to a year-end spending bill.

Alexander was the co-sponsor of a bipartisan bill that would fund subsidies to insurance companies that offer plans on the marketplace. Another bill addressing Obamacare was co-sponsored by Sen. Susan Collins of Maine.

Tennessee counties are joining the list of entities suing pharmaceutical companies over opioids. Smith County is the first to file suit in federal court. Davidson County is likely to follow after approval by the Metro Council Tuesday night.

Sen. Lamar Alexander acknowledges that the final tax bill set to pass this week will increase health insurance costs for those who use the federal exchanges. But he says his bipartisan bill to stabilize the insurance marketplace will offset the cost increase.

More Tennesseans seem to be buying health insurance through the Affordable Care Act, even though advertising has dropped considerably under the Trump Administration. Open enrollment for 2018 ends Friday at midnight, and the number of applications processed by federally-funded insurance guides — known as navigators — has already surpassed last year. Many enrollees are finding that despite a leap in average price, they are paying less.

Forensic experts say they're alarmed by two drug combinations that recently showed up in the TBI crime lab. One is a mixture of fentanyl and methamphetamine. Another is cocaine, heroin and fentanyl.

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