SMART Initiative - Substance Misuse and Addiction Resource for Tennessee

"If communities want to stay ahead of illicit laboratories, they should test sewage water. Studying untreated allows researchers to detect drug residues and metabolites at extraordinarily low concentrations in what is in effect a community-wide drug test.

Wastewater cannot reveal who used a drug, where it was bought or what household it came from. But it can show that a dangerous substance is present in a community much earlier than , and systems can."

Opinion | There is an earlier opioid alarm than 50 deaths in Tennessee Testing sewage water can help detect synthetic opioids before they kill.

Listen here: https://smartpolicypodcast.buzzsprout.com/2602147/episodes/19275758-12-hard-lessons-richard-j-baum-on-america-s-opioid-crisis

The arc of the is, by now, familiar to most people. Over-prescribing of legal in the late nineties caused escalating numbers of people to develop use disorders. In the 2000s, new prescribing guidelines and controlled substance monitoring went into effect, and the legal supply of opioids rapidly reduced - so quickly that many people with opioid dependence turned to **in to stave off . But that only made the problem much worse. And then by the mid 2010s, and its multitude of analogues hit the scene and overdose deaths exponentially skyrocketed. And then the pandemic hit, and the death toll literally doubled.

Richard J. Baum is one of those few individuals who has had a bird’s eye view of the crisis the whole time.

Baum served in the Office of National Drug Control Policy through six presidential administrations from the late nineties until he became Acting Director under President Trump. This month he joins us to discuss his perspectives.

Baum is now Adjunct Lecturer at Georgetown University, where he is teaching a course based on his comprehensive book, Inside America’s Opioid Crisis, which draws on more than three decades of work on national . In this conversation, we talk about how the crisis unfolded, but focus on the current moment defined by shifting drug trends, unpredictable spikes, a large grey market of unregulated dangerous drugs sold as supplements, and the rise in use even as fentanyl overdoses decline.

Baum has learned a lot from his experience on all aspects of this crisis, like , , and how best to inform the public about the dangers of each new drug threat.

Learn more:
Richard J. Baum: https://richardjbaum.com/
Inside America’s Opioid Crisis: https://richardjbaum.com/book
SMART: www.smart.tennessee.edu

https://smartpolicypodcast.buzzsprout.com/

"A lawsuit filed by the city of against grocery giant Publix, intended to “recover taxpayer money and resources spent to combat the epidemic wreaking havoc on the Nashville community,” has been transferred to the Middle District of Tennessee.

The lawsuit, which has been active since March 21, 2023, under former Mayor John Cooper’s administration, was originally filed in the U.S. District Court for the Northern District of Ohio as part of what’s called a multidistrict litigation suit, a legal proceeding in federal civil suits aimed at reducing the burden on federal district courts....According to the latest filing in the case ordering the transfer of venue, Nashville’s is the only active case remaining in the multidistrict litigation suit.

The original lawsuit claims that Nashville taxpayers have spent tens of millions of dollars and “countless resources” fighting the , and that Publix failed to implement adequate suspicious order monitoring to identify and stop shipments of suspicious orders, and failed to implement adequate policies allowing pharmacists to conduct due diligence prior to dispensing ."

https://www.tennessean.com/story/news/local/davidson/2026/05/26/nashville-lawsuit-publix-opioids/90221442007/?utm_source=tennessean-dailybriefing-strada&utm_medium=email&utm_campaign=dailybriefing-greeting&utm_term=Content%20List%20-%20Stacking%20-%20optimized&utm_content=pnas-nashville-nletter65

"She was astonished to find extensive changes.

Within only a few months, the brain connections in the salience network, which helps target , had multiplied.

“We didn’t expect to see this effect, and we really don’t know what it means,” Shapiro said.

Ozempic and other -1 drugs were initially understood as a metabolism breakthrough: medicines that act like hormones to control hunger, blood sugar and weight. But as researchers probe deeper into how the drugs work, early evidence suggests that GLP-1s may also be reshaping parts of the .
[...]
Scientists are studying GLP-1 drugs — medications that mimic the hormones involved in appetite, blood sugar and digestion — for how they affect not only eating behavior, but also , cognition, neurodegeneration and even motivation and pleasure.
[...]
As evidence has grown that inflammation, metabolism and may be far more connected than scientists once believed, researchers have become intrigued by patients who say GLP-1 drugs appear to ease anxiety, compulsive thinking and emotional distress."

Ozempic may be reshaping the brain, scientists say The research has implications for addictive behaviors and diseases of aging such as Alzheimer’s.

" were exposed to and sickened after arriving at a rural home earlier this week to investigate a possible that left three people dead, officials said Friday.

“Preliminary findings indicate this incident is tied to the exposure to a powdered opioid substance within the home, and on-scene DEA laboratory analysis has confirmed the presence of fentanyl, and -fluorofentanyl, also called P4 fentanyl. It’s a more illicit form or version of fentanyl,” New Mexico State Police Chief Matt Broom told reporters Friday.

The fentanyl was in powder form, police said."

First responders exposed to fentanyl in deadly New Mexico incident, officials say Of the four people found unconscious, two were pronounced dead on the scene and a third died on arrival at the hospital, officials said.

Last week, we shared the official numbers from the Tennessee Department of Health for 2024, showing that Tennessee's reduction in deaths that year was above the national average at a 31.1% decrease. That same year, stays for - both and - also declined, but at a much lower rate of reduction: 10.5% and 21%.

We're keeping more people alive, but is still here.

Drug Overdose Hospital Discharges in Tennessee 2024 | TDH Health Data

"Older men with erectile dysfunction (ED) have an increased risk of , including , , and ***ne, according to a large retrospective study."

This is notable because this same demographic has seen an increase in deaths while most others have seen a decrease over the past two years.

Erectile Dysfunction May Predispose Older Men to Multiple Types of Substance Abuse Significantly higher risk of sedative, opioid, co***ne abuse compared with no ED diagnosis

Powerful and informative film about the Center in the here in .

The Opportunity Within | Addiction Treatment in Jails | Public Screening Version www.theopportunitywithin.org

" is the leading driver of use-related fatalities in America: Each year, frequent or excessive drinking causes approximately 178,000 deaths" - well more than twice that of fatalities.

America's Most Common Drug Problem? Unhealthy Alcohol Use Alcohol is the leading driver of substance use-related fatalities in America: Each year, frequent or excessive drinking causes approximately 178,000 deaths. Excessive alcohol use is common in the United States among people who drink: In 2022, of the 137 million Americans who reported drinking in the...

Last month, the 21st District in held its annual singer-songwriter night featuring multi-award-winning country artists. Proceeds went to benefit the participants in the program, which has successfully served hundreds of locals over the past 25 years.

Recovery Court fundraiser features renowned country artists The 21st District Recovery Court held its annual singer-songwriter night on Tuesday, April 21, which featured multi-award-winning country artists HARDY, The Warren Brothers, and Lady A’s Charles Kelley, who performed