What is We C.A.R.E.?

Mission Statement: to purposefully create and foster relationships to engage our community in ending the opioid epidemic.

We C.AR.E. is a group of concerned community members of Rutherford County. The strength of We C.A.R.E. is the many different backgrounds and experiences of the members.

Community: Engage and coordinate everyone willing to help with prevention and recovery efforts related to ending the opioid epidemic
Alternatives: Champion and promote prevention, treatments, devices, and alternative choices to opioids
Relationships: Reduce stigma and remove barriers to improve access to treatment for those with opioid use disorder
Education: Educate the community, providers, and law makers about opioid use disorder and strategies to end the epidemic

We C.A.R.E. holds monthly meetings at 12 p.m. on the 2nd Tuesday of each month in the McDonald Conference Room of St. Thomas Rutherford Hospital. The meetings are open to the community and all are welcome to join us.

We C.A.R.E. is a committee of the Prevention Coalition for Success, Inc., a 501(c)3 non-profit organization.

About Opioids and the Epidemic

Opioids are a class of drug that includes prescription pain relievers (oxycodone, hydrocodone, codeine, morphine, and others), heroin, and fentanyl.

In 2018, an opioid overdose resulted in the death of 1,304 Tennesseans. 68 of these deaths occurred in Rutherford County.

https://www.tn.gov/opioids.html

For information about the epidemic:

TN Together

A comprehensive plan and set

of resources from the State of

TN to address the opioid crisis.

tn.gov/opioids

For current state and

county statistics, visit the data

dashboard:

tn.gov/health/health-program-

areas/pdo/pdo/data-dashboard

National Institue on Drug

Abuse

Opioids

drugabuse.gov/drugs-

abuse/opioidseducareprograms.org

The Sycamore Institute

An independent, nonpartisan public

policy research center for Tennessee

sycamoreinstitutetn.org

Substance abuse information:

sycamoreinstitutetn.org/opioid-

epidemic-tn-indicators/

TN Department of Health’s

Faces of Opioids

Sharing stories from Tennesseans

TN.gov/tnfacesofopioids

Substance Use Disorder

If use of a substance such as alcohol or drugs causes negative health effects or causes problems at home, work, or school, this may be substance use disorder. Substance use disorder can be mild, moderate, or severe.

Severe substance use disorder is also known as addiction. A main characteristic of addiction is continued use of the substance despite harmful consequences.

The latest science describes addiction as a brain disease because use of a substance changes the circuits in the brain that regulate reward, stress, and self-control. Correcting these ‘rewired’ circuits takes a time even after stopping use of the substance.

The continuum of care for substance use disorder starts with prevention followed by treatment then recovery.

What is Addiction?

The American Psychiatric

Association

psychiatry.org/patients-

families/addiction/what-is-

addictionpc4s.org

The National Institute on

Drug Abuse

Resource for addiction science

drugabuse.gov

U.S. National Library of

Medicine

Substance Use Disorder

medlineplus.gov

Substance Abuse and

Mental Health Services

Association (SAMHSA)

Agency within the U.S. Dept. of

Health and Human Services

leading the public health effort

to advance behavioral health.

samhsa.gov

Prevention

The best method to prevent substance use disorder is to prevent the initial use of the substance.

Prevention is any activity aimed at avoiding substance abuse and reducing social and health consequences.

Prevention takes place in different forms and settings. Here are a few examples:

Awareness campaigns and educational events increase knowledge about the risk of substance abuse
Supporting parents including tips for talking to their children about the risk of substance abuse.
After-school activities to support youth with positive peer groups and role models
Prevention efforts aimed at root causes of substance abuse such as trauma, adverse childhood experiences, and resiliency.
Drug take-back events remove addictive medications from the environment. To properly dispose of unused medications at any time, locations of permanent drop boxes in Rutherford County are on the flyer below:

For more information about prevention:

Prevention Coalition for

Success, Inc.

A non-profit organization with a

goal to make Rutherford County

healthier by preventing

prescription drug abuse, alcohol

abuse, and tobacco use in

youth and young adults.

pc4s.org

TN Department of Mental

Health and Substance

Abuse Services

Prevention information

including a best practice guide

and substance abuse

prevention coalitions across the

state.

tn.gov/behavioral-

health/substance-abuse-

services/prevention.html

Community Anti-Drug

Coalitions

of America (CADCA)

A non-profit committed to creating

safe, healthy, and drug free

communities globally.

cadca.org

Addiction Policy Forum

What is Prevention?

addictionpolicy.org/what-

is-prevention

Risk and protective factors

addictionpolicy.org/risk-and-

protective-factors

Building Strong Brains

Learn about adverse childhood

experiences, brain

development, and early

childhood from the TN

Commission on Children and

Youth.

tn.gov/tccy/tccy-aces

Trauma Informed Approach

Trauma informed approach

learning community including a

short video from The National

Council for Behavioral Health

thenationalcouncil.org

Count It! Lock It! Drop It!

Prescription drug take-back program.

countitlockitdropit.org

DEA Drug Take-Back

National drug take-back days

address a critical public health

and safety issue.

takebackday.dea.gov

Blueprints for Health Youth

Development

Evidence based programs for a

variety of populations and

settings.

blueprintsprograms.org/

Substance Abuse and

Mental Health Services

Association (SAMHSA)

Screening, Brief Intervention,

Referral to Treatment (SBIRT)

samhsa.gov/sbirt

Students Taking a Right

Stand (STARS)

A Nashville based non-profit

providing evidence-based

programming to over 160

school and community sites in

Middle Tennessee.

starsnashville.org/

TN Together: Ending the

Opioid Crisis

Opioid related resources and

community solutions to an ongoing

crisis. Get involved by completing

activities and posting success

stories.

tntogether.com

Resilience: Build Skills to

Endure Hardship

Information about resiliency

from the Mayo Clinic including

‘A Very Happy Brain’ video.

mayoclinic.org

Tennessee Suicide

Prevention Network (TSPN)

Eliminating the stigma of

suicide.

A resource for suicide

prevention training and

information.

tspn.org

Treatment

There are different treatment options for substance use disorder. Treatment should include counselling or behavioral therapy. Medication Assisted Treatment (MAT) is often used to treat severe substance use disorder involving an opioid. It is important to talk to your doctor and your treatment provider to develop a treatment plan.

Addiction is a chronic disease and relapse may occur. Relapse is not moral failure or lack of will-power. Relapse may mean that more treatment or a different type of treatment is needed.

Navigating the treatment process can be confusing and overwhelming. Here is some of the language you might encounter when discussing treatment:

Detox – Detoxification; the medical treatment of the physical effects of withdrawing from a substance
Residential treatment – longer term, in-patient treatment
Partial Hospitalization Program (PHP) – intensive clinical services lasting all day for weeks provided in an outpatient setting; a step below in intensity from residential treatment
Intensive Outpatient Program (IOP) – clinical services lasting several hours per day on several days per week; a step below in intensity from partial hospitalization programs
Medication-Assisted Treatment (MAT) – use of a medication to treat substance use disorder; for opioids, this may include buprenorphine, methadone, or naltrexone
Recovery residences – alcohol and drug free living facilities often providing temporary housing during treatment; also called sober living houses

These definitions are from the Recovery Research Institute. The link to this resource is below.

For more information:

Center on Addiction

Glossary of Addiction Terms

centeronaddiction.org/addiction/glossary

Recovery Research

Institute

Addictionary

recoveryanswers.org/addiction-ary/

American Society for

Addiction Medicine

A professional medical society

for physicians in the field of

addiction medicine

www.asam.org

Tennessee Association of

Alcohol, Drug, and other

Addiction Services (TAADAS)

taadas.org

Recovery

Even though the terms treatment and recovery are often used simultaneously, these are two different concepts.

There are multiple definitions of recovery. The Substance Abuse and Mental Health Services Administration (SAMHSA) describes recovery as a “process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.” Health, home, purpose, and community are four dimensions involved in recovery.

The Recovery Research Institute’s Addictionary defines recovery as “the process of improved physical, psychological, and social well-being and health after having suffered from a substance use disorder.”

It is important to support those in recovery. Support from friends, family, support groups, behavioral health services, and the faith community are all support systems that can help sustain recovery.

For more information:

Substance Abuse and

Mental Health Services

Association (SAMHSA)

Agency within the U.S. Dept. of

Health and Human Services

Recovery Month

recoverymonth.gov

Dept. of Health and Human

Services (HHS)

Recovery Resources and Tools

hhs.gov/opioids/recovery/recovery-

resources-tools/index.html

Recovery Within Reach

Recovery information including

information for Certified Peer

Recovery Specialist

recoverywithinreach.org

Faces and Voices of

Recovery

Supporting individuals in long-

term recovery including

support of the national recovery

movement and fighting the

stigma addiction.

facesandvoicesofrecovery.org

Recovery Research

Institute

A non-profit research institute

of Massachusetts General

Hospital, an affiliate of Harvard

Medical School, dedicated to

the advancement of addiction

treatment and recovery.

recoveryanswers.org

Tennessee Dept. of Mental

Health and Substance

Abuse Services Faith-Based

Initiative

Leveraging caring individuals

and faith communities as a

means to help address addiction

in our state.

tn.gov/behavioral-

health/substance-abuse-

services/faith-based-

initiatives.html

Harm Reduction

According to the Tennessee Department of Mental Health and Substance Abuse Services, harm reduction is a way of preventing disease and promoting health that meets people where they are rather than making judgments about where they should be. Scientifically- proven ways of mitigating risk associated with use are essential. This includes the distribution of the lifesaving opioid overdose antidote Naloxone.

Syringe exchange programs are another example of harm reduction. Harm Reduction International includes non-abstinence based housing and employment as examples of harm reduction.

The TN Department of Mental Health and Substance Abuse Services Regional Overdose Prevention program offers naloxone training sessions. Attendees receive a free kit with two doses of Narcan, the nasal spray version of Naloxone. For more information about these training sessions, contact:

Sarah Murfree, director of the Prevention Coalition for Success at smurfree@pc4s.org

Trey Dees, the Regional Overdose Prevention Specialist for Rutherford County at tdees@wcadctn.org

For more information:

Tennessee Dept. of Mental

Health and Substance

Abuse Services Regional

Overdose Prevention

Specialist (ROPS)

Providing training on opioids,

opioid overdose prevention, and

supplying Naloxone.

tn.gov/behavioral-

health/substance-abuse-

services/prevention/prevention

/rops.html

Harm Reduction

International

An international, non-

governmental organization

hri.global

Street Works

A non-profit organization

providing free, confidential HIV

testing and services to Nashville

and Middle Tennessee.

streetworks.org

Nashville Cares

A non-profit with a mission to

end the HIV/AIDS epidemic in

Middle Tennessee.

nashvillecares.org

Substance Abuse and

Mental Health Services

Association (SAMHSA)

What is Naloxone?

samhsa.gov/medication-

assisted-treatment/

treatment/naloxone

National Institute on Drug

Abuse

Opioid Overdose Reversal with

Naloxone

drugabuse.gov/related-

topics/opioid-overdose-

reversal-naloxone-narcan-evzio

Neonatal Abstinence Syndrome

According to the University of Rochester’s Medical Center health encyclopedia, neonatal abstinence syndrome (NAS) happens when babies are exposed to drugs, including opioids, in the womb before birth.