The toll that the opioid crisis has taken in Tennessee is clear.
In 2017, 1,776 people in the state died of drug overdoses. Of those deaths, 1,268 were caused by opioids. From 2013 to 2017, the number of opioid deaths caused by heroin rose by over 300 percent. The number of deaths from fentanyl increased even more, by 800 percent. Then there are the monetary costs. It is estimated that the state suffers $2.5 billion in economic losses each year due to opioids. The statistics are staggering, but the State of Tennessee is fighting back.
At the recent Tennessee Council of Juvenile and Family Court Judges conference in Franklin, judges from all over the state heard how state officials on the front lines of the opioid fight are using their experience and knowledge to help stem the tide of the opioid epidemic. The speakers emphasized the crucial role that judges have to play in the fight against opioids as well and shared with them evidence-based strategies and techniques that they could use to help those suffering from substance use disorder.
One of the officials judges heard from is Dr. Monty Burks. Dr. Burks is the state director of faith-based initiatives with the Tennessee Department of Mental Health & Substance Abuse Services. In that capacity, Burks’s role is to connect faith communities with the behavioral health system.
In pursuit of that goal, Dr. Burks travels across the state, visiting as many of Tennessee’s more than 12,000 religious institutions as he can to help them understand the realities of addiction. No matter where he visits, Dr. Burks finds commonalities in the struggle against opioids.
“I’ve visited with just about every faith we have in Tennessee and every single one of these faiths is suffering from the same problems,” he said.
One of the most important things that Dr. Burks and his team of faith-based community coordinators and Tennessee recovery navigators tries to impart on faith communities is that the longstanding stigma often attached to addiction is scientifically baseless.
Modern science has revealed that “long-term drug use causes a change in the brain’s chemistry that causes a disease similar to hypertension, similar to diabetes,” he said.
This deeper scientific understanding of addiction has profound implications for the way that addiction has sometimes been viewed on a social and person level.
“We want to move away from the language of morality, moral failing,” Dr. Burks said. “When children are born addicted to drugs is that a moral failing? When a person takes their first drink of alcohol and they did not know they had a genetic marker that would make them more susceptible to be addicted to something, does that mean it is a moral failing? Absolutely not.”
Unfortunately, these misconceptions about the nature of substance use disorders can have a stifling impact on a person’s willingness to seek treatment.
“There is so much stigma attached to people with addiction and mental health issues, the last thing many people want to do is go talk to somebody about it because they don’t want people to think they’re weak,” he said.
This stigma can be reinforced unintentionally by something as simple as the language someone uses around these issues.
"John is not a junky or an addict, he’s someone who lives with substance abuse disorder,” Regional Overdose Prevention Specialist Josh Crews said, by way of example. “Sometimes by just our language we drive people further into the hole they are already digging for themselves. We have to change that mindset. We have to understand that this is a disease. It’s something that is treatable. It’s something that we can fight with the right resources in the right place at the right time.”
Will Taylor is someone who is leading that fight. As one of 10 Project Lifeline coordinators in the state, Taylor uses his own personal story to inspire others and reduce the stigma associated with substance use disorder.
“I get to use my story to help individuals who feel trapped and hopeless, like there’s no way out, just like I once did,” Taylor said. “What my team does is work on the community level, we work with the judicial system, we work with recovery courts, we work with safe baby courts, to create a safe space to express physical and emotional pain.”
So far, Project Lifeline has held over 6,000 recovery events in the state. These events are intended to spread the word that “it’s alright to be in recovery,” Taylor said.
Both Dr. Burks and Taylor first entered into treatment via the judicial system.
“It took criminal justice intervention to connect me to treatment,” Dr. Burks told the judges. “Treatment connected me to recovery. That was 19 1/2 years ago. That process is now duplicated, magnified with you. You have the opportunity to take that person who society may have given up on, that person who may have given up on themselves, you have the opportunity to introduce that person to a system that can actually help them.”
Burks left the treatment “program a new person, but it took more than the program to keep me there,” he said. “I needed wraparound community-based services to keep me engaged. Once my brain had the opportunity to clear itself, I needed something else to take its place.”
For Dr. Burks, that meant a rededication to his church community. Given the primacy of religious faith to so many Tennessean’s lives, Dr. Burks has seen that same pattern play out with many others in recovery.
“Faith plays an important and vital role in people finding sobriety,” he said.
That is one of the reasons Dr. Burks thinks it is so essential for judges and others who work in the criminal justice system to seek out new partnerships with community-based organizations. There is also the simple fact, though, that the problem is too large for any one group to conquer.
“There’s never going to be enough courts, there’s never going to be enough government programs to catch everybody that gets in trouble and needs help, but there are always going to be enough community-based partners to do it,” he said. “So we have to target our community-based capacity to help us in our professional capacity.”
The community-based approach can also result in more buy-in from those in need. As Dr. Burks explained, “It’s not that the programs don’t exist, people are sometimes afraid to access the program. No matter how many times you present an access point to a program, if the community is afraid of the program, if the community doesn’t understand the program or you have leadership in the community that doesn’t endorse the program, people are not going to use the programs.”
Having community partners increases the chance that someone with a substance use disorder will feel comfortable making a connection and following through on their path to sobriety.
Henry County General Sessions and Juvenile Court Judge Vicki Snyder has seen how these partnerships and the message spread by people like Burks have had a positive impact in her community.
“All through our county, large congregations and smaller congregations are reaching out and wrapping their arms around people who need help, instead of saying, There’s the person who drinks too much, there’s the person who’s on dope,” she said. “It’s a different mentality. It’s a different mindset.”
More than just a mindset, these partnerships can come with material benefits for those in desperate need.
“This has made a huge difference for us because sometimes this is the only means for finding a bed for somebody” who may really need a safe place to stay, Judge Snyder said.
For those judges wondering how they can get more involved in the fight against opioids, Taylor had several examples, starting with a dedication to being trauma-informed and cognizant of the close relationship between substance abuse and mental illness. On the subject of trauma, those with five or more adverse childhood experiences (ACEs) are seven to 10 times more likely to use illicit drugs, as Crews pointed out. Those with six or more ACEs are 46 times more likely to be I.V. drug users than those with no ACEs.
Taylor said members of his team would be happy to come provide training to judges and judicial staff on these topics.
Taylor also encouraged judges to empower peers in long-term recovery by putting them on staff if possible. “This can be a great asset to the court and the community,” Taylor said.
