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Prescription Drug Abuse in Tennessee (Part 4): Fighting Back

October is National Substance Abuse Prevention Month. In order to raise awareness and hopefully, to help victims, we’re partnering with the Metropolitan Drug Commission to bring you a series of articles on prescription drug abuse in Tennessee. Thanks to Karen Pershing for her work with this fine organization and for her contribution to our series. Visit the blog page for the complete series.

Not a New Problem

The issue of substance exposed infants is not a new one. In 2005-2006, the National Center on Substance Abuse and Child Welfare undertook a review and analysis of states’ policies regarding prenatal exposure to alcohol and other drugs. Its purpose was to gain a better understanding of current policy and practice, and to identify opportunities for strengthening efforts in this area.

As a result of this study, five key strategies were identified.

  1. Pre-pregnancy prevention efforts
  2. Screening and assessment in the prenatal period
  3. Testing at birth and notification of Child Protective Services
  4. Provision of services to substance exposed infants and their parents
  5. Referrals to developmental disabilities agencies in order to follow up with the family and ensure needed services were being provided to the exposed infant

Seven years on, we are still fighting to get these strategies implemented. How many lives could have been saved in the meantime? Now, in a state of crisis, we are bringing together the stakeholders to try to address the epidemic of NAS in Tennessee.


In January 2013, The State of Tennessee implemented a reporting mechanism for newborns who exhibit symptoms of NAS. Though this is a step in the right direction, there still is no standard laboratory testing process for all newborns in the state of Tennessee. We have testing for PKU, which affects fewer infants than prenatal substance abuse, but routine laboratory screenings for newborns to detect exposure to dangerous chemicals which could affect the health of these children for years to come, is not occurring.


Testing after the fact is important and we need to identify these children as soon as possible. We also need to be implementing policies related to prevention and intervention prior to the pregnancy and birth of a substance-exposed infant.

All women of childbearing age need to be made aware of the dangers of using substances during pregnancy before they become pregnant. The Metropolitan Drug Commission offers a number of educational opportunities and resources including brochures, posters, and classroom curriculum for both middle and high school students. For more information, visit Metro Drug Coalition.


Any female of childbearing age who is prescribed a controlled substance, such as an opiate, should be screened for past or present issues, whether it is prescription drug abuse or another form of substance abuse, and should be subject to a pregnancy test prior to receiving a prescription. Screening tools have been designed and tested for effectiveness for over a decade. These can be administered during a medical visit in a matter of minutes. While most medical practitioners ask about tobacco and alcohol use, few ask about controlled substances. If these questions are not asked, the conversation never occurs and early signs of substance abuse go unaddressed. Effective forms of birth control should be recommended and prescribed if a female is found to be at risk of substance abuse or is already using substances.

Since the vast majority (approximately 80 percent) of our current Neonatal Abstinence Syndrome births are paid for by the TennCare program, we have an opportunity to require screenings as part of the care delivery system. If substance abuse is suspected or identified through this screening process, laboratory testing can be utilized to determine the substances being used. The confirmatory testing is especially critical if a female is pregnant. The earlier in the pregnancy an issue can be identified, the greater likelihood risk reduction for both the mother and her unborn child can be implemented.

Get Involved
  • For more information on how you can join the fight against NAS and substance abuse in our community, visit Metro Drug Coalition.
  • If you are currently struggling with an addiction and want to get help, visit the GET HELP section on the Metropolitan Drug Commission’s website.
  • If you have lost a loved one to prescription drug abuse or overdose, or if you are caring for a child afflicted with NAS, The Lawyers of Brown & Roberto would like to hear your story, at no cost or obligation to you.

Give us a call at (865) 691-2777 or contact us through our website Brown & Roberto, PLLC to set up a free consultation.

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