A 10-Year Review of Opioid-Related Deaths at West Tennessee Regional Forensic Center: 2007-2017

Prescription opioid deaths have tripled since 1999, and currently opioid overdose kills 115 Americans per day on average (1). Prior to 2014, prescription opioids have been the primary driver of opioid-related mortality. In recent years, the United States has seen a steady decline in the rate of opioid prescription. At the same time, there has been a significant increase in the number of deaths attributed to non-prescription opioids such as heroin, illicitly manufactured fentanyl, and fentanyl analogues. In 2017, among 70,237 drug overdose deaths nationally, 47,600 (67.8%) involved opioids, with increases across age groups, racial/ethnic groups, and county urbanization levels in multiple states (2). The opioid epidemic is especially profound in Tennessee, which had the 3rd highest opioid prescription rate in the country in 2017 and an opioid-related death rate of 19.3 deaths per 100,000 persons, compared to the national average of 14.6 (3). This retrospective study analyzes autopsy data from West Tennessee Regional Forensic Center (WTRFC) from 2007 to 2017 to gain a better understanding of the effects of the opioid epidemic on West Tennessee and the surrounding areas. Data from opioid-related accidents and suicides were analyzed in order to identify trends in race, age, gender, location, types of opioids, and drug combinations involved in opioid-related deaths.

Implementation and Optimization of Telehealth during the COVID-19 Public Health Crisis—Our Journey

Telehealth offered a great opportunity for the clinicians at West Tennessee Healthcare to provide an essential service to the community at large during these unprecedented times. Our telehealth footprint continues to enlarge daily with more clinicians and specialties becoming comfortable with the workflows and technology. The program is described herein. The COVID-19 pandemic tests the ability of many primary care, urgent care, and hospital systems to adapt quickly to new circumstances. In many of these offices, virtual telehealth visits have become a strategy to decrease the use of personal protective equipment, and mitigate the risk of exposure of providers, staff, or patients to the coronavirus, among many other opportunities.1 West Tennessee Healthcare noted these same strong headwinds, as the pandemic and emergency decelerations began to send individuals to continue to reschedule appointments for a multitude of reasons—including fear. West Tennessee Healthcare is located in an underserved area with a lack of access to healthcare in all of our servicing districts. Each of these districts holds a classification of a partial or full healthcare professional shortage area. In our over 40 primary and specialty care clinics, face-to-face visits began to shudder near the end of March with the Tennessee governor’s first social distancing and business step-down regulations. With the foresight of other health systems being impacted by COVID-19, our medical practices were forced into a dilemma to creatively continue to offer quality care, but from a new environment. Prior to this federal and state emergency, our clinics were in the planning stages of creating a telehealth environment but had not completed any medical telehealth visits.

Charles Wright

Charles Wright was born in West Tennessee. During his youth, his father’s work as a civil engineer for the Tennessee Valley Authority required that the family move frequently, first to Corinth, Mississippi, and eventually to three Appalachian locations—Kingsport, Tennessee; Hiwassee Dam, North Carolina; and Oak Ridge, Tennessee. After graduating from Davidson College in 1957, Wright enlisted in the army; while stationed in Italy, he discovered Ezra Pound’s ...