Overdose Response Coordination Office

High Impact Area Program Overview

The Tennessee Department of Health launched the High Impact Areas (HIA) Program within the Overdose Response Coordination Office (ORCO) to address the burden of SUD in a holistic way. As the name suggests, the program targets the areas of the state most burdened by the overdose epidemic and works with communities to fund and oversee activities aimed at preventing and reducing overdoses. Currently, there are five High Impact Areas covering nine of the 13 public health jurisdictions in Tennessee.

The HIA Program partners with existing agencies and other stakeholders to achieve a more comprehensive, equitable, and locally managed response to SUD in the state. The program oversees 27 projects covering many public health interventions across the continuum of care, from substance use screening and prevention, coordinating overdose monitoring and response efforts, to navigation to treatment and recovery services. These projects are locally owned, chosen, and managed by Substance Misuse Response Coordinators embedded in public health regions and Metros.

HIA Counties include:

West HIA: Shelby County

Middle HIA: Davidson, Montgomery, Cheatham, Rutherford, Wilson, and Dickson

Southeast HIA: Franklin, Grundy, Marion, Sequatchie, Bledsoe, Rhea, Meigs, McMinn, Bradley, Polk, and Hamilton

East HIA: Cocke, Jefferson, Roane, Knox (Knox County is independently funded by an OD2A County-supported grant)

Northeast HIA: Hancock, Hawkins, Greene, Washington, Unicoi, Sullivan, Carter, and Johnson

See regional map details here.

East HIA Service Area, Projects, and Contacts

The East Regional serves 15 counties: Cocke, Jefferson, and Roane. Knox County in the East Region HIA is indedepently supported. The East HIA supports initiatives to reduce overdose deaths and improve substance use disorder outcomes across the region. Programs focus on harm reduction, community education, and collaborative partnerships.

Projects

The East HIA partners with correctional and justice partners, Helen Ross McNabb Center, Choice Health Network, and Local Health Departments in the East Region as well as the East TN Regional Health Office in the following projects:

Overdose Monitoring and Response Plan

The East Region has developed Overdose Monitoring and Response (OMAR) Plans for the HIA, outlining procedures for identifying, monitoring, and addressing overdose spikes or significant changes in overdose patterns. These county-level plans enable effective and timely responses by leveraging data and engaging community partners.

Expanded Syringe Services Programs

In collaboration with Choice Health Network (CHN), the HIA program has expanded SSP services in Cocke County. SSPs provide comprehensive harm reduction services, sterile syringe distribution and disposal, HIV/HCV testing, overdose prevention education, naloxone distribution, and referrals to treatment and social services. See Tennessee’s SSP resources.

Linkage to Care

The East Tennessee Regional Health Office has hired program staff to receive referrals for persons at high risk for overdose to provide education, brief intervention, and linkage to care services. Additionally, the East HIA staffs a RISE (Recovery, Information, Support, and Engagement) Navigator at the Roane County Health Department who meets one-on-one with individuals, offering prevention education and linking clients to services and resources. See the Linkage to Care tab in the left-navigation menu on this webpage.

Multisector Partnerships

A quarterly, multidisciplinary collaborative meeting of community partners, led by the East Tennessee Regional Substance Misuse Response Coordinators, allows for agencies and individuals involved in SUD to share information and report on progress, destigmatization, and overdose mitigation efforts.

Community Outreach, Prevention, and Education

East HIA coordinators work with local coalitions, public health professionals, and community stakeholders to increase awareness about overdose prevention, substance use, and harm reduction strategies. These initiatives include public events, educational campaigns, and facilitating the distribution of resources, including naloxone kits and fentanyl test strips.

Contact

Middle HIA Service Area, Projects, and Contacts

The Middle HIA serves six counties:  Cheatham, Davidson, Dickson, Montgomery, Rutherford, and Wilson. The Middle HIA supports initiatives to reduce overdose deaths and improve substance use disorder outcomes across the region. 

Projects

Middle HIA projects focus on harm reduction, community education, and collaborative partnerships.

Overdose Monitoring and Response Plan

Metro Nashville Public Health Department (MPHD) and Mid-Cumberland Region work together with local stakeholders in each HIA county to establish an Overdose Monitoring and Response (OMAR) Plan to identify, monitor, and address overdose spikes and responses in the community. These plans are specific to each county and include local stakeholders such as Emergency Medical Services, police, public health, and local coalitions.

Multisector Partnerships

MPHD and Mid-Cumberland Region hosts a quarterly stakeholder meeting bringing together individuals from all Middle HIA counties. The purpose of this meeting is to review relevant data, update members on progress in HIA programs, address any programmatic barriers, identify additional stakeholders, and create data-driven action steps.

Community Outreach, Prevention, and Education

Mid-Cumberland’s HIA Coordinator targets communities with increased overdose burden according to data and attends community events and meetings. The coordinator establishes partnerships with public leaders, provides community education on overdose prevention, and shares resources. These meetings include health councils, prevention coalitions, community advisory boards, recovery festivals, and various other events.

Linkage to Care

Mid-Cumberland’s HIA RISE (Recovery, Information, Support, and Engagement) Navigator, located in Wilson County Health Department and Rutherford County Health Department, provides education, brief intervention, case management, and resource referrals for people with substance use disorders. See the Linkage to Care tab in the left-navigation menu on this webpage.

Contact

Ashley Clinard: Regional Substance Misuse Response Coordinator, Mid-Cumberland Regional Office, Ashley.Clinard@tn.gov

Jermonde Bey: RISE Navigator, Wilson County Health Department, Jermonde.Bey@tn.gov

Grace Fendick, MPH: Metro HIA Epidemiologist, Metro Public Health Department, grace.fendick@nashville.gov

Northeast HIA Service Area, Projects, and Contacts

The Northeast Region HIA comprises Carter, Greene, Hancock, Hawkins, Johnson, Unicoi, Sullivan, and Washington Counties. The Northeast HIA implements targeted initiatives to combat the overdose crisis and reduce the impacts of substance use disorder across the region. 

Projects

Overdose Monitoring and Response Plan

The Overdose Monitoring and Response (OMAR) Plan outlines the procedures for identifying, monitoring, and addressing overdose spikes or significant changes in overdose patterns. The county-level plans enable timely responses to overdose events by leveraging data and engaging community partners.

Multisector Partnerships

The Northeast Overdose Response Task Force comprises multisector representation across the region. Meeting bi-monthly, this group reviews regional trends, collaborates on response efforts, and implements targeted initiatives. Sullivan County has also formed its own task force in partnership with the Northeast HIA.

Community Outreach, Prevention, and Education

Northeast HIA works with local coalitions, public health professionals, and community stakeholders to increase awareness about overdose prevention, substance use, and harm reduction strategies. These initiatives include public events, educational campaigns, and facilitating the distribution of resources such as naloxone kits and fentanyl test strips.

Pretrial Diversion Program

In collaboration with the Sullivan County Anti-Drug Coalition (SCAD), the Northeast HIA has developed and implemented a pretrial diversion program for individuals with substance use disorder (SUD) in the justice system. This program is a collective effort involving representatives from jail staff, judicial staff, public defenders, defense attorneys, probation officers, state district attorneys, certified peer recovery specialists, faith-based organizations, mental health professionals, and prevention coalitions.

Currently, the program is active in two criminal courts, four general session courts, and one juvenile court, with ongoing expansion efforts. It offers alternative treatment options in lieu of jail time, with efforts to expand to additional courts and jurisdictions. Referrals come directly from clients, defense attorneys, and judges both inside and outside of court. Participants are screened to determine appropriate treatment and connected to services such as counseling, inpatient treatment, medications for opioid use disorder (MOUD), and peer support.

Corrections Navigation

In partnership with the Insight Alliance in Washington County, the Northeast HIA has implemented a navigation program within the Washington County Detention Center's RESET Program, designed to support individuals in maintaining their recovery. This program includes two OD2A-funded Corrections Navigators, providing re-entry navigation, harm reduction resources, and naloxone access to individuals exiting the detention center.

For more information on the RESET Program please email jenn@insightalliance.org.

Contact

Adam Clark: Northeast HIA Coordinator, Northeast Regional Health Office, adam.clark@tn.gov

Alice McCaffrey: Director, Sullivan County Anti-Drug Coalition, alice@scadcoalition.org

Lisa Christian: Sullivan OMAR Coordinator, Sullivan County Anti-Drug Coalition, lisa@scadcoalition.org

Barbara Hale: Pretrial Diversion Project Coordinator, Sullivan County Anti-Drug Coalition, barbara@scadcoalition.org

Jennifer Berven: Director of Insight Alliance/Correction Navigation, jenn@insightalliance.org

Southeast HIA Service Area, Projects, and Contacts

The Southeast High Impact Area (SE HIA) is jointly comprised of Hamilton County and the surrounding counties served by the Southeast Regional Office (SERO). The 10 SERO counties include Bledsoe, Bradley, Franklin, Grundy, Marion, McMinn, Meigs, Polk, Rhea, and Sequatchie, led by SERO’s Substance Misuse Response Coordinator. Hamilton County Health Department’s Overdose Prevention Program Manager leads the SE HIA on behalf of the Hamilton County/Chattanooga Metro.

Projects

Southeast Regional Office

Overdose Monitoring and Response Plan

The Overdose Monitoring and Response (OMAR) Plan outlines the procedures for identifying, monitoring, and addressing overdose spikes or significant changes in overdose patterns. Local planning enables timely responses to overdose events by leveraging data and engaging community partners.

Multisector Partnerships

The SERO HIA continually engages with multi-sector partners across the region, including public safety/law enforcement, healthcare, faith-based organizations, schools and higher education, mental health, substance use treatment and recovery, nonprofits, community advocates, and the private sector. The SERO HIA plans and implements local responses to overdoses in the region by providing prevention education, harm reduction, and public health outreach. In addition, the SERO currently has a multi-sector task force that actively monitors overdoses and coordinates targeted community responses to unusual or heightened overdose activity within these communities.

Community Outreach, Prevention, and Education

The SERO HIA works with local coalitions, public health professionals, and community stakeholders to increase awareness about overdose prevention, substance use, and harm reduction strategies. These initiatives include education at public events and the distribution of naloxone kits.

STEPS Project

The Southeast Tennessee Emergency Department Protocols for substance use disorder (SUD) or ‘STEPS’ serve 19 hospital Emergency Departments (EDs) through public health outreach. The project aims to support the implementation of best practices in screening for substance use, referrals to treatment and services, peer navigation and recovery services, access to naloxone, and protocols for medications for opioid use disorder (MOUD) in the ED setting. Project partners include the Council for Alcohol and Drug Abuse Services (CADAS) and a Physician Consultant.

Linkage to Care

SERO’s HIA RISE (Recovery, Information, Support, and Engagement) Navigator meets one-on-one with individuals, offering prevention education to reduce the risk of drug overdose while linking clients to a range of substance use services and resources. Navigation is currently available in three counties (McMinn County, Meigs County, and Rhea County), with plans to expand to other counties in the Region.

Hamilton County Health Department

Overdose Monitoring and Response Plan

The Overdose Monitoring and Response (OMAR) Plan outlines the procedures for identifying, monitoring, and addressing overdose spikes or significant changes in overdose patterns. The county-level planning enables timely responses to overdose events by leveraging data and engaging community partners.

Addiction and Dependency Committee

The Hamilton County Health Department’s (HCHD) Addiction and Dependency (A&D) Committee fosters collaboration between stakeholders to increase accessibility to treatment and recovery services within the community. While located in Hamilton County, the A&D Committee’s efforts extend beyond the county level, influencing organizations and providers across the Southeast Region. The committee facilitates critical discussions, shares vital data, and strengthens regional partnerships to enhance response efforts.

Community Outreach, Prevention, and Education

The Hamilton County Overdose Prevention Program prioritizes community and professional collaboration to reduce overdoses through education and outreach efforts. Additionally, the program promotes naloxone access and training through public engagement and health department initiatives. Also, to support data-driven decision-making, the program compiles and distributes comprehensive reports that help to shape effective overdose prevention efforts in Hamilton County.

Contact

West HIA Service Area, Projects, and Contacts

The Shelby County Health Department’s Opioid Response team in Tennessee’s West High Impact Area (HIA) continues to make strides in addressing substance use disorder (SUD), with a focus on opioid use disorder (OUD). West HIA emphasizes harm reduction, data-driven strategies, and community collaboration to improve outcomes and reduce overdose deaths.

Committed to continuous improvement, the West HIA seeks to expand programming and remain responsive to the community's evolving needs. Analysis provides valuable insights to guide the next steps in enhancing effectiveness and ensuring a comprehensive continuum of services. Together, these efforts strengthen support for individuals affected by the opioid crisis and build a more resilient community.

Projects

Overdose Monitoring and Response Plan

The West High Impact Area (HIA) created Overdose Monitoring and Response (OMAR) Plans outlining procedures for identifying, monitoring, and addressing overdose spikes or significant changes in overdose patterns. This county-specific plan establishes rapid and appropriate responses by involving local stakeholders, including Emergency Medical Services, police, public health, and community stakeholders. West HIA is committed to continuous improvement efforts of the OMAR Plan through stakeholder engagement.

Multisector Partnerships

The Shelby County Opioid Response Coalition is a vital force in combating opioid overdoses locally. The multisector coalition comprises individuals with a wide range of experiences, including those who have lived with opioid use, lost loved ones to overdoses, and professionals dedicated to treating individuals with substance use disorders (SUD). Recruiting community partners is an ongoing mission essential to success. The shared goal of reducing opioid-related deaths is accomplished through five key pillars: 1) Data Usage & Integration, 2) Prevention & Education, 3) Treatment & Recovery, 4) First Responders & Law Enforcement, and 5) Harm Reduction.

Expanded Syringe Services Programs

In collaboration with A Betor Way (ABW) and Memphis Area Prevention Coalition (MAPC) the West HIA program has expanded syringe service programs (SSP) in Shelby County. SSPs provide comprehensive harm reduction services, sterile syringe distribution and disposal, HIV/HCV testing, overdose prevention education, naloxone distribution, and referrals to treatment and social services.

Syringe Drug Checking Pilot Program

The West HIA program is building on its existing partnership with A Better Way (ABW) to implement a drug-checking pilot project in Memphis. In collaboration with ABW, the Memphis Shelby Health Department, and the National Institute of Standards and Technology (NIST), this initiative aims to empower people who use drugs (PWUD) by offering drug-checking services. The project involves syringe sample analysis, enabling PWUD to make more informed decisions about the substances they use, which enhances safety. Public health and local officials also stay abreast of local drug trends for overall community safety.

Community Outreach, Prevention, and Education

The West HIA conducts START and STOP events to target communities with a high overdose burden and attends various community events. START (Strategic Team Accessing Recovery and Treatment) events are family-friendly spaces aimed at raising awareness about opioids, substance use disorder (SUD), and recovery resources, helping families start conversations and find support. STOP (Street Team for Overdose Prevention) is an initiative connecting individuals to harm reduction services and treatment options. The program provides outreach and education to prevent overdose fatalities. Through these efforts, West HIA continues its mission to support individuals and families affected by substance use and help communities begin the recovery process.

Naloxone Distribution

West HIA initiated naloxone distribution by placing a vending machine in a clinic located in a high-need area. This service allows participants free and unhindered access to naloxone, a life-saving overdose reversal drug. They also have access to fentanyl test strips, a tool for PWUD to check their drug supply for the presence of fentanyl and make informed decisions. The machine was strategically placed to ensure priority populations who are at increased risk of overdose can easily obtain naloxone, thus reducing overdose-related fatalities in the community. West HIA is exploring the possibility of project expansion by increasing the number of machine locations and increasing the types of harm-reduction materials available in the machine(s).

Linkage to Care

The West’s HIA RISE (Recovery, Information, Support, and Engagement) Navigator located in Memphis Shelby County Health Department provides education, brief intervention, case management, and resource referrals for people with substance use disorders (SUD).

Contact

Overdose Prevention Education

Quiztime

• PREPARING EDUCATORS TO HELP SAVE LIVES: WHAT YOU SHOULD KNOW ABOUT OPIOID USE AND ADOLESCENTS
• Opioid-related overdoses, including prescription pills (e.g., oxycodone, hydrocodone), heroin, and synthetics like fentanyl, are increasing among our adolescents and young adults. School leaders, teachers, coaches, and staff play an integral role in creating safe learning environments for our youth, educating students and families about the dangers of drug use and preventing opioid misuse and addiction, enhancing student wellness to reduce engagement in dangerous behaviors, and being prepared to respond if an opioid overdose occurs on school property or during a school activity.
• Five minutes of your workday could provide you and your colleagues with the knowledge to save a life. This course is designed for school leaders, teachers, athletic directors, coaches, trainers, counselors, school nurses, and all educators who work with adolescents and young adults. Topics include understanding how opioid-naïve adolescents are exposed to opioids, suggestions for non-opioid pain management to prevent these exposures, impact of opioids on the developing adolescent brain and physiology of addiction, interplay of sports injuries, depression/anxiety (about not playing) and opioid misuse strategies for best practice management when treating adolescents with acute painful conditions, the recognition of signs and symptoms of opioid withdrawal plus opioid use disorder in adolescents, how family factors and adverse childhood experiences contribute to opioid misuse in adolescents, and key knowledge about naloxone including when to give it, how to administer, and address concerns about side effects.
• Use the following link to enroll in Quiztime, an educational application developed by Vanderbilt University Medical Center and take this learning opportunity - QuizTime Catalog 2024 Preparing Educators to Help Save Lives: What You Should Know about Opioid Use and Adolescents Part 1 (quiztimehealth.com)
  

Additional Education Resources

Research tells us that adolescence is a critical period for risk of developing substance use disorders as the adolescent brain is not yet fully developed and can be characterized by impulse behaviors and reward-seeking.  Preventing or delaying the onset of substance use among adolescents is an important public health strategy.  

This guide developed by the Partnership to End Addiction is a guide for parents and families to better understand the risks of opioids, to arm themselves with information to spot early use and partner with their children in addressing risky behavior.

 A Comprehensive Resource for Families with a Tenn or Young Adult Struggling with Opioid Use

Botvin LifeSkills Training (LST) is an evidence-based substance abuse and violence prevention program used in schools and communities throughout the US and in 39 countries around the world. LST has been extensively tested and proven to reduce tobacco, alcohol, and illicit drug use by as much as 80%.

 Botvin LifeSkills Training

There are several evidence-based substance use prevention programs, that can be implemented in schools or other settings with youth. 

 BlueprintsPrograms.org to Learn More

Connecting to Care

Many people with Substance Use Disorder (SUD) often come from underserved communities, have low educational attainment and socioeconomic status, and lack access to healthcare. Following the philosophy that there is no wrong door to receive help for SUD, ORCO has developed and expanded Navigation Programs to link people with SUD to the appropriate treatment or social services available in Tennessee. These navigators are in different settings such as hospitals, corrections, and EMS agencies. RISE (Recovery, Information, Support, and Engagement) Navigators are available at select local health departments, see below map for specific locations.

Contacts

Partner & Community SUD Resources

Mental Health and Substance Abuse Services (tn.gov)

Mental health and substance abuse services : The mission of the department of Mental Health and Substance Abuse Services is to create collaborative pathways to resiliency, recovery, and independence for Tennesseans living with mental illness and substance use disorders.

CDC

The CDC is one of the major operating components of the Department of Health and Human Services.  As the nation’s health protection agency, CDC saves lives and protects people from health threats and is a leading agency working to tackle drug overdose in the United States. Learn more about drug overdose response programs of CDC at Drug Overdose | Injury Center | CDC

HIV/STD Program - Sexually-Transmitted Diseases (tn.gov)

Information on TDH's many HIV, AIDS, and STD prevention and care activities in Tennessee, with basic disease facts, information regarding counseling and testing, and infection statistics. Additional information valuable health care professionals includes reporting, treatment, and legal information. 

End the Syndemic

Ending the Syndemic : End the Syndemic Tennessee is a movement to create an integrated plan that addresses HIV, sexually transmitted infections, substance use disorder, and viral hepatitis. End The Syndemic – Many Voices, One Plan (endthesyndemictn.org)

Overdose Response Strategy

The Overdose Response Strategy (ORS) focuses on addressing the opioid crisis through a collaborative effort between public health and public safety agencies. The ORS is a unique initiative that operates nationwide, aiming to reduce overdoses and save lives. The program is supported by major partners such as the Centers for Disease Control and Prevention (CDC), the CDC Foundation, the High Intensity Drug Trafficking Areas (HIDTA) program, and the Office of National Drug Control Policy (ONDCP). ORS Teams include Drug Intelligence Officers and Public Health Analysts working across various states to share information, inform policy, and implement local overdose prevention initiatives. These teams are responsible for analyzing data, coordinating responses, and facilitating communication between stakeholders to enhance the effectiveness of the overdose response efforts. For more information, visit the ORS program page.

TN Together

TN Together is a community engagement website designed to empower Tennesseans to address addiction in their own communities.  Individuals and organizations can learn about activities that are taking place in communities across Tennessee, report success stories and learn about resources. Activities are listed in each of Tennessee’s 95 counties.  See tntogether.com for more information.

Harm Reduction and Syringe Services Programs (SSP)

Syringe Services Programs (SSPs) provide comprehensive harm reduction services including providing free sterile needles, syringes, and other injection equipment; safe disposal containers; HIV and viral hepatitis testing and linkage to treatment; overdose prevention and education; referrals to substance use disorder treatment, medical providers, and social services; and HIV, STIs, and viral hepatitis prevention education.

Office of Informatics and Analytics (OIA)

Since its inception in 2016, OIA has worked steadily to build a robust data infrastructure that guides best practices for data sharing, interoperability, analysis, and reporting for the Tennessee Department of Health (TDH).

Links to Help

Access naloxone from Local Health Departments (limited supply)

Click to access local navigation resources

Find Help Now TN

How to identify signs and symptoms of an overdose 

How to access Naloxone

Good samaritan law and more information from our current page

SAMSHA Treatment Locator

REDLINE: TAADAS website  or call/text 1-800-889-9789

Locate Syringe Service Programs in TN

For printable resources related to overdose prevention, please email ORCO.Group@tn.gov