Principals from Knox County's law enforcement community are exploring using a drug that blocks the brain from feeling the effects of opioids as part of their strategy to fight a surging epidemic.
Knox County District Attorney General Charme Allen and representatives from the Knoxville Police Department and Knox County Sheriff's Office traveled last week to Barnstable County, Mass., the Cape Cod area east of Boston. Helen Ross McNabb Center personnel also went.
The groups are considering using a drug called Vivitrol, also called naltrexone, that effectively blocks highly addictive opioids such as OxyContin and heroin. It can be administered as a pill, effective for several days, or through a shot, effective for several weeks to a month.
The drug eliminates the user's craving for opioids. It also has been found to counter alcohol addiction, according to the manufacturer.
Usage has reduced recidivism rates among inmates who get out of jail, Allen said.
"We're collectively as a community trying to come up with anything to try to help kind of curb this opioid problem," Allen said.
The prosecutor, who met with Barnstable inmates in the program and toured the county facilities, argues it's worth pursuing the idea.
"So much of our crime is tied to our drug problem," she said.
The Barnstable County Sheriff's Office incorporates use of Vivitrol as part of its treatment right before drug users are released from jail. They also require convict addicts to participate in treatment and counseling.
"They are currently one of the most successful Vivitrol treatment programs in the country," Allen said.
The office, which won recognition from the White House in 2014 for its work, introduced use of Vivitrol as part of a treatment program in 2012, according to the Sheriff's Office.
Simply using the drug without the reinforcement that comes from counseling won't work, Allen said.
Knox County - all of Tennessee, in fact - is combating a sharp rise in opioid abuse, overdoses and deaths.
The White House drug czar came to Knoxville a couple months ago to review the community's abuse problem. Last month, KPD Chief David Rausch went to the White House as part of an effort to promote the need to address opioid addiction, including more federal money.
So far this year, 142 people have died from suspected overdoses just in Knox County, according to estimates tracked by the Knox County District Attorney General's Office. The death rate has steadily risen in recent years.
Combined, Knoxville police and Rural/Metro personnel administer dozens of shots a week now of a drug called Narcan, or naloxone, that can revive someone who is overdosing on an opioid. KPD officers have been carrying Narcan about a year.
Vivitrol is different. Made by Alkermes Inc., it attaches to opioid receptors in a person's brain and blocks the pleasurable feelings associated with taking opioids, according to the maker.
It's also extremely expensive.
It can cost about $1,200 a shot, according to Allen. Knox County could catch a price break through a medical plan that would lower the price to about $300 a shot.
That's still pricey. Massachusetts has a health care program that can cover Vivitrol. According to the McNabb Center, public money isn't as readily available for patients. Private insurers may cover its use.
"Here, we're going to have to figure out how to pay for those shots," Allen said.
The county has secured some free shots from the maker already, according to the DA.
It's also pursuing a grant to start a pilot program using Vivitrol on addict convicts in the Knox County jail system. It already has secured $15,000 in grant money and hopes to get more to cover the initial cost of therapy and counseling, according to the prosecutor.
Knox County Sheriff Jimmy "J.J." Jones said use of Vivitrol is under "serious consideration" in the jail. The Sheriff's Office would play a primary role in its administration.
Allen said authorities still must figure out how they would conduct a program. In Barnstable County, for example, Sheriff's Office personnel do much of the work themselves.
Knox County might want to go a different route.
Barnstable County authorities also wait until an inmate is about to get out before taking on applicants for their treatment program. In such a focus, the DA's Office isn't as involved. But perhaps if Knox County pursued a program, officials might want to introduce inmates to it earlier in the process, such as before trial, Allen said.
Kurt Rudd of Knoxville is a recovering opioid addict. He began craving and abusing pain pills after getting medicine for surgery. Eventually, he said, he sought out a prostitute on Magnolia Avenue - not for sex, but for guidance on how to find someone who would sell him opioids such as heroin.
Rudd also believes in Vivitrol, which is non-addictive and not habit-forming, in conjunction with counseling. He said he's been taking Vivitrol about 16 months.
He's on his last shot, he said. Once, his opioid addiction threatened to destroy him and his family. In the past, he said, he was a "chronic re-lapser."
Rudd is a champion of Vivitrol, and touts it often when called on to speak to individuals and groups. He works today as a salesman for a printing company and he also is a deliveryman part-time for an area restaurant chain.
He acknowledges the drug is expensive. Private insurance has helped, he said, along with help from doctors to ensure he gets Vivitrol.
Rudd thinks Knox County would do well to try it - along with counseling and treatment - as a way to address opioid drug abuse. It won't fix everything. But it'll help, he said.
"It's not the cure," he said. "You gotta have counseling and you gotta have a recovery program in order to stay clean because you won't go get your shot if it comes down to it."