Stacey McKenna, a resident senior fellow at the R Street Institute, provided testimony to the Tennessee Senate Health and Welfare Committee in support of Senate Bill 1848. The bill aims to reduce barriers for patients seeking buprenorphine treatment for opioid use disorder (OUD).
McKenna stated, “OUD is a complex, often recurring health challenge that requires access to a comprehensive continuum of evidence-based, individualized treatment options, including low-barrier access to gold standard medications like buprenorphine. This is why SB 1848 is of special interest to us.”
Tennessee currently has the highest rate of OUD diagnoses among insured individuals in the United States, with nearly 1,500 cases per 100,000 people—almost three times higher than the national average. Despite some progress in expanding access to treatment in recent years, more than 1,500 Tennesseans died from opioid overdoses last year.
The economic impact on Tennessee is significant as well. Each case of OUD costs the state an estimated $808,000 annually.
Medications approved by the FDA for opioid use disorder (MOUD), such as buprenorphine, are considered highly effective in reducing health and social harms related to OUD. Buprenorphine acts as a partial opioid antagonist and has been shown to lower overdose risk by over 60 percent while decreasing illicit drug use and criminal activity.
However, Tennessee maintains stricter regulations on buprenorphine compared to federal guidelines. Only 835 clinicians in the state can prescribe it, and current rules restrict certain formulations and require supervised administration by a limited set of providers. SB 1848 would expand the pool of clinicians able to administer these medications.
McKenna explained that similar regulatory requirements for methadone force patients into daily clinic visits—sometimes requiring commutes of 45 minutes or more—which can disrupt employment and family responsibilities. She said that while SB 1848 does not eliminate all in-person dosing requirements for mono-buprenorphine products, it would make medication more accessible across the state: “This would help overcome some of these barriers by making the medication more widely available—which is likely to be especially beneficial to rural residents.”
She also noted that current law prevents most OUD patients from accessing mono-buprenorphine products unless they meet narrow criteria. According to McKenna: “By allowing clinicians to offer mono-buprenorphine products to those patients they think would benefit—rather than those the government has deemed candidates—SB 1848 puts medical decision-making back in the hands of experts.”
In closing her testimony McKenna said: “Expanding access and reducing barriers to evidence-based treatment for OUD would save Tennesseans’ lives, improve quality of life, increase community wellbeing and safety, and reduce costs to taxpayers. SB 1848 is an important step toward doing just that. Therefore, we urge you to vote in favor of SB 1848.”
