SMART Policy Podcast

On April 18th, 2026, President Trump signed Executive Order 14401, which directs federal agencies to accelerate research into psychedelic medications for the treatment of serious mental illness, including substance use disorder. One of the most prominent substances mentioned in this EO is the alkaloid ibogaine.  As of this podcast episode, ibogaine is a Schedule I controlled substance in the U.S.,...

The arc of the opioid crisis is, by now, familiar to most people. Over-prescribing of legal opioids in the late nineties caused escalating numbers of people to develop use disorders. In the 2000s, new prescribing guidelines and controlled substance monitoring went into effect, and the legal supply of opioids rapidly reduced - so quickly that many people with opioid dependence turned to heroin to s...

There’s been growing attention to a new chemical in the illicit drug supply: N-Propionitrile Chlorphine, also known as cychlorphine.  On top of being more potent than fentanyl, it’s also extremely hard to detect on toxicology tests. Currently, all deaths attributed to cychlorphine have been identified in the East Tennessee region around Knoxville, but experts believe it is in more areas already -...

Something really has changed over the past twenty years, especially in the last ten. Our culture has increasingly come to accept the idea that addiction is a chronic, treatable disease, not a moral failure. Secretary RFK Jr. of the Dept. of Health and Human Services said this almost word-for-word just about a month ago when President Trump signed the Executive Order establishing the Great American...

Ask just about any teacher or parent about what concerns them, and you’ll hear about vaping. According to the Tennessee Dept. of Health, 22% youth admit to vaping, which is a rate more than twice the national average. 22 counties across the state have identified nicotine, tobacco or youth vaping as one of their top health concerns in recent health assessments. An additional 46 counties identify su...

In our last episode, we heard from Andi and Tanner Clements from Uplift Appalachia that churches and communities want to help with recovery, but most don’t feel equipped to take on the challenge. There’s also the persistent fear that they might get things wrong. The Tennessee Lifeline Peer Project, a statewide effort by the Tennessee Department of Mental Health and Substance Abuse Services Office...

This is the kind of dilemma that faces many people in Tennessee: staying in recovery while trying to rebuild a life, but resources are limited and local public transportation is not reliable or readily available. This has been identified in dozens of needs assessments across the state as a major barrier to recovery. This is where many people believe that church can have a massive impact. Andi and...

It is increasingly well understood that the criminal justice system is one of the most significant and valuable intervention points for getting people into recovery. When people are given access to the services they need to enter and maintain recovery, the success stories are common. But providing those resources in jails can be tough, especially in small, rural counties. For one, there are a numb...

West Virginia has been often described as “ground zero” of the opioid epidemic, largely because of the explicit targeting of the state by Purdue Pharma for its aggressive marketing of OxyContin. First Responder Jan Rader, long-time champion in the fight against the overdose crisis and the first woman to serve as Fire Chief in West Virginia, disagrees. At the 2025 Syndemic Summit held in Huntington...

When it comes to any large government program targeting health, social, and cultural issues, there are always concerns that the money won’t be spent well. The opioid settlements are no exception. So when a program involves multiple community partners, a transparent and collaborative decision-making process, and is based on the local data, the rate of success tends to be high. This is what makes Su...

If you’ve ever worked in the field of recovery in East Tennessee, there’s a strong chance you’ve met Trent Coffey, executive director of the Schools Together Allowing No Drugs, or STAND, Coalition in Scott County, TN. And if are connected to Appalachia and use Instagram, TikTok or YouTube, there’s an equally strong chance you’ve encountered his cousin, Andi Marie Tillman, a comedian, actor and mus...

Cannabis, cannabinoids, and cannabimimetics like Delta-8 and THC-P and more are increasingly common across America, including in the state of Tennessee, where we have passed numerous regulations on the industry in recent years. And in states where cannabis has been fully legalized, some products containing Delta-9 THC, the psychoactive ingredient of what is defined in Tennessee state law as mariju...

Small business owners, industry leaders, law enforcement officers, teachers, and even other elected offices like city councilperson - these are some of the most common professions that people have before becoming a county mayor in Tennessee. But it may surprise you that a fair number of our county executives were EMTs, paramedics, or first responders before seeking public office. On the one hand,...

The group of people that are dying of overdoses at the highest rate, by far, are men in their 30s-50s. This group is also statistically less likely than others to ask for help. This is one of the biggest reasons why it can be difficult to implement effective prevention strategies targeting working age men. My guest this month is Dr. Monty Burks, Deputy Director of the Tennessee Governor’s Faith-Ba...

Despite significant changes at the federal and state level, the rate of opioid prescriptions remains startlingly high. The most recent data shows that Tennessee is still hovering around 60 prescriptions for every 100 people in the state. And again, that’s prescriptions, not pills. As such, many patients are still facing the same on-ramp to opioid medications that got stuck in the opioid crisis in...

Overdose Fatality Review, or OFR, is a fairly new and yet already proven strategy for identifying gaps in recovery ecosystems. In other words, you bring together people from healthcare, law enforcement, criminal justice, harm reduction services and more to jointly examine cases of fatal overdoses and find out how these people fell through the cracks. Lauren Savitskas works for the Institute for In...

Late last year, Maury County Commission approved the spending of $920,770 in opioid settlement funding, abating the opioid crisis in their community from multiple angles. But it’s more than just the broad and comprehensive approach that caught our eye at SMART. The formal and transparent procedures of the Maury County Opioid Abatement Committee have made it so that any local resident can follow al...

From 2001-2011, as the prescription opioid crisis spiraled out of control, Kim Harmon, then with Tennessee Bureau of Investigation, went undercover to bust pill mills, among other investigations into medical fraud. Shortly after she progressed up into a new role, however, her daughter Taylor’s own actual struggles with substance use disorder began to spiral out of control, and suddenly this law en...

The data is clear: 18-25 is a critical time for substance use and mental health interventions. This is why programs implemented on college campuses have significant impacts. But that isn’t to say these interventions are easy to launch. My guests this month are Dr. Jessi Gold, Chief Wellness Officer for UT System and Associate Professor of Psychiatry at UT Health Science Center, and Megan McKnight,...

As we’ve discussed many times on this show, the criminal justice system has long since become the primary point of contact for substance use disorder, especially in Tennessee. My guest this month is Eric Bauder, Deputy Chief of Corrections for the Davidson County Sheriff’s Office. While participating in an overdose fatality review team, he learned key details about how people were overdosing short...

There’s no question that over-prescribing of opioids kick-started the opioid crisis - the data is so overwhelming that nearly two dozen major companies have settled lawsuits to the tune of tens of billions of dollars because of that evidence. We’ve since dramatically cut the supply of prescription opioids, so problem solved, right? My guest this month is Dr. Clay Jackson, a chronic pain specialist...

When staff shortages and tight funding meet a rise in drug crime, you might not expect an overburdened police department to make extra work for themselves. Yet that is exactly what happened in Chattanooga in the mid 2010s, when calls to EMS started backing up so severely the cops had to start shouldering more of the response than ever before. Today I’m speaking with Investigator Terry Topping of t...

“How can anyone be doing drugs when we all know fentanyl is in everything?” We at UT SMART hear this question a lot from community leaders across the state. How is it that people keep risking their lives when we know for a fact that drugs are more lethal than ever? Sam Quinones, award winning author of Dreamland and the Least of Us, two books that dive deep into the social and cultural realities o...

A cop, a guitar company, and a public health analyst walk into a bar…and mount an opioid overdose first aid kit to the wall. We have covered the Training and Empowering Musicians to Prevent Overdose, or TEMPO, project before, specifically the effort to get these high tech naloxone kits called ONEboxes into easily accessible locations, where they may be treated no differently than a defibrillator -...

According to the most recent report from the Tennessee Department of Health, two-thirds of all overdose fatalities are men, most of whom are aged 25-54. According to independent research, this group is also far more likely to lack health insurance. My guest this month is Bob Merritt, CEO of Myrtle Recovery Centers in rural Scott County. Drawing on a long career in behavioral healthcare, Mr. Merrit...