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MORNING
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July 31, 2016
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johnsoncitypress.com
Tri-Cities, Tennessee
the
opioid
war
$1.50
Regions history
not favorable to
methadone clinics
By Nathan Baker
nbaker@johnsoncitypress.com
WEATHER/2A
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the
opioid
war
A proposed
opioid addiction treatment clinic
would use a
multipronged
approach
health officials say is
rare. Page
2A
By Jessica Fuller
Press Staff Writer
jfuller@johnsoncitypress.com
DEATHS/4A, 6A
JOHNSON CITY
Irene Chase Bryant
Naomi Katherine Zeoli
KINGSPORT
Steven Andrew (Andy) Hale
THERES
MORE
LIMESTONE
Pamela Block
Doris J. Ramsey
YOU LIKE US
Two visions
Tennessees
medical
director of
substance
abuse services understands the
pain of
addiction.
He should.
He was once
an addict
himself.
Page 2A
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clinic.
Later that year, Kingsports
Planning Commission and
Board of Mayor and
Aldermen scrambled to put
a new, more restrictive
zoning ordinance in place
when
Dallas-based
Behavioral Health Group
moved to open a methadone
facility in a vacant restaurant near John B. Dennis
Highway.
The city board approved
an emergency ordinance
boxing methadone clinics
and substance abuse facilities into M-2 (general industrial) districts and prohibited them from operating
within 1,000 feet of schools,
day care facilities, parks,
religious buildings, hospitals, mortuaries, establishments selling alcohol, public
recreation facilities and residential dwellings.
Then-state Rep. Tony
Shipley,
R-Kingsport,
encouraged Sullivan County
to enact similar regulations,
saying It strikes me this
program substitutes one
addiction for another. Might
it be possible (the people in
the program) introduce
another illegal substance
into
the
community?
according to Kingsport
Times-News reports from
the time.
Shipley later said there
would be a fight in the
streets against the clinic
and the zoning amendment
was a shot across their
bow.
The clinics backers then
withdrew their proposal for
the facility and vacated their
lease for the property.
Taking the advice of the
state legislator, the same
month the Kingsport methadone clinic application was
withdrawn, the Sullivan
County Regional Planning
Commission
restricted
clinics to general industrial
districts and the Sullivan
County
Commission
approved
a
resolution
opposing methadone clinics
and other nuisance businesses within the borders of
Sullivan County.
Ten years after the first
failed clinics application,
Tri-Cities Holding LLC
applied in early 2013 for a
state certificate of need to
build a methadone clinic at 4
Wesley Court in Johnson
City.
Part-owner Steve Kester
said the company reviewed
50 possible sites before
choosing Wesley Court, a
property that met the zoning
district and distance requirements of the citys code.
Were the antidote to drug
addiction, not the contributor to it, Kester said while
making his case to local
leaders.
After a resolution from
Washington County commissioners
unanimously
opposing the facility and an
overwhelming showing of
opposition from local residents at a public hearing for
the clinic, the state Health
Services and Development
Agency denied the clinics
certificate of need.
Tri-Cities Holdings filed
suit twice, first in Davidson
County Court, then in U.S.
District Court in Greeneville,
claiming the citys zoning
regulations were too restric-
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August 1, 2016
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johnsoncitypress.com
Methadone
Its neat
because
people do
actually get
better. You
get to
witness
them get
their life
back.
Dr. Jana Burson
Stepping Stone
of Boone
the
opioid
war
Exploring East
Tennessees battle
with the pain
of painkillers
By Zach Vance
zvance@johnsoncitypress.com
tcasey@johnsoncitypress.com
On Tuesday, classrooms
across Johnson City will be
filled with excitement, anxiety, confidence and emotion
its the first day of classes
for the Johnson City Schools
district.
Some of the teachers
leading those classes have
been through many first
days, but many others will
be doing it for the first time.
Debra Bentley, the systems supervisor of instruction and communication,
said about 60 new educators
will begin working in
Johnson Citys schools. Some
of those are interim teachers
and others are accepting
full-time positions within
the schools.
I would say, historically,
we have about 50 to 60 new
educators
each
year,
Bentley said. Last year, we
had about 50 and had a
smaller number of retirees.
We never know until we get
through June.
Over the course of the
summer, a teachers situation can change. They might
retire, transfer to another
district, follow a spouse to a
See SCHOOL, Page 8A
It hit me that I
had to change
Man says addiction treatment with
buprenorphine has saved his life
By Zach Vance
zvance@johnsoncitypress.com
Contributed
Misty
Smith
clearly
remembers the moment she
walked into a buprenorphine
clinic, fell to her knees and
begged doctors to admit her
husband, Darrell Smith, into
treatment.
The year was 2008, and
Misty was expecting her
second child.
Darrell had spent two
ggray@johnsoncitypress.com
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Another
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Its back to
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75 cents
By Tony Casey
A fine
line separates
methadones
treatment
attributes and
its deadly
nature.
The difference between
appropriate prescribed doses and
dangerous doses
of methadone is
small, the Centers
for Disease Control
has published on its
website.
Methadone was
first synthesized 77
years ago, but the
substitute medication is still perceived
in contrasting ways by
the public.
Whether deemed a
savior or a monstrosity,
its undeniable that methadone use has increased
over the past 15 years.
And a gain in popularity
means an increase in overdoses and diversion.
According to the CDC,
six times as many people
died of methadone overdoses in 2009 as did a
decade before.
Approximately 15,500 people
died in 2009 from overdoses,
and the CDC says methadone
played a central role in the
See METHADONE, Page 8A
Homestead destined
for new role/4A
Tri-Cities, Tennessee
Medicine or drug?
Inside the dual world of
It can free
an addict
from the
grip of
opioids ...
but it also
plays an
outsized
role in
overdose
epidemic
Log by
log
Chuck Branham/
The Evening News/Via AP
A plastic cup
holds a dose of
methadone at an
Indiana clinic.
ABOUT
THIS SERIES
While epidemic prescription drug abuse
has long been a concern in Northeast
Tennessee, the issue
took the spotlight this
year when Mountain
States Health Alliance
and East Tennessee
State University proposed to
establish
a substance
abuse
clinic in
Gray. The
proposal generated tremendous concern
among Gray residents
about safety issues
associated with methadone treatment. With
state and local authorization pending, the
Johnson City Press has
developed a five-day
series of articles discussing the proposal,
the challenges of
opioid addiction, legal
implications and treatment options.
Coming Tuesday: Law
enforcement and
courts.
Coming Wednesday:
Pain clinics and pharmacies.
Coming Thursday:
Impact on local agencies and the future of
the proposal.
the
opioid
war
DEATHS/3A
JOHNSON CITY
Virginia Jenny (Mama C)
Collins
Sharron Verran Butler
ELIZABETHTON
Harold Dean Matherly
Kingsport looking
at murals to help
beautify city/3A
In Johnson
City, about
60 new
teachers
will join
veterans to
welcome
students
Sherry
Cockerham
Incoming
students hear
stark numbers
on rape, abuse
By Tony Casey
tcasey@johnsoncitypress.com
To an auditorium filled
with
incoming
East
Tennessee State University
freshmen and their parents
Friday
morning,
Kate
Emmerich used the scheduled key conversations
time slot to address one of
the most important issues
facing college campuses
today.
Sexual awareness was
the topic, but the talk
included many things,
including sexual misconduct
Its not
this tiny,
minute
issue that
were
putting a
lot of
resources
and time
into.
Kate Emmerich
YOU LIKE US
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Johnson City
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Tri-Cities, Tennessee
the
opioid
war
The courts
75 cents
JOHNSON CITY
SCHOOLS
Exploring East
Tennessees battle
with the pain
of painkillers
By Becky Campbell
bcampbell@johnsoncitypress.com
Arrests, legislation, prescribing guidelines, prosecution, drug court are all components used to attack a drug
epidemic that has the nation,
including Tennessee and specifically Upper East
Tennessee, in its tight and
deadly grip.
Opioids and the addiction
they can cause can be a never-ending cycle of pain, prescriptions, arrests and prosecution. It starts out innocently enough as a pain medication prescription for a
broken bone, toothache, surgery or injury of any type.
The patient begins to depend
heavily on that medication
and seeks it out from their
doctor. If they cant get it
there, they might resort to
the streets even the dark
route of heroin because its
cheaper and if theyre
unable to afford the illicit
prescription medication or
illegal heroin, they could
delve down the road of crime
to fund their habit.
Opioids had a big hold on addicts
long before healthcare providers
and lawmakers knew what was
happening, possibly due to its pre-
Schools Superintendent
Dr. Richard Bales said
this will be his last year
at the helm of the city
school system.
Bales
to leave
after
this year
By Tony Casey
tcasey@johnsoncitypress.com
Drug Court
phases
bcampbell@johnsoncitypress.com
Phase I
(3-6 months)
n Intensive outpatient
counseling or outpatient
treatment
n Probation meetings, up
to three times a week
n Multiple drug screen/
testing search per week
n Daily self-help (NA, AA)
n Appear in Drug Court
each Friday
Phase II
(3-6 months)
n Counseling sessions/
relapse prevention
n Probation meetings
n Random drug screens
n Self-help meetings (NA
and AA)
n Attend Recovery Court
each Friday
n Employment, school or
community service work
Phase III
(3-6 months)
n Counseling sessions
as recommended
n Probation meetings
n Random drug screens
n Self-help meetings
n Attend Recovery Court
each Friday
n Employment, school or
community service work
Phase IV
(Up to one year)
n Counseling sessions
as recommended
n Probation meetings
(step down)
n Random drug screens
(step down)
n Self-help meetings
(step down)
n Attend Recovery Court
every other week
n Employment, school or
community service work
ABOUT THIS
SERIES
While epidemic
prescription drug
abuse has long been
a concern in
Northeast Tennessee,
the issue took the
spotlight this year
when Mountain
States Health Alliance
and East Tennessee
State University
proposed to establish
a substance abuse
clinic in Gray. The
proposal generated
tremendous concern
among Gray residents
about safety issues
associated with
methadone
treatment. With state
and local
authorization pending,
the Johnson City
Press has developed
a five-day series of
articles discussing the
proposal, the
challenges of opioid
addiction, legal
implications and
treatment options.
Coming Wednesday:
Pain clinics and
pharmacies. Coming
Thursday: Impact on
local agencies and
the future of the
proposal.
bcampbell@johnsoncitypress.com
embroiled in an
opiate
addiction
after a back injury
several years ago,
according to information gleaned from
documents filed in
U.S. District Court
in
Greeneville.
Hendrix came upon
Hendrix
a direct supply when
he found Resolutions
HealthCare and Weight Loss, a
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a teacher.
The board voted to bring
in the Tennessee School
Board Association into the
process of finding Bales
replacement.
For much of his time in
that role, Ron Dykes was
his peer as director of the
Washington County School
System,
until
Dykes
announced his retirement
in May 2015. Dykes was
replaced in his position by
Kimber Halliburton on July
1.
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TONIGHT
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CORRECTION
The Johnson City Press
strives for accuracy in all
its reports. Readers who
notice factual errors in the
newspaper should call
News Editor Sam Watson or
Night Editor Robert Pierce
at 929-3111.
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KID'S WEATHER
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drug, and eventually began
writing opioid prescriptions
for others including Hendix
and one of his employees,
Robert Stanton II.
With all that was going
on in her life, the moment
that she used the drug she
was euphoric and she felt
that she could handle her
crumbling marriage and
the excessive amount of
work and school she had
planed
on
her
own
shoulders, Smith wrote. It
began with a half pill a day,
then two pills a day, then
five and finally 20 to 30 pills
a day after the death of her
husband in July 2013.
Barnetts guard was down
and the ugly face of
addiction was staring right
at her.
She knew she was in
trouble and she began to
search for a way out, even
using Narcan, an opiate
antidote, to help herself
withdraw. She realized the
clinic was an obstacle to her
recovery, but it was the only
way she had to support her
children, and threats from
her fellow addicts and friends
and their pleas of being dope
sick was a significant barrier
to her taking more decisive
action, Smith said.
But when the Tennessee
Bureau of Investigation
came knocking on Aug. 19,
2014, Barnett apparently
took the opportunity to
escape the pressure of her
fellow dope addicts and
seek recovery, Smith said.
She closed the clinic that
very day and ended up
hospitalized two days after
passing
out
due
to
hypertension. She remained
in the hospital for two
weeks, which allowed the
opiates to leave her system.
The two weeks away
from the drugs gave her the
first clarity from her
addicted state and she knew
that she needed help, Smith
said. Barnett reached out to
TnPAP, the Tennessee
Professional
Assistance
Program,
that
assists
impaired
healthcare
professionals rehabilitate
from addiction and facilitate
their safe return to practice.
After three months of
sobriety, Barnett obtained
employment at an area
hospital
as
a
nurse
practitioner, but lost that job
in May 2015 when the state
Board of Nursing put her
license on probation for two
years. Through friends who
knew her non-addict self,
Barnett was able to get a job
at another area hospital as an
RN. She began volunteering
to help others recover from
addiction.
At the one-year mark of
her sobriety, Barnett learned
shed been indicted in federal
court on the drug distribution
charges. Again, she lost her
job but eventually found
work as a case manager in a
recovery clinic. Her nursing
and nurse practitioner
licenses expired. She has
remained under supervision
in the TnPAP and completed
numerous
educational
requirements, a psychiatric
evaluation, continued to
attend two 12-step meetings
each week and is subject to
random drug tests.
As of May 31 the date
of Smiths filing the
sentencing memorandum
document Barnett had 19
clean drug tests from
TnPAP and four clean drug
tests from U.S. Probation.
Most of these actions were
initiated by and completed
long before Sherry was
indicted.
After
her
indictment, she has continued
her recovery, Smith said.
But during Barnetts
struggle with her addiction,
she aided others in theirs as
well, including Hendrix.
Through the words of
friends and relatives, by
means of 11 letters of
support filed in federal
court on Hendrixs behalf,
the story of his addiction
reads like so many others.
Hendrixs introduction to
opioids apparently occurred
after injuring his back in a
water-skiing accident, for
which he was legally
prescribed painkillers to aid
in his recovery. He, like
millions of other Americans
who obtained that first
prescription through innocent
means, became addicted to
the drugs and could not
function without them.
A single father of two girls,
Hendrix has been a fixture in
the community since opening
his first restaurant, Rockys
Pizza, in Jonesborough, in
1996. Since then, two more
stores opened. Hendrix was
always involved in community
events and donated to various
organizations, churches and
schools in the areas his
restaurants served. His family
maintains the restaurants now
and continues the things he
started.
Hendrixs arrest in the
opioid conspiracy was his
first brush with law
enforcement, but it proved
to be a hard one.
In the U.S. Attorneys filing
regarding
Hendrixs
sentencing, it stated a
sufficiently punitive sentence
is necessary to promote
respect for the law. Hendrixs
behavior in the instant case
demonstrates a lack of respect
for the law. His crimes were
not limited to obtaining a few
unlawful prescriptions over a
short period of time; rather,
he obtained hundreds of them
over approximately three
years.
Prosecutors had sought a
9- to 11-year sentence for
Hendrix. U.S. District Judge
Ronnie Greer opted for 78
months, or 6 years. He must
compete 500 hours of
substance abuse treatment
while in prison.
In April, Stanton was
sentenced to six years, which
will be followed by three
years of supervision. He
must compete 500 hours of
substance abuse treatment
while in prison, and the court
recommended
Stanton
receive credit for his
participation in that program.
Barnetts
sentencing
hearing is set for Sept. 28.
Prosecutors have asked for
a sentence of 70 to 87
months.
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Tri-Cities, Tennessee
75 cents
the
New laws cut opioid Incomplete?
war
Board
cant
clinic numbers
WASHINGTON COUNTY BOARD OF EDUCATION
By David Floyd
dfloyd@johnsoncitypress.com
With new
database
and tougher
guidelines,
number of
Tennessee
pain clinics
has fallen by
nearly a third
Exploring East
Tennessees battle
with the pain
of painkillers
select new
school site
jfuller@johnsoncitypress.com
Beyond medication: A
shift to multi-modal care
dfloyd@johnsoncitypress.com
The
number of
pain clinics
per county,
as of July
21.
0-1
2-4
5-9
10-15
16-28
ABOUT
THIS SERIES
While epidemic prescription drug abuse has
long been a concern in
Northeast Tennessee,
the issue
took the
spotlight
this year
when
Mountain
States Health Alliance
and East Tennessee
State University proposed to establish a
substance abuse clinic
in Gray. The proposal
generated tremendous
concern among Gray
residents about safety
issues associated with
methadone treatment.
With authorization
pending, the Johnson
City Press has developed a five-day series of
articles discussing the
proposal, the challenges
of opioid addiction, legal
implications and treatment options.
Thursday: Impact on
local agencies and the
future of the proposal.
the
opioid
war
By Tony Casey
WWW
85
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68
By Tony Casey
tcasey@johnsoncitypress.com
High
A file photo
shows customers at the
Noli food
truck. Owner
Jason Howze
said the
trailer, taken
last week,
was recovered Tuesday
in Mars Hill,
North
Carolina.
tcasey@johnsoncitypress.com
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YOU LIKE US
Deana Morganstern
Johnson City
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From Page 1A
Numerous pharmacies in
Northeast Tennessee have
been robbed in recent years,
not just for cash, but for the
controlled substances themselves.
Drug-seeking robbers hit
five Johnson City Walgreens
stores in a six-month period
beginning last summer.
Some have been armed,
demanding
prescription
drugs from the pharmacists
at gunpoint. In some cases, a
robber leapt over the counter
to obtain drugs. In one incident, a pharmacy technician
was clubbed with a gun.
In an earlier incident, a
robber fired a shot into the
ceiling of Bevins Pharmacy
and demanded Oxycodone
and Oxymorphone. Police
charged 24-year-old Andrew
Ryan Givens with the robbery four months later.
Police say one repeat
offender struck pharmacies
in Kingsport and Johnson
City,
alleging
that
Christopher J. Fox struck
the same Kingsport pharmacy in May and August of
2015 before robbing a
Johnson City location the following October. Each time,
he demanded drugs.
And in November 2014, a
Johnson City pharmacy robbery led to a police standoff
that ended when the robber
took his own life. Anthony
Eugene Goad, 46, 2421
Clearview Dr., Johnson City,
died outside his vehicle at
Blakemore
Circle
and
Mayfield Drive after police
pursued him after the robbery at Val-U-Pharmacy on
West Market Street.
Police said Goad had
forced employees inside the
pharmacy to lie on the floor
while he took narcotics.
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LAWS
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CORRECTIONS
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for accuracy in all its reports.
Readers who notice factual errors
in the newspaper should call News
Editor Sam Watson or Night Editor
Robert Pierce at 929-3111.
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GOOD
MORNING
Thursday
August 4, 2016
Globetrotter
Name that
park
And now...
Volume 95 - No. 342
Rezoning
request for
proposed
Gray drug
addiction
treatment
clinic goes
before
Planning
Commission
Aug. 9
johnsoncitypress.com
By Zach Vance
zvance@johnsoncitypress.com
East
Tennessee
State
University and Mountain States
Health Alliance are pursuing a
February 2017 date for their proposed addiction treatment clinic
at Gray Commons Circle to be
completed.
But potential hurdles remain.
Before the clinic can open, the
Johnson
City
Planning
Commission and City Commission
must approve a rezoning request,
and the Tennessee Health
Services and Development
Agency will have to approve the
clinics certificate of need application.
The rezoning request will be
heard Aug. 9 during the Planning
Commissions next meeting. If
approved, the request will
be sent in ordinance form
to the City Commission for
consideration on three
readings.
The clinics certificate of
need application would
then be heard by the HSDA
Board on Aug. 24 in
Nashville.
Well have our attorneys there. I mean thats
the real deal. Thats where
the decision is going to be
made, said Alan Levine,
CEO of Mountain States.
During the CON meeting,
Mountain States and ETSU
will have the opportunity
to make a short presentation on why they believe
the Tri-Cities region needs
an addiction treatment clinic, and
how the CON application meets
the necessary criteria for being
approved.
The 11-member board will then
ask questions of the applicant,
any supporting party or opposing
See REZONING, Page 6A
Jessica Fuller/
Johnson City Press
THERES
MORE
By Zach Vance
Administration.
They have such a long history
zvance@johnsoncitypress.com
and they are so effective for pain
management when used propAs opioid overdose deaths rise, erly, Batson said. I dont think,
a growing stigma can obscure the realistically speaking, that we
medicinal benefits of
say they would
We have to be could
the pain medication.
be eliminated from
But is doing without
judicious and pain control.
opioid prescriptions
Batson said there is
you dont
having a patient
no doubt that opioids
live without some- necessarily need
have legitimate uses,
thing to douse the
especially
when
Lortabs
to
treat
excruciating pain
cancer
worth extinguishing kidney stones or treating
patients and as an
the addiction?
an abscess. end-of-life treatment.
Dr. Jim Batson,
There are defichairman
of
the Dr. Anastasia Brown
Tennessee Medical Association nitely legitimate uses (for opiBoard of Trustees, doesnt believe oids), Batson said.
Opioids are likely to remain a
opioids will ever be withdrawn by
the U.S. Food and Drug
See PROTOCOLS, Page 6A
By Nathan Baker
nbaker@johnsoncitypress.com
A patients daily
dose of methadone is dispensed
into a small cup
to be taken orally.
ABOUT
THIS SERIES
Olive
Advocates: TennCare
rules slowing response
Assistant News Editor
Exploring East
Tennessees battle
with the pain
of painkillers
the
opioid
war
Mullican
expansion
a go, with
200 jobs
75 cents
Tri-Cities, Tennessee
Brown
states response to a public health epidemic and unequally impacting the wellbeing of low income residents.
In 2005, amid pressure from lawmakers and a drastic purge of TennCare
rolls, Tennessees Medicaid program
stopped covering methadone as a treatment for drug dependency for those 21
and older.
Under the programs rules, the drug
can be used to treat chronic pain, but its
on the non-preferred list, meaning the
See TENNCARE, Page 2A
While epidemic
prescription drug
abuse has long been a
concern in Northeast
Tennessee, the issue
took the spotlight this
year when
Mountain
States
Health
Alliance
and East
Tennessee State
University proposed to
establish a substance
abuse clinic in Gray.
The proposal
generated tremendous
concern among Gray
residents about safety
issues associated with
methadone treatment.
With authorization
pending, the Johnson
City Press has
developed a five-day
series of articles
discussing the
proposal, the
challenges of opioid
addiction, legal
implications and
treatment options.
the
opioid
war
Expanded
Manna House
concept draws
lawmakers eyes
By Zach Vance
zvance@johnsoncitypress.com
WEATHER/2A
WWW
High
85
Low
68
DEATHS/3A
JOHNSON CITY
James A. Southerland
ERWIN
Janice Crowder Cox
Dollie Mae Simmons
UNICOI
Raymond Tolley
SULLIVAN GARDENS
Betty Harvey
Republican
frustrations with
Trump mount/7A
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TENNCARE
From Page 1A
NASHVILLE With no
statewide positions on the
Tennessee primary ballot on
Thursday, much of the attention this election season has
focused on congressional
and state legislative races.
An open congressional
seat in western Tennessee
attracted a bakers dozen of
candidates to enter the fray
for the Republican nomination, while U.S. Reps. Scott
DesJarlais and Diane Black
are trying to fend off primary challenges from GOP
candidates who are trying to
Re-Elect
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C O N S TA B L E
1st District
Lifelong resident of
Washington County
(USPS276-320)
Published Daily and Sunday except
Christmas Day, December 25, by
Johnson City Publishing Corporation,
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POSTMASTER: Please send address
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PROTOCOLS
From Page 1A
HOUSE
From Page 1A
ulty
affairs
at
East
Tennessee State Universitys
Department of Internal
Medicine, said the curriculum has been updated with
more pain management and
pain therapy education.
In fact, Olive also said
ETSU will soon implement
CDCs new opioid guidelines
into the medical programs
curriculum.
Olive said a student going
through ETSUs medical
program would have had
less opioid addiction education than today.
There would be much
less emphasis on problems
related to opioid abuse
and say prescribing than
there is today, Olive said.
Olive said students first
begin learning about prescribing
medications,
including opioids, during
their second year in medical
school, before gaining firsthand experience during a
third-year clerkship.
Virtually all of our thirdyear clerkships include
issues on pain management
in patients, Olive said.
Olive said ETSUs location
gives medical students the
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