Themes and ideas from participant table discussions at 2018 summit


  • Need for better coordination of not just treatment but all efforts to address substance misuse
  • Consider utilizing hub and spoke model, where a recovery resource center serves as the central source for addiction treatment services in the community, directing those in need to treatment options and helping coordinate other services, such as housing and transportation


  • Need for coordinated system to access care (potentially addressed by hub and spoke model discussed above)
  • Transportation options/support
  • Access to treatment
  • Lack of payment for adequate treatment; both insured and uninsured have limitations on days, type, etc.
  • Wrap-around services (case management, mental health services, housing, education, legal and other needs-based services, etc.) happening, but not enough or not well-coordinated


  • Employers’ willingness to hire those with history of addiction or incarceration


  • Availability of/access to affordable housing


  • Insurance reform:
    • Increase payment for alternative therapies for pain (physical therapy, acupuncture, etc.)
    • Increase length of treatment for addiction that is covered
    • Change costs for pain medications (i.e., make a five-day supply a lower co-pay than a 30- or 90-day supply)
  • Expand TennCare or make a substance misuse or mental health diagnosis a qualifier for TennCare


  • More funding for primary prevention efforts, preventing drug misuse before it starts (examples of programs can be found here and here)
  • Address difficulty in staying ahead of drug and prevention trends; often the response and/or availability of funding occurs well after an epidemic has been identified
  • Need to mitigate adverse childhood events (ACE), negative childhood experiences (abuse, neglect, etc.) that have a tremendous impact on lifelong health and opportunity, including the child’s risk for future drug misuse
  • Support families
  • End generational cycles of addiction


  • Continue community education to reduce stigma by emphasizing addiction is a disease, not a moral failing as people are more likely to seek treatment/help if they aren’t ashamed of their addiction
  • More education to parents, athletic directors and coaches
  • Reduce stigma of medication assisted therapy (MAT)
  • Promote better understanding among agencies/elected officials/community of best practices to address epidemic
  • Work with universities and colleges to educate future health care workers about addiction

Criminal Justice System

  • Criminal justice reform – treat vs. incarcerate low-level offenders
  • Consider implementing model such as Delancey Street Project


  • Increase engagement and coordination with churches and faith-based organizations

Data Sharing

  • More coordination needed among agencies/organizations

2018 summit outcomes and next steps

The 2018 Mayors’ Summit: A Community Discussion on Substance Misuse was a first step toward developing a communitywide strategic plan to reduce non-fatal overdoses and overdose deaths in our community. That said, many agencies and organizations are taking steps now, in addition to helping with the development of a strategic plan, to help address this epidemic.

Below are just a few of the current efforts by Knox County, the City of Knoxville, Knox County Health Department (KCHD), Metro Drug Coalition (MDC) and the Knox County District Attorney General’s Office. Please note, many other organizations are working to address this issue as well, but that work is not captured here. Next steps include:

  1. Development of this website
  2. Increase opportunities/effort to remove pills from homes and the community
    • Explore distributing medication deactivation packs
    • Increase the number of permanent medication disposal sites throughout the county
  3. Repurpose a KCHD position to oversee the long-term, community strategic plan; this employee, the substance misuse response coordinator, is:
    • Working closely with MDC
    • Serving as a resource for the community on best/evidence-based practices
    • Facilitating the development of a communitywide strategic plan
    • Identifying gaps and working with community partners to address issues/needs
  4. Explore partnership between KCHD and a local hospital, funded by the Centers for Disease Control and Prevention (CDC) and Appalachia HIDTA, to create a standard protocol for treating overdoses in the emergency department
  5. Review KCHD policies and protocols to determine what best practices could be implemented in its clinics to help address the epidemic
  6. Lead by example by comparing current Knox County and City of Knoxville employee policies/benefits to best practices, including:
    • Review benefits to see if/how well alternative treatments for pain are funded and how well addiction treatment is covered
    • Develop a recovery-friendly workplace policy
    • Educate staff about:
      • Opiates and risk of addiction
      • Identifying addiction
    • Determine if staff need:
      • Lock boxes for medications
      • Medication deactivation pouches
    • Explore hosting an employee take-back event
  7. The City of Knoxville will be developing space on outlining the work of the Knoxville Police Department and the Knoxville Fire Department, as well as other efforts in the community.

About Us

All4Knox is a joint effort of Knox County and the City of Knoxville with facilitation and coordination support from Metro Drug Coalition, the Knox County District Attorney General’s Office and Knox County Health Department. Our hope is to bring together our governments, businesses, nonprofit organizations, faith-based communities and many others in a coordinated fashion to address the substance misuse epidemic.