Harm reduction in Tennessee: a week of perspectives

This week, This Is Nashville took a deep look into the innovative — and at times controversial — approaches to getting out of the opioid addiction crisis. The latest available data has Tennessee losing 3,600 people a year to fatal drug overdoses.

The numbers in Davidson County are on a downward trend — which is something to celebrate. But it’s unclear how much credit to give tactics known as “harm reduction,” in which people help folks use drugs more safely without necessarily trying to get them to stop. The method is all about saving lives.

Here, you’ll find links to each of the four episodes, as well as an audio feature from each day.

• Monday 9/8/25 — The work of Miriam Field, harm reductionist
• Tuesday 9/9/25 — Sanctioned harm reduction
• Wednesday 9/10/25 — The opioid that’s saving lives in Nashville
• Thursday 9/11/25 — Substance use, survival, recovery and loss call-in

Anyone need Narcan? Save a life.

On the Sept. 9, 2025, episode of This Is Nashville, medical professionals, professors and nonprofits sat down at the mic to talk about sanctioned, legal, harm reduction.

FEATURE: This Is Nashville’s managing editor Tasha AF Lemley went out with Metro Police Sgt. Mike Hotz at a regular service event by People Loving Nashville, as he put overdose reversal drugs into the hands of people who would use it.

Opioid overdoses have been a killer in this city. And one of the harm reduction tactics credited with turning the tide is liberally passing out the overdose reversal drug naloxone. First responders don’t just have it ready to use — ones like Sgt. Hotz are distributing and training folks how to use it.

REFLECTION: And another MNPD officer reflected on the losses he’s seen — and experienced — on his beat.

A welcome MAT

On the Sept. 10, 2025, episode of This Is Nashville, we heard a lot about why mobile Medication Assisted Treatment (MAT) could help in the Nashville area. But in rural Tennessee, it could be the only chance someone has. Tasha A.F. Lemley sat on the porch of an MAT patient who has been doing gymnastics to keep her prescription coming.

FEATURE: Christine Burress lives in rural East Tennessee and, over many years, transitioned from opioid prescriptions to Suboxone that she was purchasing on the street. Now, a virtual medication-assisted treatment doctor is monitoring her health and legally prescribing Suboxone.

Unsanctioned Harm Reduction: In the Field with Miriam

To kick off a week of learning about harm reduction, the Sept. 8, 2025 episode of This Is Nashville featured a longform piece on Miriam Field, an unsanctioned harm reductionist in Middle Tennessee. This is a complicated tale of underground harm reduction and Miriam’s work trying to overcome the stigma of drug use in an effort to keep people alive. She is committed to the idea that saving the lives of people in active drug addiction is more important than trying to get them to stop using. Through her story, we also learn that stigma can do as much damage as drug use itself.

Listen here or on your podcasting app of choice.

“I think most of my patients end up trusting me because I am believing them… part of the struggle that happens with these use disorders is not being able to tell the truth. And when you start being able to tell the truth and someone receives you, it’s healing.”