Tennessee lawmakers have grappled for two years with how to regulate the newest kind of opiate detox drugs — which have their own potential for abuse. They’ve found a compromise with doctors, who didn’t want to make getting help any harder for heroin addicts and pain pill abusers.

One of the difficulties of this debate is that very few legislators have heard the first thing about these drugs, which contain buprenorphine.

Even Sen. Ken Yager, who sponsored
the regulations, struggled to pronounce the word during committee hearings. Suboxone is the more widely known brand name. (It contains the overdose reversal drug
Naloxone, which makes it almost impossible to overdose).

The replacement therapy is in such demand that there’s now a type of business known as a
Suboxone clinic. Often they are just a satellite location where several family physicians band together and see only opiate addicts.

“These storefront Suboxone mills are targeting small towns and rural areas in this state and they’re moving in with little or no regulation,” Yager said on the floor of the state senate.

Yager, who is from Kingsport in northeast Tennessee, says some clinics have hundreds of patients. He argues they become defacto treatment centers, especially in places where opiate addicts abound. And he suspects they may do more harm than good.

The original proposal would have treated these facilities almost like methadone clinics, which have to go through a public process to obtain a Certificate of Need. They often face community resistance,
like this company trying to open in Johnson City.

Doctors lobbied legislators to go lighter on Suboxone, which is considered a much safer alternative to methadone.

“We didn’t want to deter people from treating patients, because we know we have a lot of opiates out there,” said Julie Griffin, lobbyist with the Tennessee Medical Association. “Just because you’re a Suboxone clinic doesn’t mean you’re doing anything wrong.”

If the bill gets final passage in the coming weeks, state health officials will be charged with writing the detailed rules, like requiring these clinics to accept health insurance and making sure the prescriptions are paired with drug counseling.