Even with the availability of naloxone, the opioid overdose antidote, and fewer prescription drugs being diverted, the number of Tennesseans who die each year due to drug overdoses increased again in 2014. The total of overdose deaths rose by nearly 100, from 1,166 in 2013 to a record-setting 1,263 in 2014. If those numbers are hard to comprehend, consider this: more people died from drug overdoses in Tennessee last year than were killed in motor vehicle accidents.

In Rutherford County alone, 35 people died from drug overdoses in 2014.

"If you, a friend or a loved one is at risk for an opioid overdose, talk with your healthcare provider about a very safe antidote that anyone can learn to administer," said TDH Commissioner John Dreyzehner, MD, MPH. "In many opioid overdoses, death can be prevented by administering the drug naloxone, almost immediately reversing the deadly effects of opioids and allowing time to reach further medical treatment.

"Injectable naloxone is approved by the Food and Drug Administration and has been used by emergency responders for years," Dreyzehner continued. "This life-saving 'overdose antidote' can save lives and can prevent a mistake from being deadly or give more people a second chance at recovery instead of death. Ask for it, prescribe it, keep it around; relatively speaking, it is more effective at saving lives than CPR or an AED."

"Abuse and misuse of powerful drugs are having disastrous consequences for not just individuals and their families, but for all Tennesseans," said E. Doug Varney, commissioner of the Tennessee Department of Mental Health and Substance Abuse Services. "The impacts go far beyond overdose deaths; they include costs of emergency department visits, hospital expenses, babies born dependent on drugs their mothers used during pregnancy, children in state custody and costs for legal fees and incarceration. I would encourage everyone to visit the Tennessee Prescription for Success website to learn more about prevention strategies."

While overdose deaths can occur anytime, the most high-risk individuals are those using escalating doses and those using a combination of drugs, such as opioids and benzodiazepines. Overdose deaths aren't confined to any particular area of the state. In fact, 91 of Tennessee's 95 counties had at least one death attributed to a drug overdose, providing evidence of a statewide problem. The only counties not recording a confirmed drug overdose death in the past year were Hancock, Lake, Trousdale and Van Buren, while 28 other counties recorded at least a dozen and three of those, Davidson, Knox and Shelby, each surpassed 100 deaths.

To protect the identities of victims, the Tennessee Department of Health is not releasing data for counties with less than one dozen overdose deaths. Here is a list of confirmed drug overdose deaths for all other counties in 2014:

• Anderson 18
• Blount 21
• Bradley 24
• Campbell 19
• Cheatham 17
• Cocke 12
• Cumberland 16
• Davidson 129
• Dickson 12
• Greene 19
• Hamblen 23
• Hamilton 58
• Hardin 12
• Knox 133
• Loudon 15
• McMinn 13
• Maury 20
• Montgomery 26
• Putnam 21
• Roane 22
• Rutherford 35
• Sevier 18
• Shelby 148
• Sullivan 44
• Sumner 28
• Washington 25
• Williamson 18
• Wilson 26

The 2014 total continues a disturbing trend. Tennessee confirmed drug overdose deaths and incidence rates per 100,000 people for the last four years are:

• 2014 1,263 deaths 19.3 rate
• 2013 1,166 deaths 17.9 rate
• 2012 1,094 deaths 16.9 rate
• 2011 1,062 deaths 16.6 rate

For comparison purposes, here are some other causes of death in Tennessee in 2014:

• Diabetes Mellitus 1,724
• Pneumonia and Influenza 1,599
• Drug Overdoses 1,263
• Discharge of firearms 1,016
• Motor vehicle accidents 989
• Hypertension and Kidney diseases 636

"Emergency responders in Tennessee used naloxone 45 times last year," said TDH Director of Emergency Medical Services Donna Tidwell. "Timely use of naloxone, combined with follow-up medical treatment, can rescue a person who otherwise might be another overdose death."

When a healthcare provider writes a prescription for naloxone, he or she can provide instructions on how the medication should be used. Instructions may vary, depending on the type of system, injectable or nasal spray, or by the supplier of the medication.

In July 2014, Tennessee became the 18th state to pass a "Good Samaritan" law centered on the lifesaving medicine naloxone. Key components of the law include granting immunity from civil suit to providers who prescribe naloxone to a patient, family member, friend or other person in a position to assist giving the medicine naloxone; requiring individuals to receive basic instruction, including taking a quiz and printing the certificate, on how to give naloxone; and granting a "Good Samaritan" civil immunity for administering the medicine to someone he or she reasonably believes is overdosing on an opioid. TDH has information on the law and training available online at http://tn.gov/health/topic/information-for-naloxone.

In all cases when naloxone is administered, it's important to call 911 as quickly as possible because naloxone provides only temporary reversal of an overdose. When first responders arrive, they should be informed naloxone has been administered and they should be given the empty syringe or nasal spray device. This will help greatly with their life-saving efforts.

The overdose victim may experience intense withdrawal and it is important he or she be treated as quickly as possible by healthcare professionals to ensure medical care is continued to save the person's life. If the overdose victim is not treated quickly by healthcare professionals, the victim may die when the temporary effects of naloxone end.