In 2018, Tennessee ranked 3rd in the nation for opioid prescription rates per person and had more than 25,000 fatal and nonfatal overdoses.1 While recognized as a serious statewide issue, rural Appalachian regions have the highest rates of opioid use and overdose in the country.2 Furthermore, East Tennessee suffers from a lack of treatment and recovery services and opioid use disorder (OUD) remains  undertreated.2,3

Telehealth presents an opportunity for improving access to treatment and recovery support for individuals afflicted OUD. The opportunities were highlighted during the COVID-19 pandemic in Tennessee when Governor Bill Lee issued a series of Executive Orders that lessened or eliminated key regulations pertinent to telehealth.4,5,6,7,8 Subsequently, the Tennessee General Assembly passed time-limited legislation related to reimbursement for telehealth services.9 These changes have already had a measurable impact on the use of  telehealth.10 Following the issue of the first of these Executive Orders in mid-March, Blue Cross Blue Shield of Tennessee saw the number of telehealth claims jump to eighteen times the baseline rate during the one month period through mid-April  alone.11

The SMART Policy Network will research and compare state policies regarding telehealth and identify best practices for improving outcomes of Tennesseans with OUD beyond the pandemic. Issues to be explored include coverage and reimbursement for telehealth services, licensure for telehealth providers, and patient safety and security.


1 National Institute on Drug Abuse. Tennessee: Opioid-involved deaths and related harms. Published April 2, 2020. Accessed July 16, 2020.

2 Moody L, Satterwhite E, Bickel WK. Substance use in rural Central Appalachia: Current status and treatment considerations. Rural Ment Health. 2017;41(2):123-135.

3 Understanding the state of opioid use disorder in the RCORP-ETC Region: 2018-2019. Accessed July 17, 2020.

4 Tennessee Executive Order No. 15 (Mar. 19, 2020).

5 Tennessee Executive Order No. 20 (Mar. 26, 2020).

6 Tennessee Executive Order No. 24 (Apr. 4, 2020).

7 Tennessee Executive Order No. 32 (May 1, 2020).

8 Tennessee Executive Order No. 63 (Sep. 29, 2020).

9 Electronic Delivery of Health Care Act of 2020, Tenn. Code Ann. Title 56 § 63-1-155.

10 Sy, S. & Fritz, M. (September 10, 2020). Could the pandemic change addiction medicine for better? Public Broadcasting Services (PBS) News Hour. Retrieved from:

11 Wicklund, E. Tennessee Lawmakers Pass New Telehealth Coverage Law – With Limits. Published August 13, 2020. Accessed September 29, 2020.


Policy Brief

Better Broadband for Better Health

Broadband access is increasingly seen as a “super-determinant” of health, affecting not only healthcare delivery but educational and employment opportunities. When it comes to the treatment of substance use disorder (SUD), telehealth directly addresses the most common access barriers faced by rural patients. However, telehealth is not being utilized in rural areas as much as it could be, due to a lack of broadband internet access and affordability.

Full Text   Download PDF   Play Audio Version read by Jeremy Kourvelas

UPDATE: Public Broadband is Coming to Knoxville

At the end of June, 2021, Knoxville City Council voted in favor of the public broadband plan proposed by Knoxville Utilities Board (KUB).  Over the next ten years, KUB will lay fiber optic cable and begin offering public broadband internet as a fifth utility.

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March 2021

Policy Brief

Telehealth Improves Access to Treatment for Substance Use Disorder

About 400,000 Tennesseans have substance use disorder (SUD). Only 1 in 10 Tennesseans who need treatment for SUD obtain it, mainly due to local provider shortages, long distances between a small number of treatment centers, stigma and cost. Telehealth directly addresses barriers and improves access to care.

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January 2021


Featured Video
Stephen Loyd, MD was featured on the PBS News Hour to discuss how the coronavirus pandemic is changing how addiction medicine can be provided.

September 2020


Telehealth SMART Team

Carole Myers
Carole Myers, PhD
Professor, UT Knoxville College of Nursing and
Associate Professor, UT Knoxville Department of Public Health


Stephen Loyd
Stephen Loyd, MD
Medical Director
Cedar Recovery and Journey Pureth


Jeremy Kourvelas
Jeremy Kourvelas
SMART Policy Network Graduate Research Assistant
UT Knoxville Master of Public Health student


Jennifer Tourville
Jennifer Tourville, DNP, CPNP
Director of Substance Misuse Outreach and Initiatives, UT System
Clinical Assistant Professor, UT Knoxville College of Nursing


Katie Cahill
Katie Cahill, PhD
Associate Director
Howard Baker Jr. Center for Public Policy
UT Knoxville