Tennessee has over 400 licensed substance abuse treatment facilities and recorded approximately 3,500 drug overdose deaths in 2023. The state has been among the hardest hit by the opioid epidemic, particularly in rural East Tennessee and urban areas like Memphis and Nashville. The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) oversees the state's publicly funded behavioral health system.
Substance Abuse Statistics in Tennessee
According to NSDUH data, approximately 7.8% of Tennessee adults reported a substance use disorder in the past year. Tennessee has one of the highest per-capita opioid prescribing rates in the nation, though prescribing has declined significantly since the state implemented prescribing guidelines. Fentanyl is now the leading driver of overdose deaths, surpassing prescription opioids and heroin. Methamphetamine remains a major concern, particularly in rural areas, where meth-related deaths have more than doubled since 2018.
Alcohol misuse continues as the most prevalent substance issue — accounting for approximately 27% of all treatment admissions. The state has also seen increases in polysubstance use, particularly the combination of fentanyl with stimulants.
Types of Treatment Programs Available
Medical Detox: Medically supervised detoxification programs are available across Tennessee, with major facilities in Nashville, Memphis, Knoxville, Chattanooga, and the Tri-Cities region. Programs provide 24/7 medical monitoring during the acute withdrawal phase.
Residential/Inpatient Treatment: Tennessee has over 140 residential treatment facilities with programs ranging from 28-day to long-term therapeutic communities. Evidence-based modalities include CBT, trauma-informed care, Matrix Model, and 12-step facilitation. TDMHSAS funds specialized residential programs for women, adolescents, and individuals with co-occurring disorders.
Outpatient Programs: IOPs and PHPs are widely available across the state. Tennessee allows outpatient SUD treatment via telehealth, expanding access to rural communities. TennCare (Tennessee's Medicaid) covers outpatient services including individual and group counseling and peer recovery support.
Medication-Assisted Treatment (MAT): Tennessee has over 100 Opioid Treatment Programs and a growing number of buprenorphine prescribers. The state's "TN Together" initiative includes funding for MAT expansion in underserved communities. TennCare covers all three FDA-approved MAT medications.
Tennessee's Opioid Response — TN Together
In 2018, Tennessee launched "TN Together," a comprehensive plan to fight the opioid epidemic through three pillars: prevention, treatment, and law enforcement. Key elements include prescribing limits (a 3-day supply for acute pain, with exceptions), expanded MAT access through grant programs, the statewide naloxone standing order, and public awareness campaigns. Tennessee also operates a Prescription Drug Monitoring Program (CSMD) that requires prescribers to check patient history before issuing controlled substance prescriptions.
Insurance & Payment Options
TennCare (Medicaid): Tennessee has not expanded Medicaid under the ACA. TennCare provides coverage for SUD treatment services to eligible populations, including low-income children, pregnant women, parents/caretakers, elderly, and disabled individuals. Covered services include assessment, detox, residential treatment (with limitations), outpatient counseling, and MAT.
Private Insurance: Major carriers including BlueCross BlueShield of Tennessee, UnitedHealthcare, Cigna, Aetna, and Ambetter cover SUD treatment under federal parity requirements. Check your coverage to see what’s included in your plan.
State-Funded Programs: TDMHSAS funds treatment through regional planning councils and contracts with community providers to serve uninsured and underinsured residents.
Finding Help in Tennessee
SAMHSA National Helpline: Call 1-800-662-4357 for free, confidential, 24/7 referrals.
Tennessee REDLINE: Call 1-800-889-9789 for statewide substance abuse referral services, available 24/7.
Crisis Text Line: Text "TN" to 741741 for free crisis support via text message.