SMART Policy Podcast

Why a New Synthetic Opioid is Outsmarting Drug Tests

There’s been growing attention to a new chemical in the illicit drug supply: N-Propionitrile Chlorphine, also known as cychlorphine.  On top of being more potent than fentanyl, it’s also extremely hard to detect on toxicology tests. Currently, all deaths attributed to cychlorphine have been identified in the East Tennessee region around Knoxville, but experts believe it is in more areas already - we just haven’t been able to identify it.  Cychlorphine is an excellent example of why staying on top of new drug trends can be so challenging. This month I am joined by Chris Thomas of the Knox County Regional Forensic Center, Dr. Shravani Durbhakula of Vanberbilt University Medical Center, and Adam Gray of the Tennessee Bureau of Investigation to discuss the challenges of these new drugs from forensic, clinical, and law enforcement perspectives.  In this conversation we talk about several of the newer drugs in the supply, the technological and logistical limitations of testing for drugs, and of course, the policy options that could make this problem a little better.  Learn more: CFSRE Summary of N-Propionitrile Chlorphine: https://www.cfsre.org/nps-discovery/monographs/n-propionitrile-chlorphine  Importance of Naloxone with Cychlorphine: https://www.tn.gov/health/news/2026/3/18/tdh-reinforces-importance-of-naloxone-with-rise-in-cychlorphine-fatalities.html  Knox County Regional Forensic Center: https://www.knoxcounty.org/rfc/  Dr. Shravani Durbhakula: https://www.shravanimd.com/about-dr-shravani-durbhakula/  SMART: www.smart.tennessee.edu

What the Brain Disease Model of Addiction Gets Right — and What It Misses

Something really has changed over the past twenty years, especially in the last ten. Our culture has increasingly come to accept the idea that addiction is a chronic, treatable disease, not a moral failure. Secretary RFK Jr. of the Dept. of Health and Human Services said this almost word-for-word just about a month ago when President Trump signed the Executive Order establishing the Great American Recovery Initiative, adding that for too long we have treated substance use disorder with “fragmentation, stigmatization and silence instead of science, compassion and coordination.”In the field of science, both clinical and academic, this is often referred to as the “brain disease model of addiction,” based on the definition of a disease as a condition that changes the structure or function of at least part of an organ or system. However, though this framework has done a lot to reduce stigma and increase the acceptance of evidence-based treatment, you don’t have to go looking very long before you see that our healthcare, housing, and criminal justice systems are still stuck in the past. And on top of that, the recovery community itself remains split on what it even means to have the disease of addiction.My guests this month are Dr. Kirsten Smith, a researcher and clinical social worker who found recovery and earned her doctorate after going to prison for robbing banks in order to pay for heroin, and Dr. Stephen Loyd, Chief Medical Officer of Cedar Recovery and Chair of the Tennessee Opioid Abatement Council, who is also in recovery from opioid and benzodiazepine use disorder. Dr. Smith was recently featured in an article by the Guardian, wherein she offered some intriguing criticisms and limitations of the brain disease model, and it caught our attention at the SMART Initiative, as well as that of Dr. Loyd. Fortunately, the two agreed to come onto our show for a deep dive, and as you can see, this episode turned out to be longer than normal. It also contains some concepts that some might find controversial. Additionally, though we frequently discuss drug use on this show, we get a bit up close and personal to the topics of cravings, recovery, and more, so some listener discretion is advised. And as always, this episode is intended to be educational, showcases the personal opinions of the guests, and does not reflect any opinion or belief of the University of Tennessee.That being said, I found this conversation to be insightful and challenging, with compelling takeaways for everyone, no matter where they stand on the matter. Learn more:Dr. Stephen Loyd: https://www.cedarrecovery.com/dr-stephen-loyd/ Dr. Kirsten Smith: https://www.theguardian.com/news/2025/sep/04/bank-robber-scholar-knoxville-change-addiction Dr. Alan Leshner’s 1997 paper on the brain disease model of addiction: https://pubmed.ncbi.nlm.nih.gov/9311924/ “Behave” by Robert Sapolsky: https://www.sackett.net/sapolsky_behave.pdf SMART: www.smart.tennessee.edu Listen on Apple: https://podcasts.apple.com/us/podcast/smart-policy-podcast/id1642539321 Listen on Spotify: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM Listen on Soundcloud: https://soundcloud.com/smart-initiative

When There's No License to Lose: How Tennessee Teens Are Still Buying Vapes

Ask just about any teacher or parent about what concerns them, and you’ll hear about vaping. According to the Tennessee Dept. of Health, 22% youth admit to vaping, which is a rate more than twice the national average. 22 counties across the state have identified nicotine, tobacco or youth vaping as one of their top health concerns in recent health assessments. An additional 46 counties identify substance use or mental health, especially of youth, as top concerns, and research widely associates teen tobacco product use with these issues. In recent years, Tennessee has passed numerous laws to restrict youth vaping, including limiting products to just the list of FDA-approved devices, banning sales to anyone under 21, restricting marketing and significantly increasing punishments for breaking these laws. However, despite a reference in the law to revocation of a license as a potential penalty, there is no licensing system to sell tobacco products in Tennessee. Last year, Tennessee also charged the Alcoholic Beverage Commission, or ABC, with conducting compliance checks on vape sales, as well as regulating hemp-derived cannabinoid products. Since launching that work, they have found a state average compliance rate of only 82%, meaning a lot of youth are slipping through the cracks and illegally buying vapes. My guests this month are Aaron Rummage of the TN ABC and Jamie Kent, Chair of Smokefree Tennessee, the state’s official nicotine prevention coalition. In this conversation, we talk about the ins and outs of tobacco retail licensure, a policy option that could potentially improve transparency, compliance, youth prevention, and more. We also talk briefly about how recent federal actions might change the availability of hemp-derived cannabinoid products in Tennessee. Learn more:Tennessee ABC: www.tn.gov/abc Smokefree Tennessee: www.smokefreetennessee.com SMART: www.smart.tennessee.edu Listen on Apple: https://podcasts.apple.com/us/podcast/smart-policy-podcast/id1642539321 Listen on Spotify: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM Listen on Soundcloud: https://soundcloud.com/smart-initiative

Equipping Communities for Recovery: Inside Tennessee’s Lifeline Peer Project

In our last episode, we heard from Andi and Tanner Clements from Uplift Appalachia that churches and communities want to help with recovery, but most don’t feel equipped to take on the challenge. There’s also the persistent fear that they might get things wrong. The Tennessee Lifeline Peer Project, a statewide effort by the Tennessee Department of Mental Health and Substance Abuse Services Office of Faith-Based Initiatives, is making a massive impact in providing that vital information, training, and connection to resources. Through their team of 20 coordinators across the state, they have had a significant impact on reducing stigma and strengthening local support. My guests this month are Jessica Youngblom, Director of Strategic Initiatives, and Jaime Harper, Director of Faith-Based Initiatives. In this conversation, we talk about why the Lifeliners are having a huge impact, the challenges faced by the communities they serve, how little things can make huge differences for people in recovery, and how the long term outcomes from this work can last deep into the future. Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas.Learn more:TN REDLINE: 1-800-889-9789TN Lifeline Peer Project: https://www.tn.gov/behavioral-health/faith/lifeline.html SMART: www.smart.tennessee.edu Listen on Apple: https://podcasts.apple.com/us/podcast/smart-policy-podcast/id1642539321 Listen on Spotify: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHM Listen on Soundcloud: https://soundcloud.com/smart-initiative

Uplift Appalachia: Equipping and Empowering the Church to Support Recovery

This is the kind of dilemma that faces many people in Tennessee: staying in recovery while trying to rebuild a life, but resources are limited and local public transportation is not reliable or readily available. This has been identified in dozens of needs assessments across the state as a major barrier to recovery. This is where many people believe that church can have a massive impact. Andi and Tanner Clements of Uplift Appalachia think so too. For a few years now, their church and others they have mentored have provided transportation to courts, recovery meetings, job trainings and more, with the goal of helping people not only survive, but thrive. Uplift Appalachia provides education, training, consulting, and connecting to churches and organizations, motivating and equipping them to love and serve those living with addictions, mental health, and other life challenges on their journey to flourishing. They also have a three year grant to cross-train faith, health, and social service communities about addiction and trauma. As always, this episode is intended to be educational. Any opinions or views or specific language presented in this episode does not reflect the opinion of the University of Tennessee.Original music by Blind House. Hosted and produced with additional scoring by Jeremy Kourvelas.Learn more:Uplift Appalachia (including Intrinsically Motivated podcast): https://upliftappalachia.org/ Clements, A. D. (2023). The Trauma Informed Church: Walking with Others Toward Flourishing: 2nd Edition with Study Guide. Uplift. ISBN: 979-8-9870371-1-9.Clements, A. D., Clements, T., & Hedrick, M. J. (2025). Interpersonal connection and medication for opioid use disorder (MOUD): Does the endogenous opioid system inform the etiology and treatment of addiction? Available at SSRN: https://ssrn.com/abstract=5363291 or http://dx.doi.org/10.2139/ssrn.5363291 Clements, A. D., Cyphers, N. A., Whittaker, D. L., Hamilton, B., & McCarty, B. (2021). Using trauma informed principles in health communication: Improving faith/science/clinical collaboration to address addiction. Frontiers in Psychology: Health Psychology, 12, Article 781484 https://doi.org/10.3389/fpsyg.2021.781484 Clements, A. D., Cyphers, N. A., Whittaker, D. L., & McCarty, B. (2021). Initial validation and findings from the willing/ready subscale of the Church Addiction Response Scale (CARS). Frontiers in Psychology: Health Psychology, 12, Article 733913. https://doi.org/10.3389/fpsyg.2021.733913Listen on Apple: https://podcasts.apple.com/us/podcast/smart-policy-podcast/id1642539321Listen on Spotify: https://open.spotify.com/show/5qbzONIr0hlWxiQsPwkXHMLastly, the SMART Initiative empowers communities to overcome the overdose crisis and build a healthier Tennessee where individuals impacted by substance use can thrive. Our annual Week of Giving is December 15th-19th, wherein we will be accepting charitable donations that are matched up to $15,000. Your gift would support ongoing zero-cost training and technical assistance to local governments and community partners to implement evidence-based opioid abatement strategies, continued development of interactive mapping of recovery resources across the state, and research, analysis, education and outreach on substance use prevention, mitigation, and other health initiatives. Visit giving.tennessee.edu/smart today to donate, or contact Kristen Davis at 865-974-9609 or at kristen.davis@tennessee.edu. Thank you for your consideration and support!