Community Leaders Tackle Issue of Opioid Addiction in Pregnant Women

– story by Matthew Torres, News Channel 5
read full story and watch video here

NASHVILLE, Tenn. (WTVF) — When it comes to the opioid crisis, pregnant women tend to feel the most vulnerable and stigmatized. However, treatment services are becoming more available to help with recovery, counseling and support.

The Next Door in Nashville held a panel with community partners to discuss addiction and the effects on the unborn child. Experts shared best practices to a room full of people on treating pregnant women with addiction and how to approach their situation without shedding judgment.

“It’s such a huge problem that we wanted to have time to educate and equip the community with resources to let them know what is available,” April Barnes, The Next Door director of outreach told NewsChannel 5.

The panel also had experts from JourneyPure, Vanderbilt Center for Women’s Health and Strongwell. One of the speakers, Dr. Jessica Young, said 60 to 70 percent of the time women want treatment because of their pregnancy.

The Next Door is a treatment center strictly for women 18 and up who are battling addiction, trauma and mental illness. For someone like Kimberly Ladd, the organization was one of a very few, if not, the only service that served pregnant women with addiction several years ago.

Ladd is a mother in long-term recovery who became dependent on opioids nearly a decade ago. She said her daughter needed treatment for heroin addiction, which proved to be tricky.

“Getting her treatment was incredibly and overwhelmingly difficult. We went to ER’s and that wasn’t really the right place to go,” Ladd recalled.

Many pregnant women abusing opioid substances deliver babies with Neonatal Abstinence Syndrome, a condition in which the baby goes through withdrawals.

Ladd eventually received help and turned her life around to become the director of the Maury County Prevention Coalition. She urged other pregnant women to not be afraid to seek help. Experts worry fear of the unknown tend to prevent women from getting prenatal care.

“A lot of times they’re already addicted when they become pregnant so it’s not easy to stop,” Ladd said. “One of the wonderful things about pregnancy at this time is we can actually leverage the Oxytocin that’s happening in the mom’s brain to get her on a healthy track of recovery.”

In majority of the cases, at least one of the drugs causing NAS was prescribed to the mother by a health care provider, according to the state. Experts say what can be helpful are Medication-Assisted Treatment (MAT) and prescribed medications. The annual NAS state report said the MAT trend indicates that pregnant women at risk of delivering a substance-dependent infant are working with their medical providers to promote a healthy pregnancy. It continued to say reduced access to opioid medications may have also resulted in fewer of these medications being used irresponsibly or made available for diversion.

Tennessee is one of four states most affected by NAS with 15 to 20 cases per 1,000 hospital births, according to recent data from the Centers for Disease Control and Prevention.

To help address the problem, Tennessee became the first state to require reporting of NAS. Providers must report all diagnoses of NAS within 30 days of diagnosis. In 2018, Tennessee saw its first decline in NAS rates since recording began six years ago.

The number dropped from 1,096 in 2017 to 927 in 2018, with more boys being diagnosed than girls.

There have been 358 NAS cases in Tennessee since the start of 2019, according to the Tennessee Department of Health. The highest rates of NAS this year happened in the Northeast and Upper Cumberland Health Regions.

Betty Dickens – Board Member Recognition by nFocus Magazine

from nFocus Magazine, written by Holly Hoffman
Photograph by Alex Berger

The Next Door is on track to offer services to more than 1,600 Middle Tennessee women in crisis this year. Fifteen years ago, it opened to meet the needs of transitional housing and support for female ex-offenders, and programs have since expanded to include those impacted by addiction, mental illness and trauma. The organization’s excellence in providing evidence-based programming is empowering clients for lifetime recovery.

“What a blessing it has been in my life to be a very small part of TND’s effort to bring hope and healing to women in crisis!” Betty Dickens says. Actually, her role in its success has been anything but small. She is a founder of the nonprofit and longtime board member, ardently focused on fundraising efforts like annual giving and the inspiring fall luncheon. She and her husband, Marty, even host events in their home for the board, staff and community. Recently, they welcomed a group to hear Sam Quinones, who authored a book about the opioid crisis. At TND, 85 percent of the women are caught in the widespread epidemic. Betty is always there to help because she knows no other organization is as effective in addressing their needs, as well as those of their families,as The Next Door.

The Next Door

The Next Door provides a continuum of evidence-based substance abuse and mental health services for women in an environment of faith and healing to restore hope and a lifetime of recovery.

Johnathan Kayne red floral ball gown (Glitz Nashville); Alex Evenings black evening shawl (Dillard’s at The Mall at Green Hills); White gold and diamond pave earrings, Fred Leighton yellow gold and white topaz necklace (King Jewelers)


News Channel 5 Nashville – Overdose Deaths are Spiking in Rural Counties, but No One’s Sure Why

Our very own April Barnes is in this video, talking about the opioid crisis and what The Next Door is doing to fight it. Click here to watch it.


NASHVILLE, Tenn. (WTVF) — Some rural counties in Tennessee saw a big spike in overdose deaths in 2017, but researchers aren’t sure what caused the trend.

According to Tennessee Department of Health statistics, Cheatham County had an overdose death rate of 61 per 100,000 people. That’s nearly double the rate of deaths in Davidson County.

“Some of the really small counties look like they have high per capita rates because the counties are so small, Dr. Tim Jones, a state epidemiologist for the Tennessee Departement of Health said. “But clearly, Cheatham County is high up on that list.”

Meanwhile, counties like Williamson have lower rates, just 15 per 100,000 people.

Dr. Jones said another factor could be access to addiction treatment. “We would expect to see more overdoses in places where people that are using these drugs can’t get help to get off of them,” Jones said. “Right now, our drug misuse treatment options are really patchy and variable across the state.”

Jones said the number of prescriptions written for opioids is going down in the state, but the number of overdose deaths hasn’t reflected that yet.

TN Faces of Opioids

The TN Department of Health is launching a new publicity campaign this week called The Faces of the Opioid Crisis. They state, “As you all know, Tennessee is among the hardest-hit states when it comes to the opioid epidemic. The story of its impact is often told in numbers:  1,268 opioid overdose deaths in Tennessee in 2017; more than six million painkiller prescriptions in our state in 2018.  But behind the numbers are people – the Tennesseans bearing the devastating impacts of this crisis.”

These stories of these Tennesseans are being shared to put a face on the epidemic and to highlight what people are doing in every county and community of our state to bring it to an end. Each of the 90 counties across the state of Tennessee will have ONE spokesperson known as the FACE of their county, a person with a personal connection to the opioid epidemic.

It is with pride that we share with you that TWO of our amazing TND staff members have been selected for this campaign.

  • Kecia Harris, Family Recovery Specialist, is the FACE of the Opioid Crisis for Robertson County
  • April Barnes, Director of  Outreach, is the FACE of the Opioid Crisis for Cheatham county

Starting soon and over the next year, there will be a state-wide PR effort to spread the word about the deadly disease of opioid addiction and put a “face” to this important issue impacting our state.  Don’t be surprised if you see our very own Kecia or April on billboards, TV commercials, etc., in addition to the signage you see in our lobby today.

Click on this link to read more of Kecia and April’s powerful stories:

Christ Presbyterian Spotlights The Next Door


As a Nashville facility that provides rehabilitation services to women impacted by addiction, mental illness, trauma or incarceration, the non-profit known as The Next Door regularly relies on volunteers to help with needs such as stocking the supply closet, serving a meal or building relationships with the female residents.

Leisha Nischan began to experience all this when she started volunteering five years ago. A member at Christ Presbyterian Church, Leisha was part of a Missional Community comprised of individuals from several area churches who regularly engaged with The Next Door and offered support to employees and residents. But when a need arose to volunteer at the front reception desk, Leisha soon discovered the role included more than just answering phones and emails.

She started coming face to face with women as they took their first step through the front door seeking help, answers, healing and restoration. She saw the pain and desperation in their eyes. She witnessed how the facility functioned as a lifesaver to so many who felt they had nowhere else to go.

Leisha began to gain a deeper understanding of the suffering of others and the spiritual calling to meet them in their pain and serve as the hands and feet of Christ.

Many times, a woman would walk through the door with just one little bag, Leisha recalled. Maybe she was leaving a life of abuse, trauma or fear. Or perhaps she was weary from a long, ongoing battle with drug or alcohol addiction. She could have just been released from jail or was suffering from mental illness. I saw it all. No matter the scenario, these women were leaving their old life and attempting to step into something hopeful. They were done with the past. Their entrance through our doors represented the first day of the rest of their lives.

Christ Presbyterian Church shares a rich history of partnering with The Next Door. Church members have served on the board of directors, volunteered to lead bible studies and served in various capacities as volunteers. Under the leadership of a team recruited by Leisha, a rebooted Missional Community called Hearts for the Next Door kicked off in May. Its purpose is to partner with the staff of The Next Door in the mission of equipping women to move from the hopelessness of addiction, mental illness or trauma to the wholeness and hope of Christ-centered lives.

Upcoming opportunities for the Missional Community will include movie nights, game nights and holiday gatherings with the residents of The Next Door. An ongoing need also exists for donations toward the facility’s supply and clothing closet.

Leisha and her leadership team prayerfully desire to grow the new Missional Community, stating that, a tremendous opportunity exists to encourage women at The Next Door. Often, when they learn we are from a church, they ask for prayer. Many are longing for that connection. They feel like they can open up to us and often do.

Leisha said she and other Missional Community members receive ongoing encouragement from engaging with the women. The connections formed build empathy, understanding and friendship. 
While some of the women come from poverty or abusive relationships, others gradually slid into addiction based on tough circumstances, Leisha said. Some turned to drugs to cope with mental illness while others struggled in the aftermath of an injury where strong prescription drugs became addictive.

“Pain crosses all demographics,” Leisha said. “We see women from age 18 to those in their 60s. We see the affluent, the poor and the homeless. Brokenness can find us at any age or phase. That’s why we need each other.”

The Next Door is unique as it offers myriad services for women in need, including a 30-day residential treatment program, an outpatient program and an affordable apartment rental complex called Freedom Recovery Community for women who’ve completed recovery. The large facility includes a commercial kitchen, medical clinic, computer lab for job searching, large dining room and event space, conference room, a chapel and meeting rooms.

See the original post here.

The Next Door is a TOP Workplace!

We’re proud to announce that we’ve been named a Top Workplace by The Tennessean for the FIFTH year in a row! We are officially in the Hall Of Fame. We ranked 11 out of the 25 finalists in the Mid-size Companies.

This year is particularly special, as we received the “Meaningfulness” Award. This means that our staff believe that the work they do at TND is meaningful.

A big thank you to all of our employees, who helped to make this happen!

You can find more info on the Top Workplaces website!

Nashville Public Television Opioids Town Hall


As our country grapples with the opioid epidemic, NPT held a public forum about how Middle Tennesseans are dealing with this health crisis, recorded on April 9, 2019, in studio A. Our audience discussed how this substance is affecting communities, families and health systems. Participants included members of the public, addiction experts, medical and public safety professionals. Learn more about NPT Reports: Town Halls at

Rx Summit Spotlight: Blending Faith and Science a Winning Combination

Even amid a crippling opioid crisis, medication-assisted treatment for opioid use disorder remains highly controversial in the state where April Barnes, RN, works. At this month’s Rx Drug Abuse & Heroin Summit, the outreach director at Nashville, Tenn.-based The Next Door will argue for a treatment approach that fully integrates physical, emotional and spiritual components.

“Many other ministries have great programs but don’t have medication,” Barnes tells Addiction Professional. “We’ve had difficult situations where it’s hard to find a placement for a patient, because at many facilities the patient can’t be on medication.”

At her April 25 workshop session at the Atlanta conference, Barnes will outline how the faith-based treatment organization where she works has moved in a different direction from some similar programs. The Next Door was launched 15 years ago as a halfway house for women reintegrating into the community from incarceration, and has grown into a multi-level treatment provider at a time when the opioid epidemic was intensifying in the state and nationally.

“We’ve always been about adapting to what the greatest need is in the community,” says Barnes, who formerly served as director of admissions and business development at The Next Door. “With the number of overdoses that were occurring, that’s when it went from strictly re-entry into treatment. We’ve been learning and growing over the last five years.”

Chronic illness factor

Barnes sees the role of medication treatment for opioid use disorder in the same way she views medication for type 2 diabetes: an essential component but not the cure-all. Medications such as buprenorphine can keep the patient alive and engaged so that there is time for the other elements of comprehensive treatment to have an effect, the logic goes.

“You’re not going to achieve complete healing unless you have all of the components,” Barnes says, referring to the physical, emotional and spiritual. “All these areas of human life are interconnected.”

That is not an attitude universally put into practice in faith-based programs, however, she suggests. Barnes will discuss in her session how The Next Door’s perspective has evolved over the years.

“Even within our own facility, we were for years abstinence-based,” she says. “This took some time even for our leadership, for our team, to stop moralizing it.”

The Next Door has inpatient capacity for 82 female patients (12 detox beds and 70 residential beds). It is now adding to its outpatient offerings a recovery care clinic where medication-assisted treatment will be at the core of programming.

Buprenorphine and extended-release naltrexone are both available to patients in programs at The Next Door. The organization has a diverse payer mix that includes both public and private insurance sources.

Barnes says she still sees a great need for community education on the importance of comprehensive, integrated treatment. “When I tell people we’re a faith-based program, they often say, ‘Oh, you must not prescribe,’” she says. “We absolutely believe in the power of prayer, but we also believe in science.”

The Rx Drug Abuse & Heroin Summit, April 22-25 in Atlanta, is where solutions are formulated, stakeholders from Federal to family convene, and change begins. It is the annual gathering for stakeholders to discuss what’s working in prevention and treatment. For more information, visit

WKRN Nashville – Decoding the Fentanyl Formula

NASHVILLE, Tenn. (WKRN) – There are two types of opioids: naturally-occurring and synthetic. Fentanyl is a synthetic opioid.

Dr. Michael Ferri, medical director at Next Door, explained further, There are naturally occurring opioids like morphine, which comes out of the poppy plant, the tar of the poppy pod. There are semi-synthetic ones like hydrocodone, oxycodone, which are derivatives of the naturally occurring poppy product, and then there are synthetic products, which are made to look just like the naturally-occurring opioids. For instance, fentanyl was invented in the 60s by a pharmacologist called Jansen.

According to the State Medical Examiner’s office, there were 103 fentanyl-related deaths in 2016. That number grew to 180 in 2017.

In 2018, there were at least 346, but the state is still waiting for more data to complete the report.

A similar trend can be seen in Davidson County. The Health Department reports 60 fentanyl-related deaths in 2016, 105 in 2017, at least 174 in 2018, and so far in 2019, 15.

The U.S. National Library of Medicine reports the full chemical formula for fentanyl is  N-(1-(2-phenethyl)-4-piperidinyl-N-phenyl-propanamide. However, creators use different derivatives which can increase the drug’s potency.

Dr. Ferri said it’s unpredictable, Even the dealers have had a hard time cutting into a batch of heroin. Because it just takes a few grains to bring the potency up dramatically. He adds the man-made drug can be 100 times more potent than naturally occurring opioids.

“It turns out that fentanyl is much more lipophilic, so it goes through the blood-brain barrier much easier than other, more naturally-occurring opioids,” Ferri added, So that means higher concentrations right off the bat get into the brain. And when this molecule is floating around, and it meets the opiate receptor, it’s much more sticky on that receptor, and it induces a response to the nerve in a more effective way.

See the impact fentanyl is having, as News 2 investigates the so-called Third Wave of the opioid crisis. We have special reports all day Thursday, in every newscast.

Join in on the discussion during our live town hall meeting at 6:30 pm on News 2.

WKRN Nashville – Fentanyl’s Potency Creates Hurdle in Fighting Opioid Overdoses

NASHVILLE, Tenn. (WKRN) – Overdose deaths are skyrocketing across the country from synthetic opioids.

According to the Centers for Disease and Control and Prevention, much of the overdoses stem from illicitly-manufactured fentanyl, a synthetic opioid health experts call dangerously potent.

A woman, News 2 is naming Sarah out of confidentiality, knows this all too well.

What began as a way to treat pain after a visit to the dentist, evolved into a 25-year addiction to opioids.

Some of that, Sarah said, was laced with illicit fentanyl.

News 2 was there on a big day on her road to recovery.

After almost 25 days in rehab at The Next Door in West Nashville, Sarah packed up her past.

“I feel much better emotionally, physically,” said Sarah. “I don’t want to get up ever again and have to do some type of drug to make myself feel better or get off sick.”

Sarah’s departure from the recovery center means she’s preparing for the next big test in beating her opioid addiction.

“Mainly I want to see my son get off the bus and squeeze him real tight,” she said. “The temptations are out there so I am a little nervous about that, but I also think I’m in the perfect spot or set up for success from here on out. It’s just me and my will power.”

For recovering opioid addicts like Sarah, the test lies in overcoming the need for the high that comes with drugs like heroin – the danger, lying in the unknown.

“The bottom is ultimately dying and that’s what’s going on right now is the fentanyl being mixed with stuff and if you don’t end up dying, you’re pretty darn close to it,” said Sarah.

“Fentanyl is a synthetic opioid, so it’s in the same family of morphine and heroin and demerol and all the opioids,” said Dr. Michael Ferri at The Next Door. “What makes it sort of unique is that it’s incredibly potent.”

Dr. Ferri said the danger comes from how quickly fentanyl can get to the brain to give users that high.

“It turns out that fentanyl and its derivatives are one of the most potent molecules to bind the opioid receptor, which is responsible for anesthesia and pain, but also for respiratory depression which is what can kill people,” said Dr. Ferri.

That bind is so tight, it can make it hard for life-saving Narcan to reverse an overdose.

“Fentanyl binds much, much more tightly. It’s much more potent and it’s more sticky at that receptor site,” said Dr. Ferri. “So a dose of Narcan may not be enough to push off that fentanyl.”

For comparison, fentanyl is roughly 100-times more potent than morphine, a naturally-occurring opioid.

Just a couple of grains of fentanyl would be enough to kill the average person.

The potency has drug dealers cashing in.

“People are cutting the heroin with the fentanyl just to make it stretch,” said Sarah.

“At a certain point, buying Oxy, things like that off the street becomes too expensive,” said Dr. Ferri. “And that’s where the fentanyl comes in. The drug dealers can cut that fentanyl to make it cheaper for them to make it a more potent product.”

Sarah said she’s had close calls with fentanyl-laced heroin.

“Luckily, I’ve been fortunate you know,” said Sarah. “But yeah, that’s the bad part is nobody knows what’s in there and I know overdoses are on the rise, because I’ve lost several friends to it.”

But Sarah said she’s determined not to let that happen – for herself, her family, and especially her son.

“I’m looking forward to being a much happier mom and I was an involved mom before, but I want to be a more involved mom,” said Sarah.

Sarah added this is her second effort to get clean and hopes it’ll be her last.

She said she’ll be continuing her recovery with four days a week of intensive outpatient treatment at The Next Door.