How should the opioid settlements be spent? Those hit hardest often don’t have a say

Article content

A new analysis finds that people with substance use disorder across the country are not getting an official say in how most of the nearly $50 billion in opioid-related lawsuit settlement money will be used to stop the crisis.

Article content

Article content

Some advocates say that’s one factor why portions of the money go to efforts they don’t consider proven ways to save lives from overdoses, including equipment to screen prison inmates for contraband, drug-sniffing sniffer dogs, and neutralization systems. Its effect. Unnecessary medical medications.

Article content

In Jackson County, West Virginia, officials voted earlier this year to use more than $500,000 in settlement funds to create a first responder training center and shooting range. They also allocated $35,000 to a rapid response team that works with overdose survivors.

Josh George, who has been in recovery for three years after 23 years of drug abuse, especially heroin, now runs a recovery group with his wife and other family members.

Some of the money could have gone to the county’s only recovery home, he said.

“All these people were doing it at their own expense, trying to help these people,” George said.

Over the past eight years, drug makers, wholesalers, pharmacy chains and other companies have agreed to settlements to resolve thousands of lawsuits filed by state and local governments and Native American tribal governments alleging that corporate practices contributed to the crisis.

Opioids have been a major problem in the United States since the late 1990s, with the deadliest period earlier this decade reaching more than 80,000 cases annually. The main culprits have shifted from prescription pills to heroin to fentanyl and other lab-produced substances that are often added to other illicit drugs.

Article content

Article content

Money from multibillion-dollar nationwide settlements began flowing in 2022 and will continue until at least 2038. The agreements require most of the funds to be used to fight the crisis but provide significant flexibility in how to do so.

Christine Menhey of the public health group Opioid Settlement Tracker and Vital Strategies plans to release a state-by-state guide on Monday outlining how state funding decisions are made. The guide aims to help advocates know where they can raise their voices.

Using this information and other data, Minhei, who counted just under $50 billion in settlements excluding the settlement with OxyContin maker Purdue Pharma that was rejected by the Supreme Court, found that advisory groups help determine spending about half of it. But they have decision-making authority over less than a fifth of them.

Less than $1 in every $7 is moderated by boards that reserve at least one seat for someone who uses or uses drugs, although some places that don’t require it may have such members anyway.

Brandon Marshall, a professor of epidemiology at Brown University School of Public Health and a former member of Rhode Island’s Opioid Reconciliation Advisory Committee, said he has noticed that operations involving experts and people with experience with drug abuse have made quick allocations to anti-drug groups. Harm reduction and other areas because they know the groups.

Article content

“It’s not just a way to ensure that the money is used effectively,” he said. “These types of systems also ensure money gets out the door faster.”

Public health advocates say the money should be used in ways proven to save lives, prevent drug abuse and focus on racial equity and that decisions should be transparent.

But many communities follow regular government spending practices instead of assessing local needs or consulting with experts or people affected by the pandemic.

Renville County, Minn., used $100,000 in settlement money to pay about two-thirds of the cost of a county jail body scanner to detect drugs in incoming inmates, even if they have swallowed bags of them.

“You can’t tell me whoever made those decisions thought that was the best use of the funding,” said Alicia House, executive director of the Steve Rumler Hope Network, which provides overdose prevention and education throughout Minnesota.

Renville County Sheriff Scott Hubble said in an interview that keeping drugs out of the jail — without subjecting people entering to strip searches — fits with the facility’s focus on treating inmates with substance use disorder.

Article content

The scanner has been used nearly 1,400 times since last year, and contraband was identified in six cases. He said he twice found packages of drugs that inmates had swallowed before entering.

The district governing body made the spending decision. The government is forming an advisory group for future use of the settlements and wants to include people with life experience, said Sarah Benson, the province’s public health director.

In West Virginia, Jackson County Commission Chairman Dick Waybright said the training center will help law enforcement, EMS and 911 personnel respond to the opioid crisis.

“It’s not just going to be spending money on a program that’s not going to last,” he said in an interview. Furthermore, he said no one other than the Rapid Response Team requested money from the down payment for the opioid settlement.

George’s mother, Kelly DeWeese, said there are many needs in the area hit hard by addiction, including transportation for people in recovery, prevention education and counseling for children with substance use disorder. Breath of Life, the group run by her son and daughter-in-law, could use help launching a recovery house.

The group is asking for the $15,000 currently remaining in the county fund, and Waybright said he expects to grant it to them soon.

For others, spending decisions are more personal.

Tonya Ahern, community coordinator for the National Center for Advocacy and Recovery, lost her son to an overdose when he was 29 years old. She co-founded a group that plans to produce a booklet of suggestions for New Jersey communities on how to use the funding.

“If you’ve never tried it before, you have no idea what they need,” Ahern said.

Article content