How should opioid settlements be spent? Those most affected often have no say

By GEOFF MULVIHILL

People with substance use disorders across the country have no formal say in how most of the roughly $50 billion in opioid lawsuit settlement money is being used to stop the crisis, a new analysis has found.

Some advocates say that’s one reason some of the money goes to efforts they don’t see as proven ways to save lives from overdoses, including equipment to scan prison inmates for contraband, police sniffer dogs drugs and neutralization systems. non-prescription drugs.

In Jackson County, West Virginia, officials voted earlier this year to use more than $500,000 in settlement funds for 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 use, mostly 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 on their own,” George said, “trying to help these people.”

Over the past eight years, drugmakers, wholesalers, chain pharmacies and other companies have agreed to settlements to resolve thousands of lawsuits filed by state, local and Native American tribal governments alleging the companies’ practices contributed to the crisis.

Opioids have been a major problem in the US since the late 1990s, with the deadliest stretch since the beginning of this decade reaching over 80,000 annually. Major causes have shifted from prescription pills to heroin to fentanyl and other substances produced in the laboratory often added to other illicit drugs.

Funds from the multibillion-dollar nationwide settlements began rolling out in 2022 and will continue through at least 2038. The agreements call for most of the money to be used for fight the crisis but it offers a lot of flexibility in how to do this.

Christine Minhee of the Opioid Settlement Tracker and Vital Strategies, a public health organization, released a state by state guide Monday, outlining how government funding decisions are made. The guide aims to help advocates know where to raise their voice.

Using this and other data, Minhee, which has amassed just under $50 billion in deals, excluding one with OxyContin maker Purdue Pharma, that The Supreme Court rejectedthey found that advisory groups help determine the spending of about half of that. But they have decision-making authority for less than a fifth of it.

Less than $1 of the $7 is overseen by boards that reserve at least one seat for someone who uses or has used drugs, although some places that don’t need to have such members anyway.

Brandon Marshall, a professor of epidemiology at Brown University’s School of Public Health and a former member of Rhode Island’s Opioid Solution Advisory Committee, said he’s seen lawsuits involving drug experts and people with experience make quick allocations to groups working in harm reduction and other areas because they know the groups.

“It’s not just a way to make sure the funds are being used effectively,” he said. “These types of systems also ensure that funds get out the door faster.”

Public Health Advocates they say the money should be used in proven ways to save lives, prevent drug use, and focus on racial equity, and that decisions should be transparent.

But many communities rather follow regular government spending practices assessment of local needs or consultation with experts or people affected by the epidemic.

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

“You can’t tell me that whoever made these decisions thinks this is the best use of the funding,” said Alicia House, executive director of the Steve Rummler Hope Network, which provides overdose prevention and education in Minnesota.

Renville County Sheriff Scott Hable said in an interview that keeping drugs out of the jail — without subjecting people who enter without being searched — fits with the facility’s focus on treatment for inmates with substance use disorders.

The scanner has been used nearly 1,400 times since last year, identifying contraband in six cases. Twice, he found packages of drugs inmates had swallowed before entering, he said.

The county board made the spending decision. Sara Benson, the county’s director of public health, said the government is forming an advisory group on the future use of the settlements and wants to include people with lived experience.

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

“We wouldn’t just be throwing money at a program that wasn’t going to last,” he said in an interview. Additionally, he said, no one other than the Rapid Response Team has requested funds since the first opioid settlement payment.

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

The group is applying for the $15,000 that currently remains in the county fund, and Waybright said they expect it to be awarded soon.

For others, spending decisions are even more personal.

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

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

Originally published: December 9, 2024 at 12:16 PM CST