Local governments struggle to distribute their share of billions from opioid settlements

Money from settlements to help curb opioid addiction and the decades-old overdose epidemic is being distributed to small and large cities across the U.S., but advocates worry that portions of it could be used in ways that would not affect the crisis.

As state and local governments decide how to use the money, advocates say local governments may not have the capacity to take the right steps to identify the needs of their communities and direct their funding shares to projects that use proven methods to prevent deaths.

Opioids have been linked to about 800,000 deaths in the U.S. since 1999, including more than 80,000 annually in recent years, with the majority of them involving illicitly produced fentanyl.

Drug manufacturers, wholesalers and pharmacies have been involved in more than 100 opioid-related lawsuit settlements with state, local and Native American tribal governments over the past decade.

The agreements, some of which have not yet been finalized, could be worth a total of more than US$50 billion over almost two decades and also imply requirements for better monitoring of prescriptions and for the public disclosure of company documents.

Only states fought the tobacco industry in the 1990s and used only a portion of the resulting settlement money on tobacco efforts.

“We don’t want to be 10 years from now and say, ‘After we screwed up tobacco, we entrusted opioids to small governments — and we did even worse,’” said Paul Farrell Jr., one of the lead lawyers representing local governments in the opioid lawsuits.

He notes that with settlement money being implemented for at least another 14 years, there is time for cities to use it properly and resources to help.

The goal, experts say, is to help those who take opioids get treatment, make people who use drugs less likely to overdose and create an environment so people don’t take them in the first place.

For many, it’s personal.

Suzanne Harrison and her family launched a nonprofit organization dedicated to providing New Jersey residents access to treatment and recovery programs after her brother and Navy veteran King Shaffer Jr. died of a fentanyl and heroin overdose in 2016. days before he tried another treatment program.

At the time, he was staying with a sister who lived in Moorestown, New Jersey.

That city’s administration decided to turn over its share of the settlement money to Burlington County, which used the settlement funds to distribute an overdose antidote and run camps for children affected by addiction.

“The county was in a much better position to address this matter,” he emailed City Manager Kevin Aberant, noting reporting requirements and restrictions on how the money could be used.

Major opioid deals, which include agreements with Walgreen Co., CVS Health, Walmart, Johnson & Johnson and another with OxyContin maker Purdue Pharma, which is before the U.S. Supreme Court, are demanding that most of the funds be used to combat the crisis.

More than half of the funds will be controlled by local governments, according to Christine Minhee, who runs the website Opioid Settlement Tracker. In the larger deals, states receive larger sums by getting eligible local governments with populations greater than 10,000 to join the settlements.

Unlike most states, New Jersey required local governments to file funding reports.

Using these submissions and additional reports, The Associated Press examined spending and decision-making processes for communities in Burlington County, which includes the suburbs and rural areas of Philadelphia. Fourteen communities received allocations, and last June the amounts ranged from $5,000 to nearly $88,000.

Last year, the majority of communities in Burlington County had not yet spent allocated funds, nor had they followed advice to collect public input, develop strategic plans, conduct assessments of their communities’ needs, and design processes for allocating funds.

In Mount Laurel, New Jersey, the police department was tasked with and launched outreach events around cheap motels where first responders often administer an overdose antidote. The idea is to connect people with treatment and other services, but advocates prefer that police not be responsible for the costs.

Deputy Chief Constable Tim Hudnall also said hiring peer support navigators is being considered to try to help people deal with addiction.

Another New Jersey town, Willingboro, spent just over $57,000 on a back-to-school wellness event, where students received backpacks filled with school supplies and information about mental health resources.

“We’ve been trying to be aggressive about this,” Gary Lawery II, deputy city manager, said of spending the funds. “If not, he’ll just sit there.”

But those approaches haven’t relied on the kind of community needs assessments that Sara Whaley, a researcher at the Johns Hopkins Bloomberg School of Public Health who helps develop guides for counties, considers essential.

Some service providers, like Shaffer’s sister, Suzanne Harrison, found the process frustrating. Her organization, King’s Crusade, helps connect people to services, pays rent at sober living facilities and provides transportation to treatment. They have raised up to $80,000 a year, but there is always more demand.

Harrison said he has not had the opportunity to apply for funding to subsidize this. Instead, the organization received $6,625 in opioid settlement money to host a one-time recovery community event in Evesham Township.

In Evesham, a suburb of 45,000 that is Burlington County’s most populous, most control over settlement funds is in the hands of the local Alliance to Prevent Alcoholism and Drug Addiction, which is the type of body that Whaley says should be involved.

Marc Romano, director of operations for Prevention Plus of Burlington County, said he would also like there to be a call for proposals on how to use the money. The group received $2,000 to hold a painting night for women in recovery, which it said was “a beautiful event for recovery and recovery awareness,” but the group could do more by getting funds to help support programs geared toward recovery. its prevention mission.

Board member Heather Cooper, whose own brother was killed by a fentanyl overdose, said there are service providers in the area who can help get people into treatment, get them there and offer other services.

“But what we hear is that families still don’t know where these resources are,” she said. “So I think the marketing of this has to increase.”

Other governments have used different approaches.

In Arkansas, all the cities and counties pooled their money creating the Arkansas Opioid Recovery Partnership.

Donations went to a drug task force to hire an overdose investigator and a peer recovery specialist, to the American Indian Center of Arkansas to hire peer recovery specialists, and to a faith-based organization expanding its project recovery housing center ranging from $100,000 to more than $2 million.

Kirk Lane, a former police chief and director of state drug policy who now serves as the partnership’s director, said it is able to target projects to underserved parts of the state and fill gaps in the state’s treatment, recovery and prevention systems.

He explained, “Mayors and county judges didn’t have to worry about ‘How are we going to spend this money?’”