A recent analysis indicates that individuals grappling with substance use disorders are not adequately represented in decisions regarding the allocation of nearly $50 billion from opioid lawsuit settlements geared towards addressing the opioid crisis. Advocates express concern that this lack of input contributes to funding being directed towards initiatives they deem unproven for effectively preventing overdose deaths. Some of these initiatives include devices to search inmates for contraband, narcotic detection canines, and systems for disposing of unnecessary prescription medications.
In West Virginia’s Jackson County, officials made the choice to allocate over $500,000 of settlement funds for a training center for first responders and a shooting range. Additionally, $35,000 was designated for a rapid-response team dedicated to assisting those who have survived overdoses. Josh George, who has been in recovery for three years following a 23-year battle with heroin addiction, expressed disappointment that some of these funds could have been utilized to support the county’s only recovery house, noting that various individuals were funding recovery efforts out of their own pockets.
Over the past eight years, several companies, including pharmaceutical firms and distributors, have settled thousands of lawsuits from state, local, and Native American governments claiming that their actions contributed significantly to the opioid crisis. Since the late 1990s, opioids have posed a significant challenge in the U.S., with peak fatalities exceeding 80,000 annually during a peak period earlier this decade. The predominant causes of overdose have evolved from prescription medications to heroin to increasingly potent synthetic opioids like fentanyl, often mixed into other illegal drugs.
Funds from the extensive national settlement agreements commenced distribution in 2022 and will proceed until at least 2038. These agreements mandate that a majority of the funds be utilized to combat the crisis but allow considerable freedom in implementing these strategies. Christine Minhee from Opioid Settlement Tracker and Vital Strategies has produced a state-by-state guide to assist advocates in understanding funding decision processes, making it easier to voice their concerns effectively.
Based on this guide and her research—which accounts for nearly $50 billion in settlements, excluding a previously rejected one involving Purdue Pharma—Minhee reported that advisory groups have a hand in deciding half of the funds, but their decision-making power is limited to less than 20%. Fewer than $1 of every $7 is managed by committees that include at least one representative who has a history of substance use, although some jurisdictions might still include these representatives without any formal requirement.
Brandon Marshall, an epidemiology professor at Brown University and former member of the Rhode Island Opioid Settlement Advisory Committee, has noted that involving experts and those with personal experiences in substance use has led to faster funding distributions to harm reduction and other urgent initiatives, ensuring a more efficient utilization of funds. Public health advocates argue that the available funds should be committed to strategies with proven efficacy in saving lives and preventing drug misuse, while also emphasizing the need for equitable decision-making processes.
Some communities are adopting standard governmental spending procedures rather than focusing on local requirements or seeking input from individuals affected by the epidemic. For instance, Renville County, Minnesota, allocated $100,000 from settlement funds towards purchasing a body scanner capable of detecting drugs on new inmates, even if they have concealed items internally. Alicia House, the executive director of the Steve Rummler Hope Network, expressed skepticism about the rationale behind such spending priorities.
Renville County Sheriff Scott Hable defended the decision by emphasizing the need to restrict drugs in the jail environment while prioritizing rehabilitation for inmates with substance use disorders, stating that the scanner has been utilized nearly 1,400 times and successfully detected contraband on six separate occasions. The county is now forming an advisory group to guide future fund distribution, with steps being taken to include individuals with direct experience in substance use.
In West Virginia, Jackson County Commission President Dick Waybright argued that their training center would enhance the capabilities of emergency responders during opioid-related crises. He asserted that this was a sustainable investment and mentioned that the only proposal for funding from the initial settlement payment came from the rapid response team.
Families affected by addiction, like George’s, stress the pressing needs within their communities, including transportation services for individuals in recovery, preventive education, and counseling services for the children of those struggling with substance use issues. His family’s organization is seeking a $15,000 grant from the remaining settlement funds, which Waybright indicated would be awarded soon.
For some individuals, the allocation of these funds is deeply personal. Tonia Ahern, a community coordinator for the National Center for Advocacy and Recovery who lost her son to an overdose at age 29, has co-founded a group dedicated to creating a handbook to advise New Jersey communities on effectively utilizing their funds. “If you haven’t ever experienced it, you have no idea what they need,” Ahern stated, highlighting the crucial role of lived experiences in shaping effective response strategies.
