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

People with substance use disorders across the country have no say in how much of the roughly $50 billion in Opioid Lawsuit Settlement Money is being used to stem the crisis, according to a new analysis.

Some advocates say that’s one reason some of the money goes toward efforts they don’t see as proven ways to save lives from overdoses, including equipment to scan detainees searching for contraband, police drug-sniffing dogs and incapacitation systems. unnecessary prescription medications.

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, in recovery for three years after 23 years of drug use, mostly heroin, now runs a rehab group with his wife and other family members.

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

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

Over the past eight years, drugmakers, wholesalers, pharmacy chains and other companies have reached agreements to resolve thousands of lawsuits filed by state, local governments and Native American tribes, claiming that corporate practices had contributed to the crisis.

Opioids have been a major problem in the United States since the late 1990s. the deadliest streak of the beginning of this decade reaching more than 80,000 per year. The leading causes have shifted from prescription pills to heroin to fentanyl and other laboratory-produced substances often added to other illicit drugs.

Funds from the multibillion-dollar national settlements began being deployed in 2022 and will continue until at least 2038. The agreements require that most of the money be used for fight the crisis but offer great flexibility in how to do it.

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

Using this and other data, Minhee, who has totaled just under $50 billion in settlements, excluding the one with OxyContin maker Purdue Pharma, which the The Supreme Court rejectedfound that advisory groups help determine spending about half of that amount. But they have decision-making power over less than a fifth of this amount.

Less than $1 in $7 is overseen by boards that reserve at least one seat for someone who uses or has used drugs, although some places where this is not required may have anyway such members.

Brandon Marshall, professor of epidemiology at the Brown University School of Public Health and former member of the Rhode Island Opioid Settlement Advisory Committee, said he has observed that processes involving experts and people with experience with drug use have helped to quickly allocate allocations to groups working on harm reduction and other areas because they know the groups.

“This is not just a way to ensure that funds are used effectively,” he added. “These types of systems also ensure that funds go out more quickly. »

Public health advocates 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 follow standard government spending practices rather than assess local needs or consult experts or people affected by the outbreak.

Renville County, Minnesota, 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 new inmates, even s They swallowed bags of it.

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

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

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

The county governing body made the spending decision. Sara Benson, the county’s public health director, said the government was putting together an advisory group for future use of the settlements and wanted to include people with lived experience.

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

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

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

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

For others, spending decisions are even more personal.

Tonia 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 planning 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.