Opioids

Most Opioid Settlement Funds Aren't Going to Addiction Services

Despite what the media and politicians have said, that isn't how this works.

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Attorneys general from across the country reacted to the opioid crisis by taking big pharmaceutical companies to court. The fund they won, they promised, would be spent on addiction services, thus working to end the crisis. "This settlement helps hold these companies accountable for their role in contributing to the opioid epidemic and will provide Floridians struggling with opioid addiction the services they need to recover," Florida Gov. Ron DeSantis declared in July, after agreeing to a massive settlement with the McKesson Corporation.

But that's not how the story has been working out.

Since 2011, the United States has seen spikes in fentanyl overdoses. They killed an estimated 93,000 people in the last year alone. The popular media narrative is that this crisis was caused by Purdue pharma's OxyContin and the company's marketing push to use addictive opioids to treat chronic and acute pain. This wrongly puts the blame on patients while ignoring public health authorities' role in creating this addiction epidemic. Nor does it recognize how public health agencies (in particular, the FDA) made an addiction crisis lethal by forcing Purdue to reformulate oxycontin to be abuse-deterrent, thus pushing millions of casual drug users onto more dangerous black-market substances. Nevertheless the pharma-only narrative has been a winner in court. Thousands of state and local governments have sued pharmaceutical manufacturers and distributors, winning billions.

The largest of these settlements is this year's McKesson/AmerisourceBergen/Cardinal Health settlement, worth $26 billion. Their alleged transgression, which the companies still dispute, is to not do enough to stop suspicious opioid orders. When the settlement is finalized, it will account for most of the 3,000 or so opioid lawsuits nationwide and will be the second largest settlement in U.S. history—with a whopping $2.3 billion allocated for lawyer fees and expenses.

Then there's the $12 billion settlement with Purdue pharma, over the company's negligence and mismarketing of Oxycontin and other drugs. Under the bankruptcy settlement terms, Purdue is dissolved, its assets are now managed by a public benefits firm, and the former owners (the Sackler family) are on the hook for $4.5 billion. Both settlements provide some protection from future litigation. However, the Justice Department is apparently miffed the Sacklers will not see jail time and is threatening to hold the Purdue settlement up. Even still, this is one of the most punitive settlements in legal history.

"As opioid settlements are reached, we must learn from the missed opportunity with tobacco," Sen. Dick Durbin (D–Ill.) wrote in Stat News earlier this year. "That means dedicating the funds from opioid settlements to build the public health systems our nation needs to respond to the opioid crisis and prevent future addiction."

But due to the separation of powers established in the Constitution, courts cannot dictate much about how the states use litigation settlement funds. Unless specified otherwise by state law, those funds are at the discretion of the state attorneys general, who must vet the funds for use in the general budget. Fighting addiction with settlement funds is a lie, and it always was.

This isn't the first time this con has been played. The largest settlement in U.S. history was the 1998 tobacco master settlement, which cost American tobacco companies $206 billion. Then as now, the narrative said the government was getting big bucks to stop America's cigarette habit. Despite those assurances, 98 percent of those funds ended up in states' general budgets.

Durbin and other politicians promise that this time it will be different. So far, 19 states have passed legislation designating settlement money as special funds, with another nine legislating allocation agreements. But those bills sound better than they really are.

For an example, look at Colorado

The Colorado Memorandum Agreement, which is more detailed than most states' measures, states how opioid settlement funds are to be divvied up. State coffers will receive 10 percent of the funds, then 20 percent for local governments. The lion's share, 60 percent, will go to different regions, whose leadership and advisory groups will—with broad discretion—determine how to spend the funds. Of the $400 million in settlement money coming their way, Coloradans can only be sure that $40 million, just 10 percent, will go towards "opioid abatement infrastructure projects."

Even then, it's unclear how that money will be spent and how effective it will be. While addiction experts generally favor harm reduction, state leaders of both parties are prone to advocating heavy-handed law enforcement policies, such as mandatory drug courts and further surveillance of physicians and patients. And even if you could push aside the drug crusaders, an anti-addiction policy might mean anything.

Consider just a sampling of the "anti-addiction" policies those settlements are funding. In West Virginia, addiction services mean more in education spending; in Oklahoma, it means more money for corrections. Oregon likes medical research and equity; Connecticut is particular to social services. In Minnesota, the focus is on non-narcotic pain treatments. Michigan's plans include efforts to help new mothers.

And there's a bigger problem: There is little to stop states from using those funds according to the established parameters, then shifting the regular budgeted funds elsewhere. After the McKinsey settlement, then–New York Gov. Andrew Cuomo notified the Office of Addiction Services and Supports that of the state's $32 million share, $21 million will be going to the state's general fund.

It could get worse. In 2007, then–West Virginia Gov. Joe Manchin tried to use settlement funds from Purdue Pharma to purchase a gubernatorial helicopter. Who knows what misappropriations could be on the way now? The public reaction to the misallocation of funds from the tobacco master settlement will be nothing compared to the angry response from the families of opioid overdose victims when they realize the healing and justice promised to them was a sham.

NEXT: California Is Clueless About Homelessness

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    1. You are an insufferable faggot.

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            1. Stop raping your kids you syphilitic worm.

    2. No bad. Just most government employees at all levels of government want more government and are Democrats. This is just those in power supporting their base. With your money, but what’s new about that.

    3. sarcasmic –

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  5. Damn! This is a surprise! At least most of the tobacco settlement money is going to pay for the healthcare expenses of smokers and ex-smokers, right?

  6. You missed a big one Pete. The Tobacco Settlement is being made in payments. Several States have borrowed against the future payments to support their Liberal Socialist agenda. Now these States have no desire to reduce smoking, because they need tobacco to be profitable so they can get those future payments. That’s one of the reasons for the war on vaping. Is this settlement going to be any different?

  7. gubernatorial helicopter

    Nice band name, albeit perhaps too similar to Jefferson Airplane.

  8. Do Something!

    Drug addiction? Do something . . . even the wrong thing but do something. “Addiction services” are a proven failure. Rate of recidivism? 85%!

    What to do? As in southeastern Asia, make possession a capital offense — public hanging; first offense, public flogging. Alternative? Legalize all mind-altering drugs with certain minimal restrictions as specified in the novel, Retribution Fever.

    1. Addictive drugs are body-altering. Psychedelic drugs alter no minds. They simply make it easy to decide to quit using depressants, narcotics, stupefacients… Or is THAT why Ray Gun and other scientist-impersonators banned them?

  9. Nor does it recognize how public health agencies (in particular, the FDA) made an addiction crisis lethal by forcing Purdue to reformulate oxycontin to be abuse-deterrent, thus pushing millions of casual drug users onto more dangerous black-market substances.

    If it saves one life…

  10. Never mentioned in this article is the fact that 90% of people who graduate from government approved/funded opioid addiction treatment/recovery programs (most of which don’t allow the use of methadone) have relapsed back into their addiction.

    As such, spending opioid settlement money on opioid treatment programs would be yet another waste of government funds.

    The same has been true of government approved and healthcare insurance funded smoking cessation (technically tobacco addiction treatment) programs (i.e. more than 90% of treatment program attendees have relapsed, and no harm reduction nicotine alternatives like vapor and smokeless tobacco products are allowed).

    Ironically (or not), many people similarly complained that states have spent little of the 1998 Master Settlement Agreement funds on smoking cessation programs.

    But as one who actively urged State AGs to sue cigarette companies back in the 1990s, and who then challenged PA’s settlement in court, I’m pleased the states didn’t spend/waste much of the cigarette settlement money on ineffective smoking/tobacco cessation programs.

    1. “As such, spending opioid settlement money on opioid treatment programs would be yet another waste of government funds.” Not if you are getting paid for the treatment program. In Pennsylvania there was an attempt to start a center where a drug user could shoot up, with somebody there to help in case of a problem. It got turned down. it turned out that the center was going to file claims with Medicaid and any other insurance to make money.

      1. So? Why is that Medicaid claim any worse than any other Medicaid claim arising out of accidents by people doing what they want to do?

  11. Now do the Chinese government dumping fentanyl on the US. Confrontation is difficult, but you can do it.

    1. Better than wasting money on more expensive domestic fentanyl, amirite?

  12. Billions of dollars in punishment because Pharma merely followed the rules and reported suspicious purchases rather than … what exactly? Decline to ship drugs to distributors in Kentucky because the DEA declined to investigate a pill mill in Florida?

  13. The only justice would be the Sacklers rotting in prison for the rest of their lives.

    1. Why?

      Seriously, why? What exactly did they do that was so beyond the pale that you think they need to rot in cages for the rest of their lives? I know, like a lot of people these days, you’ve been conditioned to hate on command. But, usually that sort of animus would suggest some sort of rational basis. So, what exactly did they do that was wrong. Are you suggesting that selling pain relievers on prescription is such an offense that they deserve to die in a cage? If so, would you be willing to commit right here and right now to never take a pain reliever (okay, we’ll except aspirin) ever in the rest of your life? How about denying them to your loved ones? Are you willing to commit to that?

      1. Ach, they made money! They made money doing the thing authorities said they wanted done: developing and selling less-“abusable” (because sustained-release) versions of narcotic analgesics. Then they got blamed because this desideratum was not perfectly achieved.

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  15. Its theater.

  16. We have the worst of both worlds: the purveyors of narcotics being punished because their customers are deemed to be controlled by the drugs, and hence powerless to stop taking them; and the customers are punished because they’re deemed responsible for taking them. Maybe the idea is that purveyors and consumers of narcotics are conspiring to…exchange money for stuff people want to buy and use?

    Does anybody see a way to knock any sense into the world (i.e. everyone who is not us already)? Seems all we can do is adjust the blame: more of it on the consumers or more on the producers. The idea that they’re doing a bad thing together seems, I don’t know…self-evident, because some drug users overdose and die, even on high quality medical grade, and others act like bums — probably the bums, or desperate people, they would’ve been anyway.

    Since this meme has held on so hard and so long, the only way out seems to be technologic, by development of strong analgesics that can’t be overdosed no matter how hard the users try, and that don’t make consumers dopey, plus ways those who want a kick can get one without appearing to be getting one.

  17. And this is one area in which both-sides-ism hits the mark.

  18. Like the tobacco settlement, the opioid settlement solves an alleged emergency that never existed — because the so-called emergency consisted entirely of adults voluntarily taking drugs they felt helped them.

    The Nuremberg Code needs to be extended to guarantee access by any adult to any drug he or she wants and is willing to pay for. Getting to make your own risk/reward choices individually is what being an adult is all about.

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  20. ALL THIS BULLSHIT! All this crap does is HURT the VETS and people that are in intense pain. NOW these BUFFOONS at the dea screw with the GOOD pain management DOCS until they will NOT give the PEOPLE THAT NEED THE PAINS MEDS their NEEDED MEDS!!!!. SCREW THE FEDS!!!! THE feds screw up EVERYTHING THEY TOUCH!…I had stopped DRINKING for years & these MORONS started this BULLSHIT!…NOW, the ONLY way I can get the relief
    from the pain is DRINK AGAIN! SCREW THESE PEOPLE!!!!!!!

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