State governments across the country have been tasked with stewarding a portion of funds acquired through regional and national legal settlements with opioid manufacturers and distributors in recent years – including the likes of Johnson & Johnson, McKesson and CVS. The settlements stem from multiple nationwide lawsuits levied against the companies for their role in fueling the opioid epidemic.
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According to the Centers for Disease Control & Prevention, around 75% of drug overdose deaths were connected with opioids in 2022. That accounts for the deaths of more than 81,000 people that year. Kentucky’s Justice and Public Safety Cabinet said in their 2022 Overdose Fatality Report that a little over 1,500 people who died from overdoses in the state were found to have fentanyl in their system.
State governments and localities are using the settlement funds to try to heal communities affected by the opioid crisis and prevent others from being affected.
Kentucky has secured around $900 million from opioid settlements. Those funds have been split into two pools, with half earmarked for the Kentucky Opioid Abatement Advisory Commission (KOAAC) – a group specifically formed to handle the state’s use of the funds – and half divvied up among the state’s county and city governments. The first installments were distributed by the state to local governments in December of 2022. Payments are expected to continue until 2038 with no deadline in place for when funds must be spent.
Lauren Carr is an Opioid Settlement Advisor for the Kentucky Association of Counties (KACo). She assists county officials in navigating the best practices and reporting guidelines for the opioid settlement funds, which can only be used in specific ways.
“You can't take these funds and use it for a program that was already being funded. You can't take these funds and supplant. These funds are supposed to be to supplement,” Carr said. “Either integrate a new program or supplement the existing programs that you have – seeing where barriers are – and providing those services.”
Kentucky’s legislature has already outlined a list of possible uses for these funds in a state statute. Carr said the list – which was created when KOAAC was chartered – provides pathways for localities to take but she said it doesn’t expressly limit their use.
The Paducah Police Department, in far western Kentucky, is using some of the city’s settlement dollars to staff a new position focused on lowering recidivism for the people with substance use disorders.
Paducah Police Chief Brian Laird said hiring a deflection specialist has been a long-term goal for his department.
“We encounter folks regularly that are homeless, folks that have mental health issues, folks that have drug abuse issues,” Laird said. “So the goal was – instead of the officers continuing to respond over and over to these folks – we have somebody that can follow up with these individuals and try to get them some help.”
Deflection is a relatively new philosophy in law enforcement that focuses on keeping individuals with substance use disorders from entering or reentering the court system by avoiding interactions with police. Laird said that he’s aware of other social work positions within police departments in the state but believes Paducah may be the first department in Kentucky to hire a deflection specialist.
The position will be paid, in part, by the police department's budget, but the majority of the funding comes directly from the city’s opioid settlement money. Applications for the position closed in April, but Laird hopes the specialist to be officially onboard by August.
Other county and city governments in western Kentucky are still trying to figure out how to spend their portion of settlement funds.
Murray officials formed a work group before the first settlement payments were received to investigate possible uses of the funding. City Administrator Jim Osborne said the city is still working alongside the Kentucky Attorney General’s office, but that no official plans have been made as of yet.
“The goal would be using the money to not necessarily just in one area of but could combine areas that are approved uses,” the Murray city administrator said. “I think the key is finding a happy medium of where best it would be used … something that's legal, transparent and would help the community.”
Similarly, Marshall County Judge Executive Kevin Spraggs said he wants to make sure settlement funds are used in the most efficient way possible.
“We want to make sure wherever this money goes, ultimately, it's put to the best possible use,” Spraggs said. “We don't want to jump into something without doing a lot of research, and we'd like to do something with a proven track record, percentage wise, where the most people are being helped.”
For Carr, addressing the opioid epidemic has two major components – prevention and harm reduction. She said that many localities focus on prevention, with enacting programs like “Just Say No” to keep individuals from becoming substance users in the first place. Harm reduction, instead, focuses on helping individuals who are already using drugs.
The statutory list includes 29 potential uses for settlement dollars that would provide funding for projects aimed at helping those with substance use disorder or those who are at risk of using. These include programs focusing on supporting intervention, treatment and recovery services to substance users. The funds could also be used to educate the general public and provide training to healthcare providers, recovery specialists or law enforcement.
The list also includes things like drug-take back and disposal programs and any programs that cover the cost of administering naloxone.
The over-the-counter medicine (also known as Narcan) can be used to treat opioid overdoses in a crisis situation. Carr said that increasing accessibility to the medication and teaching the public about its use could help to prevent deaths.
“At the end of the day, a dead person doesn't recover,” Carr said. “We all can be first responders. Whether it's at a basketball game, at the library or at a Walmart, you never know when you may be a first responder, and so being prepared is something that will help save lives for individuals that are in active addiction right now.”
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