CAMDEN, NJ (AP) — Drugmaker Johnson & Johnson and three major distributors finalized nationwide agreements over their role in the opioid addiction crisis on Friday, an announcement that paves the way for 26 billion dollars to almost every state and local government in the United States.
Taken together, the settlements are the largest to date among the many opioid-related cases that have unfolded across the country. They are expected to give a significant boost to efforts to reverse the crisis in places devastated by it, including many parts of rural America.
Johnson & Johnson, AmerisourceBergen, Cardinal Health and McKesson announced the settlement plan last year, but the deal was contingent on the participation of a critical mass of state and local governments.
Friday was the deadline for the companies to announce whether they felt enough governments had pledged to participate in the settlement and waive the right to sue. The four companies have told government lawyers in the case that their thresholds have been met, meaning money could start flowing to communities by April.
“We will never have enough money to immediately fix this problem,” said Joe Rice, one of the lead attorneys who represented local governments in the litigation that led to the settlement. “What we’re trying to do is give a lot of small communities a chance to try to change some of their issues.”
While none of the settlement money goes directly to victims of opioid addiction or their survivors, the vast majority of it is to be used to address the epidemic. The need for financing is profound.
Kathleen Noonan, CEO of the Camden Coalition of Healthcare Providers, said some of the settlement money should be used to provide housing for homeless people with addictions.
“We have clients who struggle to stay clean to go to a shelter,” she said. “We would like to stabilize them so that we can help them recover.”
Dan Keashen, a Camden County government spokesman, said officials plan to use the settlement money for a public education campaign to warn of the dangers of fentanyl. They also want to send more addiction counselors to the streets, put more social workers in city courts, and pay for addiction drugs in the county jail.
Officials across the country are considering pumping money into similar priorities.
California Governor Gavin Newsom’s proposed budget plans to use $50 million of the state’s $86 million planned this year for opioid education for young people and to train treatment providers, improve collecting data and distributing naloxone, a drug that reverses overdoses.
In Florida’s Broward County, home to Fort Lauderdale, the number of beds at a county-run rehab facility could increase from 50 to 70 or 75, said county attorney Danielle Wang French.
“It’s not enough, but it’s a good start,” she said of the settlement.
As fatal overdoses continue to rage in the United States, largely due to the spread of fentanyl and other illicitly produced synthetic opioids, public health experts are urging governments to use the money to ensure the access to drug treatment for people with drug addiction. They also stress the need to fund proven programs, collect data on their efforts, and launch prevention efforts aimed at young people, while emphasizing racial equity.
“It shouldn’t be: ready, ready to spend,” said Joshua Sharfstein, a former secretary of the Maryland Department of Health, who is now associate dean of public health at Johns Hopkins University. “It should be: think, strategize, spend.”
In a separate agreement that is also included in the $26 billion, the four companies reached a $590 million settlement with federally recognized Native American tribes. About $2 billion is set aside for the fees and expenses of attorneys who have spent years working on the case.
Johnson & Johnson, based in New Brunswick, New Jersey, has nine years to pay its share of $5 billion. Distributors – AmerisourceBergen, based in Conshohocken, Pennsylvania; Cardinal Health, based in Columbus, Ohio; and Irving, Texas-based McKesson agreed to pay their combined $21 billion over 18 years. To achieve the maximum amounts, states must obtain buy-in from local governments.
Settlements go beyond money. J&J, which has stopped selling prescription opioids, pledges not to resume. Distributors agree to send data to a clearing house to help report the diversion of prescription drugs to the black market.
The companies do not admit wrongdoing and continue to defend themselves against allegations that they helped cause the opioid crisis that were brought by entities not involved in the settlements.
In a joint statement, the distributors called the settlement’s implementation “a key step toward resolving large-scale government claims about opioids and providing meaningful relief to communities across the United States.”
The demand that most of the money be used to deal with the opioid crisis contrasts with a series of public health agreements in the 1990s with tobacco companies. In these cases, states have used much of the settlement money to fill budget gaps and fund other priorities.
The amount sent to each state under the opioid regulations depends on a formula that takes into account the severity of the crisis and the population. County and local governments also receive shares of the money. A handful of states – Alabama, New Hampshire, Oklahoma, Washington and West Virginia – have not joined all or part of the settlement, mainly because they have their own agreements or are preparing to a trial.
In Camden, Lisa Davey, a recovery specialist at Maryville Addiction Treatment Center, was at a needle exchange this week handing out naloxone, a drug that reverses overdoses, and asking people if they wanted to start a processing.
Davey said she wants detox and treatment programs to receive more funding to keep people there longer. As it stands, she said, users can detox and be back on the streets for drugs within days.
“They need more time to work on their recovery,” she said.
A man collecting clean needles who asked to be identified only as Anthony P. said he was 46 and had struggled with addiction since he was a teenager. He said he would like to see an effort to cut fentanyl and related synthetic opioids that drive overdose death rates from the drug supply.
“Fentanyl needs to go,” he said.
Martha Chavis, president and CEO of Camden Area Health Education Center, which runs the needle exchange, said there was a need to offer services like hers in more places. Now users from outer suburbs travel to Camden to get clean needles and kits to test their drugs for fentanyl.
The settlement with J&J and the three distributors marks a major step toward resolving the vast constellation of lawsuits in the United States over responsibility for an outbreak that has been linked to the deaths of more than 500,000 Americans over the past two decades.
Other companies, including business consultant McKinsey and drugmakers Endo, Mallinckrodt and Teva, have national agreements or a series of local agreements. OxyContin maker Purdue Pharma and a group of states are mediating in US bankruptcy court to try to reach a nationwide settlement.
The crisis has deepened during the coronavirus pandemic, with opioid-related deaths in the United States peaking at more than 76,000 in the 12 months to April 2021, largely due to the spread fentanyl and other lab-made drugs. A recent commission report from the medical journal The Lancet projected that 1.2 million Americans could die from an opioid overdose between 2020 and 2029 without a change in policy.
John F. Kelly, professor of psychiatry in addiction medicine at Harvard Medical School, said he wants to see settlement money used not only for treatment, recovery and support efforts, but also for building. of systems designed to prevent this type of epidemic from occurring. again.
“Some kind of national council or organization could be put in place … to prevent this kind of lack of oversight from happening again – where industry is allowed to create a danger to public health,” he said. declared.
