Opioid settlements have been reached nationally to resolve litigation brought by states and local communities. The agreement—announced Feb. 25, 2002—with the drug distributors AmerisourceBergen, Cardinal Health and McKesson, along with opioid manufacturer Johnson & Johnson, will bring relief to states and communities affected by the opioid epidemic. A total of $26 billion is included in the settlement.
“The settlement is the first of its kind to administer resources directly to the state and local governments specifically for relief programs to help rebuild the devastation caused by the opioid epidemic,” the Plaintiffs’ Executive Committee press release noted. The opioid settlement funding will have a direct impact on first responders, with states already moving to set up funds that expand naloxone training, fund pre-arrest diversion and post-overdose response, and provide wellness and support services for first responders who experience secondary trauma.
Following are key aspects of the settlement.
When & Where Will the Money Be Accessible?
The distributor settlement includes $21 billion in funding and is open to all states except West Virginia. For a local political subdivision to receive funds, the state must agree to the settlement. The $5 billion settlement against opioid manufacturer Johnson & Johnson is open to all states. With the exception of Oklahoma, in order for a local political subdivision to receive funds, the state must agree to the settlement.
In both settlements, a limited number of “special districts,” such as school districts, fire districts and hospital districts, may be allowed to participate. Washington, D.C., and the five U.S. territories are treated as states in the agreements.
Multiple state Attorneys General filed joint lawsuits and 51 out of an eligible 56 states agreed to the settlement terms, although some are party to only one of the settlements. States that decline to participate may pursue further litigation at trial to obtain damages and abatement relief.
If the proposed settlements are fully adopted by states and subdivisions nationwide:
- The Distributors will pay a maximum of $21 billion over 18 years, while Johnson & Johnson will pay a maximum of $5 billion over no more than nine years, with approximately $22.8 billion in settlement proceeds payable to state and local subdivisions.
- Funds can begin to flow to states and local governments as early as May 2022, depending on when a settling state meets certain requirements.
The Tribes, the distributors and Johnson & Johnson are also working toward resolution of Tribal opioids claims through mediations under the Multidistrict Litigation court.
How Will Funds Be Distributed?
States will receive funds based on the impact of the opioid epidemic in their state. The share of the impact is calculated using data such as the amount of opioids shipped to the state, the number of opioid‐related deaths that occurred in the state and the number of people who suffer opioid use disorder in the state.
Although specifics vary by state, we can expect police, fire and EMS to benefit from the effects of the opioid-remediation efforts funded by the settlements and the injunctive relief the settlements provide.
The settlements require 85% of funds be allocated to programs that will help address the ongoing opioid crisis through treatment, education and prevention efforts. A majority of states have already passed agreements that dictate how funds will be distributed between state and local subdivision governments, ensuring funds will effectively reach communities in the coming months.
How Can the Funds Be Used?
The settlements allow for a broad range of approved abatement uses by state and local governments. The list of pre-approved uses includes a wide range of intervention, treatment, education and recovery services so that state and local governments can decide what will best serve their communities. Although specifics vary by state, we can expect police, fire and EMS to benefit from the effects of the opioid-remediation efforts funded by the settlements and the injunctive relief the settlements provide.
Eligible uses of funds generally include:
- Medication-assisted treatment
- Mental health treatment and capacity building
- Screening, intervention and referral services
- Training and support to emergency services professionals re: opioid overdoses and opioid-related adverse events
- Community education, outreach and prevention activities (special efforts are given to youth, criminal justice-involved populations and pregnant women)
- Narcan and opioid-reversal interventions
- Revisions to prescribing practices
How Will the Funds Support First Responders?
States are currently developing guidance for distributing the opioid settlement funding. While the funds will be used for programs across local government—including schools, health care providers, community outreach and recovery programs—state plans also outline many uses that will have a direct impact on first responders. Here are some examples specific to how the funds may be used to support public safety:
- Expand first responder training in the use of naloxone or other FDA-approved drugs to reverse opioid overdoses
- Increase availability and distribution of naloxone and other overdose treatment drugs for use by first responders and other impacted groups
- Support current and future law enforcement expenditures relating to the opioid epidemic
- Educate law enforcement or other first responders regarding appropriate practices and precautions when dealing with fentanyl or other drugs
- Provide medication-assisted treatment education and awareness training to healthcare providers, EMTs, law enforcement and other first responders
- Provide funding and training for first responders to participate in pre-arrest diversion programs, post-overdose response teams or similar strategies that connect at-risk individuals to behavioral health services and support
- Provide training for law enforcement, correctional and judicial personnel on best practices for addressing the needs of criminal justice-involved persons with opioid use disorder
- Educate law enforcement or other first responders regarding appropriate practices and precautions when dealing with fentanyl or other drugs
- Increase availability and distribution of naloxone and other overdose treatment drugs for use by first responders
- Provide wellness and support services for first responders and others who experience secondary trauma associated with opioid-related emergency events
- Increase availability and distribution of naloxone and other overdose treatment drugs for use by first responders
- Provide funds for first responders and criminal justice professionals for expenditures relating to community and statewide opioid supply-and-demand reduction strategies, including criminal interdiction efforts
- Train public safety officials and responders in safe-handling practices and precautions when dealing with fentanyl or other drugs
- Provide trauma-informed resiliency training and support, including services that address compassion fatigue and increased suicide risk of public safety responders
What’s Next?
What steps should public safety leaders take next? In a word, advocate. February 25 kickstarted a 60-day countdown to the date this settlement is considered effective. This means your local leaders are determining how to spend this money now.
Review the guidance from your state MOU and contact your local government. Be prepared to address which abatement and mitigation efforts will help address the crisis in your community. What has the opioid epidemic done to your community? How has it affected your department in terms of response times, training and equipment? Is your local government body aware? What data supports your needs for training, wellness programs, equipment, etc.?
Advocacy is a means to get your response agency needs in front of the local government decision channel. Identify your needs based on the parameters of what opioid settlement funding can be used for and meet with your local government leaders now. They need to know how this funding will impact your department, address response needs and mitigate the impact this epidemic has had. Many of the same advocacy strategies used to tap American Rescue Plan funds apply to opioid settlement funding as well. Start those conversations with your local leaders today!
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