NewsBeat

July 2023 NewsBeat 6 The basics: What you need to know about the flow of opioid settlement dollars to localities By ANNA GINELLI The epidemic has grown and intensified since opioids began being aggres- sively marketed in the late 1990s.. S tate and local governments are re- ceiving billions of dollars as part of nationwide settlements with compa- nies that manufacture, distribute and sell opioids in an effort to hold the companies accountable for the ongoing opioid addic- tion epidemic. Despite the breadth of the epidemic across the country, with thousands dying each year, public awareness is limited of the incoming grassroots settlement money. Money from the legal settlements has al- ready started flowing, but who will ensure the money goes to the "right place"? Here is what you need to know about the opioid epidemic and the opioid settlement funds. The epidemic has grown and intensified since opioids began being aggressively marketed in the late 1990s. Pharmaceuti- cal companies gave doctors incentives to prescribe opioid painkillers to vulnerable patients dealing with excruciating phys- ical pain. But many of these companies downplayed the highly addictive nature of these drugs. The lawsuits against the drug companies contended that patients pre- scribed opioids were unaware of the risks of addiction. As more people became reliant on opi- oids, distribution became more challenging to regulate. In the 2010s, illegal heroin sales began to increase. Most recently, fen- tanyl, a prescription opioid, has been made synthetically and is often found laced with illicit drugs. The high prescription rate of opioids, the manufacture and distribution of heroin, and the rapid production of synthetic fen- tanyl all contributed to the opioid epidem- ic. In 2021, over 107,000 people died of a drug overdose in the United States. Almost 75% of these deaths involved an opioid, according to the Centers for Disease Con- trol (CDC). The lawsuit settlements are designed in part to address the epidemic by funding programs and services to help those suf- fering from addiction and to prevent more people from becoming addicted. What are opioids? Opioids are a class of drugs used to reduce pain. Doctors may prescribe opioids to treat moderate to severe pain. However, they have serious risks and side effects associated with them. The most common types of prescription opioids are oxyco- done (OxyContin), hydrocodone (Vicodin), morphine and methadone. There are also illegal opioids, like heroin, that doctors cannot prescribe. Fentanyl is a synthetic opioid pain reliev- er. It is much more powerful and addictive than many other opioids. It is associated with severe pain relief, such as the pain associated with advanced-stage cancer. But outside the medical establishment, the use of illegally manufactured and distributed fentanyl has become increasingly more common. However, illegally manufactured and distributed fentanyl is becoming more common in the United States. Deaths linked to opioids have dramati- cally risen in the past decade and remain high: 80,816 people died from opioid overdoses in 2021, up from 70,029 in 2020, according to the CDC. Because illicit fen- tanyl production is experiencing such rapid growth, it has become harder to reduce the severity of the crisis. Illegal drugs, for example, can be laced with fentanyl, and the user cannot detect fentanyl lacing with the naked eye. What are Opioid Settlement Funds? More than 4,000 state and local govern- ment officials across the United States are suing opioid manufacturers, distributors and pharmacies for downplaying the drug's effects and the risk of addiction while over- stating its benefits. To resolve those law- suits, the companies have agreed to pay the states millions to help combat the opioid epidemic. The total settlement payout is estimat- ed to be around $54 billion, making the settlement the second-largest settlement in the country's history, following the tobacco settlement in 1998. There are opioid lawsuits against mul- tiple corporations; some, but not all, have concluded with settlement agreements. Here are the most prominent nationwide cases, the date filed and their settlement amounts: • February 2021: McKinsey & Company – $573 million • July 2021: Johnson & Johnson (J&J) and "The Big Three" Distributors (McKesson, Amerisource Bergen and Cardinal Health) – $26 billion • September 2021: Endo Pharmaceuti- cals – $450 million • June 2022: Mallinckrodt Pharmaceuti- cals – $260 million • November/December 2022: CVS, Wal- greens, Walmart, Allergen and Teva – $18 bllion Purdue Pharma, a pharmaceutical com- pany owned by the Sackler family, is widely known for creating OxyContin, a highly addictive prescription opioid. Purdue was entangled in hotly contested bankruptcy proceedings for nearly two years before they made a reorganization plan that a judge approved in September 2021 but later overturned on appeal. Ultimately, several states challenged the plan, and in December 2021, a federal district court overturned the plan. In response, Purdue appealed the deci- sion to the Second Circuit Court of Appeals. On May 30, 2023, the Second Circuit ruled in favor of Purdue, allowing the pharmaceu- tical company to reemerge as Knoa Pharma. As part of the settlement, the Sacklers will give up ownership of the company, and the family will also pay up to $6 billion; that money has yet to be distributed. How much is going to New York? In New York State, Attorney General Letitia James has secured about $2.7 billion in settlement money for the state and its localities.

• Cover