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How will counties spend the millions in opioid settlement funds?

Jeff Hill, executive directors of Wilson County's Substance Use Prevention Council, presented eight way the county will spend its first-year opioid settlement dollars.
Ryan Shaffer
PRE News & Ideas
Jeff Hill, executive directors of Wilson County's Substance Use Prevention Council, presented eight way the county will spend its first-year opioid settlement dollars.

The first wave of opioid settlement funds is making its way to local hands. It’s part of a $26 billion agreement to fund drug prevention and rehabilitation programs. It’s one form of accountability for the communities most affected, though the companies claim no wrongdoing. It also relieves pressure on those tackling the use of illicit opioids, as the settlement will provide a consistent stream of funds over 16 years.

The drug manufacturer Johnson & Johnson and three distributors, AmerisourceBergen, CardinalHealth and Mckesson, agreed to pay $750 million to the state of North Carolina over 16 years. Fifteen percent of those dollars will remain with the state, while the rest is distributed to counties and municipalities.

North Carolina Attorney General Josh Stein filed suit in 2020. Lawsuits alleged J&J downplayed addiction risk in its opioid marketing and the three distributors of a lack of oversight that allowed the drug to go onto the streets. The four companies proposed and approved a $26 billion deal in July 2021, seeking to end the more than 3,000 lawsuits by states, counties and local governments.

“While no amount of money will ever be enough, this settlement will force these drug companies to pay a historic amount of money to bring much-needed treatment and recovery services to North Carolina communities and to change their business practices so that something like this never happens again,” Stein said when announcing the agreement in 2021.

It’s the second largest settlement led by an NC state attorney general in history, behind the 1998 tobacco settlements.

All of North Carolina’s 100 counties and 14 municipalities signed agreements with the state to receive the settlement funds, which are now making their way to local agencies. The money is earmarked exclusively for drug prevention and rehabilitation and local agencies must account for their spending through a publicly available online dashboard.

Wilson County is among the first in the state to decide how it’ll spend the settlement dollars. The county received $575,000 this year. That amount will steadily decline each year before reaching $180,000 annually in 2032 until the last year of payments in 2038.

The Board of Commissioners approved eight strategies to receive this year’s funds:

  • Reimbursements to reduce the price of treatment for substance use disorders
  • Expand access to Naloxone, an overdose reversing drug widely known under the brand name Narcan
  • Reducing the cost of medication-assisted treatment through monthly stipends of up to $500 per recipient
  • Adding five public schools to participate in the “Miss Kendra” program, an early intervention curriculum that teaches students how to address traumatic experiences
  • Purchasing supplies for the county’s syringe exchange program, including needles and fentanyl test strips
  •  Stipends to reduce housing costs
  • Creating an online dashboard to track spending and impact of opioid settlement dollars
  • $125,000 for a “flexible funding pot” for local nonprofits who address substance use disorder

Jeff Hill, executive director of the Wilson County Substance Use Prevention Council (WCSUPC), said the money will simply sustain its ongoing work. WCSUPC was founded in 2007 and has since led the state in addressing the opioid epidemic on the ground.
“We’re very fortunate in this county that most of the work we’ve established has been that — established,” Hill said. “This allows us to expand into the further recesses of our county.”

Ron Hunt is the county manager and the treasurer for the WCSUPC.

“It’s great to talk about dollars, but at the end of the day, it’s the faces that are in my mind,” Hunt said. “Sons, daughters, mothers and fathers — that is who these dollars are for.”

Wilson County will receive $4.1 million over 16 years through the settlement. And, more is expected. North Carolina signed on to a $21 billion nationwide settlement with Walmart, CVS, Walgreens, Teva and Allergan. This second wave of opioid settlement money will bring more than $600 million to the state over 15 years. Like with wave one funds, that money will largely go to counties and municipalities.

Ryan is an Arkansas native and podcast junkie. He was first introduced to public radio during an internship with his hometown NPR station, KUAF. Ryan is a graduate of Tufts University in Somerville, Mass., where he studied political science and led the Tufts Daily, the nation’s smallest independent daily college newspaper. In his spare time, Ryan likes to embroider, attend musicals, and spend time with his fiancée.