Attorney General Josh Stein spoke in Greenville today about the state’s second wave of opioid settlements, which was finalized in court last week. The $21 billion settlement was brought by all 50 states against two drug manufacturers and three distributors – Teva, Allergan, Walmart, Walgreens and CVS.
North Carolina will receive $600 million from the settlement. Fifteen percent of those fund will remain with the state. The rest will go to all of North Carolina’s 100 counties and some municipalities over the next 15 years and are earmarked for addiction treatment and drug education programs.
From 2000-2020 more than 28,000 North Carolinians lost their lives to drug overdose, according to the North Carolina Department of Health and Human Services.
Stein was a lead negotiator in the deal and said the settlement will go toward those most affected.
“It has to go toward strategies like harm reduction, prevention, treatment or recovery services,” Stein said.
Pitt County will receive more than $8.8 million over the next 18 years. In December 2022, Pitt County commissioners agreed to spend its first installment of $805,000 on providing supplies for its syringe service program, addiction treatment through its prison reentry program, and preventative and rehabilitative programming through the Pitt County Coalition on Substance Abuse.
County Manager Janis Gallagher said Pitt county signed on early to the lawsuits.
“Six years ago, the commissioners authorized me to sign on to a lawsuit on behalf of Pitt County against the drug manufacturers and distributors whose actions created the physical and financial harm that we continue to see in our community,” Gallagher, who served as county attorney in 2017 when Pitt County signed onto the first settlement, said.
The lawsuits that led to the settlement allege the companies either inappropriately marketed their painkillers to doctors or continued to fill and deliver prescriptions despite signs of misuse. The companies claim no wrongdoing.
Stein, who is also a Democrat candidate for governor, said the settlements aim to deter companies from engaging in the practices that helped spur the public health crisis.
“$55 billion is a lot of money, and so that inflicted a lot of financial pain on those companies. That’s a strong disincentive,” Stein said.
Drug makers and distributors are also required to make changes as part of the settlement. Drug manufacturers are no longer allowed to market their opioids to prescribers, while pharmacies and distributors are required to improve internal monitoring. Opioid manufacturers are accused of misleading and intentionally withholding information about the addictiveness of its drugs to prescribers, while distributors are alleged to have ignored signs of abuse at certain pharmacies.
“They either engaged in aggressive marketing or they turned a blind eye and allowed more of these drugs to be sold through their networks because, guess what, they made money on every pill that was sold,” Stein said.
Pitt county’s chosen to award its settlement dollars through a reimbursement model as an extra form of accountability. Organizations and programs authorized to receive money must first spend on appropriate items, and the county then reimburses the purchases with funds from the settlement.
“It’s an accountability approach to make sure organization are utilizing their funds toward impactful actions,” Jennifer Roman, Pitt County’s opioid and American Rescue Plan coordinator, said. “This method also allows us to monitor them very closely and make sure they’re spending the money on eligible things.”
This second wave settlement comes months after funds from the first wave were distributed to counties and municipalities. North Carolina received $750 million from the first wave settlement with AmerisourceBergen, Cardinal Health, McKesson, and Johnson & Johnson, who also claim no wrongdoing.
These opioid settlement funds are intended for drug prevention and rehabilitation programs. As part of the memorandum of agreement that each recipient signed on to, municipalities and counties must report their spending to a centralized online dashboard 90 days after they first approve spending and then annually thereafter. Stein said transparency around spending is one form of accountability to ensure the dollars are spent appropriately.
“We are using transparency to ensure that the best decisions are made by our local officials,” Stein said. “If they fail to spend the money the way they’re supposed to, there are measures within my office to get them back in compliance.”
The settlements are one form of accountability for the role drug makers and distributors played in a public health crisis that continues to change. The first wave of the opioid epidemic began in the 1990s with overdoses largely related to prescription pills. That shifted to heroin in 2010, and later synthetic opioids like fentanyl in 2013.
“We’ve lost too many of our neighbors and friends to overdoses, and we’ve seen the turmoil that’s been created by this crisis for far too long,” Gallagher said about the opioid epidemic’s impact on Pitt County.
