State and native officers overseeing billions in opioid settlements are deluged with product affords from corporations

These pitches land every day within the inboxes of state and native officers answerable for distributing more than $50 billion from settlements in opioid lawsuits.

The cash is coming from an array of corporations that made, offered, or distributed prescription painkillers, together with Johnson & Johnson, AmerisourceBergen, and Walgreens. 1000’s of state and native governments sued the businesses for aggressively selling and distributing opioid medicines, fueling an epidemic that progressed to heroin and fentanyl and has killed more than half a million Americans. The settlement cash, arriving over almost 20 years, is supposed to remediate the consequences of that company conduct.

However because the {dollars} land in authorities coffers — more than $4.3 billion as of early November — a swarm of personal, public, nonprofit, and for-profit entities are eyeing the gold rush. Some individuals worry that firms, particularly — with their flashy merchandise, sturdy advertising and marketing budgets, and starvation for income — will now gobble up the windfall meant to rectify it.

“They see a cash cow,” stated JK Costello, director of behavioral well being consulting for the Steadman Group, a agency that’s being paid to assist native governments administer the settlements in Colorado, Kansas, Oregon, and Virginia. “Everyone is interested.”

Costello receives a number of emails every week from companies and nonprofits in search of steering on apply for the funds. To maintain up with the inflow, he has developed a typical response: Thanks, however we are able to’t reply to particular person requests, so right here’s a hyperlink to your locality’s web site, public assembly schedule, or software portal.

KFF Well being Information obtained e-mail information in eight states that present well being departments, sheriffs’ workplaces, and councils overseeing settlement funds are receiving the same deluge of messages. Within the emails, advertising and marketing specialists provide cellphone calls, informational displays, and conferences with their corporations.

Alabama Lawyer Normal Steve Marshall lately sent a letter reminding native officers to vet organizations that attain out. “I am sure that many of you have already been approached by a variety of vendors seeking funding for opioid initiatives,” he wrote. “Please proceed with caution.”

In fact, not all advertising and marketing efforts ought to immediate concern. Emails and calls are a technique individuals in energy study modern services. The nation’s dependancy disaster is just too giant for the general public sector to tame alone, and lots of stakeholders agree that partnering with trade is essential. In any case, pharmaceutical corporations manufacture medicines to deal with opioid dependancy. Companies run remedy amenities and telehealth providers.

“It’s unrealistic and even harmful to say we don’t want any money going to any private companies,” stated Kristen Pendergrass, vice chairman of state coverage at Shatterproof, a nationwide nonprofit centered on dependancy.

The important thing, agree public well being and coverage consultants, is to critically consider services or products to see if they’re needed, evidence-based, and sustainable — as an alternative of flocking to corporations with one of the best advertising and marketing.

In any other case, “you end up with lots of shiny objects,” Costello stated.

And, in the end, failure to do due diligence might go away some jurisdictions holding an empty bag.

Take North Carolina. In 2022, state lawmakers allotted $1.85 million of settlement funds for a pilot challenge utilizing the first FDA-approved app for opioid use disorder, developed by Pear Therapeutics. There have been excessive hopes the app would assist individuals keep in remedy longer.

However lower than a yr later, Pear Therapeutics filed for bankruptcy.

The state hadn’t paid the corporate but, so the cash isn’t misplaced, in response to the North Carolina Division of Well being and Human Providers. However the division and lawmakers haven’t determined what to do with these {dollars} subsequent.

$1 Million for drug disposal pouches

Jason Sundby, CEO of Verde Environmental Applied sciences, stated the Deterra pouches his firm sells are a low-cost technique to forestall costly addictions.

Verde Environmental Applied sciences

Clients place their unused medicines in a Deterra pouch and add water, deactivating the medicine earlier than tossing them, guaranteeing they can’t be used even when fished out of the trash. A medium Deterra pouch prices $3.89 and holds 45 capsules.

The aim is to “get these drugs out of people’s homes before they can be misused, diverted, and people start down the path of needing treatment or naloxone or emergency room visits,” Sundby stated.

Sundby’s firm ran an advert about spending settlement {dollars} on its product in a National Association of Counties newsletter and featured similar information on-line.

It could be paying off, as Deterra is ready to obtain $1 million in settlement funds from the well being division in Delaware County, Pennsylvania, and $12,000 from the sheriff’s workplace in Henry County, Iowa. The corporate additionally has partnerships with St. Croix and Milwaukee counties in Wisconsin, and is engaged on a deal in Connecticut.

KFF Well being Information screenshot of https://deterrasystem.com/assets/funding/on Nov. 21, 2023

A number of different corporations with comparable merchandise have additionally used their product sites to induce jurisdictions to contemplate the settlements as a funding stream — they usually’re seeing early success.

DisposeRx makes a drug deactivation product — its model prices a couple of greenback every — and obtained $144,000 in South Carolina for mailing 134,000 disposal packets to a program that educated high school football players, coaches, and parents about dependancy.

SafeRx makes $3 capsule bottles with a locking code to retailer medicines and was awarded $189,000 by South Carolina’s opioid settlement council to work with the Greenville County Sheriff’s Workplace and native prevention teams. It additionally received smaller awards from Weld and Custer counties in Colorado.

Not one of the corporations stated they’re depending on opioid settlements to maintain their enterprise long-term. However the funds present a short lived enhance. In a 2022 presentation to potential buyers, SafeRx referred to as the opioid settlements a “growth catalyst.”

Critics of such investments say the merchandise will not be worthwhile. Immediately’s disaster of deadly overdoses is largely driven by illicit fentanyl. Even when studies suggest the businesses’ merchandise make individuals extra more likely to safely store and dispose of medicines, that’s unlikely to stem the document ranges of deaths seen lately.

“The plausible mechanism by which they would even be able to reduce overdose is a mystery because prescription medications are not driving overdose,” stated Tricia Christensen, coverage director with the nonprofit Group Training Group, which is tracking settlement spending throughout Appalachia.

Secure storage and disposal will be achieved with a locking cupboard and bathroom, she stated. The FDA lists opioids on its flush list for disposal and says there may be no evidence that low ranges of the medicines that find yourself in rivers hurt human well being.

However Milton Cohen, CEO of SafeRx’s dad or mum firm, Caring Closures Worldwide, stated preserving prescription medicines safe addresses the basis of the epidemic. Fentanyl kills, however usually the place individuals begin, “where water is coming into the boat still, is the medicine cabinet,” he stated. “We can bail all we want, but the right thing to do is to plug the hole first.”

Merchandise to safe and dispose of medicine additionally present a chance for schooling and destigmatization, stated Melissa Lyon, director of the Delaware County Well being Division in Pennsylvania. The county will probably be mailing Deterra pouches and postcards about stopping dependancy to three-quarters of its residents.

“The Deterra pouch is to me a direct correlation” to the overprescribing that got here from pharmaceutical corporations’ aggressive advertising and marketing, she added. Because the settlement cash is to compensate for that, “this is a good use of the funds.”

Instruments for legislation enforcement that superheroes would envy

Different companies making pitches for settlement funds have a much less clear relationship to opioids.

Wrap Applied sciences creates instruments for legislation enforcement to cut back deadly makes use of of power. Its chief product, the BolaWrap, shoots a 7½-foot Kevlar tether greater than a dozen toes by the air till it wraps round an individual’s limbs or torso — virtually like Surprise Lady’s Lasso of Reality.

Terry Nichols, director of enterprise improvement for the corporate, stated the BolaWrap can be utilized as an alternative choice to Tasers or pepper spray when officers must detain somebody experiencing a psychological well being disaster or committing crimes associated to their dependancy, like housebreaking.

“If you want to be more humane in the way you treat people in substance use disorder and crisis, this is an option,” he stated.

Wrap Applied sciences

The corporate posts body camera footage of officers utilizing BolaWrap on YouTube and says that out of 192 area stories of its use, about 75% of conditions have been resolved with out extra use of power.

When officers de-escalate conditions, persons are much less more likely to find yourself in jail, Nichols stated. And diverting individuals from the felony justice system is among the many suggested investments in opioid settlement agreements.

That argument satisfied town of Brownwood, Texas, the place Nichols was police chief till 2019. It has spent about $15,000 of opioid settlement funds to purchase 9 BolaWrap units.

“Our goal is to avoid using force when a citizen is in need,” stated James Fuller, assistant police chief in Brownwood. “If we’re going to take someone to get help, the last thing we want to do is poke holes in them with a Taser.”

After Brownwood’s buy, Wrap Applied sciences issued a press release during which CEO Kevin Mullins inspired extra legislation enforcement companies to “take the opportunity afforded by the opioid settlement funds to empower their officers.” The corporate has additionally despatched a two-page document to police departments explaining how settlement funds can be utilized to purchase BolaWraps.

Language from that doc appeared almost word-for-word in a briefing sheet given to Brownwood Metropolis Council earlier than the BolaWrap buy. The council voted unanimously in favor.

However the course of hasn’t been as clean elsewhere. In Hawthorne, California, the police division deliberate to purchase 80 BolaWrap units utilizing opioid settlement funds. It paid its first installment of about $25,000 in June. Nonetheless, it was later knowledgeable by the state Division of Well being Care Providers that the BolaWrap is just not an allowable use of those {dollars}.

“Bola Wraps will not be purchased with the Settlement Funds in the future,” Hawthorne Metropolis Clerk Dayna Williams-Hunter wrote in an e-mail.

Carolyn Williams, a member of the advocacy group Vocal-TX, stated she doesn’t see how the units will deal with the overdose disaster in Texas or elsewhere.

Her son Haison Akiem Williams handled psychological well being and dependancy points for years. With out insurance coverage, he couldn’t afford rehab. When he sought case administration providers, there was a three-month wait, she stated. Police charged him with misdemeanors however by no means linked him to care, she stated.

In February, he died of an overdose at age 47. His mom misses how he used to make her snicker by calling her “Ms. Carol.”

She desires settlement funds to help providers she thinks might have saved him alive: psychological well being remedy, case administration, and housing. BolaWrap doesn’t make that listing.

“It’s heartbreaking to see what the government is doing with this money,” she stated. “Putting it in places they really don’t need it.”

KFF Health News, previously generally known as Kaiser Well being Information (KHN), is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF — the unbiased supply for well being coverage analysis, polling, and journalism.