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Opioid settlement money and a call to action

AILSA CHANG, HOST:

Settlements in opioid cases against pharmaceutical manufacturers, pharmacy chains and more mean as much as $50 billion is making its way to states. That money is earmarked to help local governments fight the opioid crisis, which claims hundreds of lives every day in the U.S. Now, a coalition of recovery and harm-reduction organizations has issued guidelines that they hope decision-makers will consider as they allocate the funds. Aneri Pattani, senior correspondent with KFF Health News, has been tracking the settlement funds and joins us now. Welcome.

ANERI PATTANI: Thanks for having me.

CHANG: Thanks for being with us. So these guidelines come at an interesting moment - right? -because this money is already reaching local communities. So what are some of the ways this money is already being spent?

PATTANI: You're right. So in the past year, we've started to see a lot more spending because state and local governments now have this money in hand. And what they're using it on, honestly, like, runs the gamut. There's lots of money going to things you'd expect - rehab facilities, treatment centers, recovery houses. We saw counties and cities in California spend over $2 million on naloxone, which is a medication that reverses overdoses. A lot of people call it Narcan, which is the brand name.

CHANG: Right.

PATTANI: And there's also been a lot of money going to law enforcement. There's a county in Alabama that bought Chevy pickup trucks and roadside cameras for their sheriff's department. And several counties in Michigan spent hundreds of thousands on body scanners for their jails.

CHANG: OK, got it. So these groups have come together to weigh in on what they don't want to see happen and what they want to see more of. So let's start with the plus side. Like, what do they encourage investment in?

PATTANI: They're really big on public health approaches. So that's things like increasing access to medications that treat opioid use disorder and syringe service programs, which provide sterile needles for people who are using drugs to prevent them from getting or spreading infectious diseases. The advocates are also big on social services - things like housing support, legal aid, programs that train people in recovery to get jobs and be employed. So one of the good examples they point to is a million dollars in Mecklenburg County, N.C., that went to help people get housing and rental assistance. They want to see more of that.

CHANG: Hmm. Well, what about things that they don't want to see spending on?

PATTANI: Well, top of the list is law enforcement. The advocates wrote in this document, you know, quote, "not a single dollar should go towards officers' salaries, equipment or jail renovations." They say that, you know, the law-enforcement approach has been well funded for years. But because it hasn't been effective in stemming this crisis, it's time to try something else. And they have sort of a similar approach towards things like abstinence-only treatment or certain youth prevention programs like D.A.R.E., which they say haven't worked, so they shouldn't be funded with this money.

CHANG: That is so interesting. I want to focus on the law enforcement aspect of this. Like, how are law enforcement officers responding to the argument that they should not receive any settlement funding?

PATTANI: Yeah, so when I was writing about this call from the advocates, I reached out to the National Sheriffs' Association, and their executive director, Jonathan Thompson, told me, you know, law enforcement are on the front lines of the crisis every day. So to him and a lot of these folks, it just makes sense for them to get some of these funds. And I've heard similar sentiments from sheriffs, police officers and elected officials, especially in rural parts of the country where there isn't a local treatment facility or a syringe service program. To them, you know, law enforcement are the people who handle this issue, and so it's sort of a natural place to put this opioid settlement money.

CHANG: Hmm. OK. Well, certainly a lot of viewpoints out there. How likely do you think it is that these guidelines that this coalition has issued will actually affect where these opioid dollars will go moving forward? Do you think it will have a lot of influence?

PATTANI: It's really hard to know for sure. I mean, I think the idea of putting this roadmap and this document out there is more for advocates to kind of express their hopes and concerns and encourage other people to join them in keeping an eye on this money. They're essentially trying to build - right? - a grassroots coalition across the country. But when you talk about influencing the on-the-ground decisions, that is probably more dependent on whether those advocates then follow up and show up at their city council meeting or their county commissioner meetings - because that's where the funding decisions are happening, and that's where elected officials are interacting with and listening to their constituents.

CHANG: Aneri Pattani, senior correspondent of KFF Health News. Thank you so much for joining us today.

PATTANI: Thank you. Transcript provided by NPR, Copyright NPR.

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Ailsa Chang is an award-winning journalist who hosts All Things Considered along with Ari Shapiro, Audie Cornish, and Mary Louise Kelly. She landed in public radio after practicing law for a few years.