J&J and other opioid players to pay $26 billion to states over roles in addiction crisis

Pharmaceutical manufacturer Johnson & Johnson and three major distributors have concluded nationwide agreements on their roles the opioid addiction crisis Friday, an announcement that paves the way for $ 26 billion to reach almost every U.S. state

Overall, the settlements are the largest to date among many opioid-related cases which have been played all over the country. They are expected to give a significant boost to efforts to reverse the crisis in places that have been devastated by it, including many parts of rural America.

Johnson & Johnson, AmerisourceBergen, Cardinal Health and McKesson announced the liquidation plan last year, but the deal was conditional on the participation of a critical mass of state and local governments.

Friday was the deadline for companies to announce whether they felt state and local governments had pledged to participate in the deal and waive the right to sue. The four companies warned government lawyers in the event that their thresholds were met, but did not specify an exact number. Money could start flowing to thousands of counties and municipalities and states in April.

“We will never have enough money to cure this problem immediately,” said Joe Rice, one of the top lawyers representing local governments in the litigation that led to the deal. “What we’re trying to do is give a lot of small communities a chance to try to change some of their problems.”

There is no direct settlement money to the victims

While none of the money from the settlement will go directly to the victims of opioid addiction or its survivors, the vast majority should be used to deal with the epidemic. The need for local government funding for health and addiction education programs is profound.

Kathleen Noonan, director general of the Camden Coalition of Healthcare Providers in Camden, NJ, said part of the money from the settlement should be used to provide housing for homeless addicts.

“We have clients who find it hard to stay clean to do so in a shelter,” he said. “We would like to stabilize them so that we can help them recover.”

Dan Keashen, a Camden County government spokesman, said officials were considering using the money from the settlement for a public education campaign to warn of the dangers of fentanyl. They also want to send more drug counselors to the streets, put additional social workers in municipal courts and pay for addiction drugs to the county jail.

Officials across the country are considering investing money in similar priorities.

California Gov. Gavin Newsom’s proposed budget calls for $ 50 million of the state’s $ 86 million share to be used this year to fund youth education on opioids and train treatment providers to improve revenue collection. data and distribute naloxone, a drug that reverses overdoses.

In Broward County, Fort Lauderdale, Florida, the number of beds in a county-run detox facility could be increased to 70 or 75 of the current 50, said Danielle Wang French, the county’s attorney.

“It’s not enough, but it’s a good start,” he said of the deal.

Local governments call for “strategies”

With deadly overdoses continuing to sweep across the United States, largely due to the spread of illicitly produced fentanyl and other synthetic opioids, public health experts are urging governments to use the money to secure access to treatment. drugs for people with addictions. They also highlight the need to fund programs that have been shown to work, collect data on their efforts, and launch prevention efforts for young people, focusing on racial equity.

“It shouldn’t be: ready, prepared, worn out,” said Joshua Sharfstein, a former secretary of the Maryland Department of Health who is now vice dean of public health at Johns Hopkins University. “It has to be: think, devise strategy, spend.”

In a separate $ 26 billion deal, the four companies reached a $ 590 million deal with the federally recognized Native American tribes of the nation. About $ 2 billion is being set aside for the fees and expenses of lawyers who have been working on the case for years.

Johnson & Johnson, based in New Brunswick, New Jersey, has nine years to pay its $ 5 billion share. Distributors: AmerisourceBergen, based in Conshohocken, Pennsylvania; Cardinal Health based in Columbus, Ohio; and McKesson, based in Irving, Texas, agreed to pay their combined $ 21 billion over 18 years. To reach the maximum amounts, states must get local governments to sign up.

J&J will not resume selling opioids

Settlements go beyond money. J&J, which has stopped selling prescription opioids, agrees not to resume. Distributors agree to send data to a clearing center to help mark up when prescription drugs are diverted to the black market.

Companies do not admit to crimes and continue to defend themselves against the claims that contributed to the opioid crisis made by the entities that are not involved in the agreements.

The demand that most of the money be used to deal with the opioid crisis contrasts with a series of public health agreements in the 1990s with tobacco companies. In these cases, states used large sums of money from the settlement to fill budget gaps and fund other priorities.

The amount sent to each state under the liquidation of opioids depends on a formula that takes into account the severity of the crisis and the population. County and local governments also receive some of the money. A handful of states — Alabama, New Hampshire, Oklahoma, Washington, and West Virginia — have not joined all or part of the agreement, mostly because they have their own agreements or are preparing for trial.

In Camden, Lisa Davey, a recovery specialist at the Maryville Addiction Treatment Center, was on a needle exchange this week delivering naloxone, an overdose-reversing drug, and asking people if they wanted to start treatment.

Davey said he wants to see detox and treatment programs receive more funding to keep people going longer. As it is, he said, users can detox and go back to the street in search of drugs in a matter of days.

“They need more time to work on their recovery,” he said.

Increase in synthetic opioids

A man who grabbed clean needles and asked to be identified only as Anthony P. said he was 46 and had struggled with addiction since he was a teenager. He said he would like to see an effort to cut down on fentanyl and related synthetic opioids that drive overdose mortality rates from drug supply.

“Fentanyl has to go away,” he said.

Martha Chavis, President and CEO of the Camden Area Health Education Center, who manages the needle exchange, said one need is to offer services like yours in more places. Now, users from far-flung suburbs are traveling to Camden to get clean needles and kits to test their drugs for fentanyl.

In Connecticut, about 100 bags of fentanyl were found in the bedroom of a 13-year-old boy who overdosed and died in January, according to Hartford police. It is currently being investigated how the teenager took possession of the powerful opioid.

The agreement with J&J and the three distributors marks an important step towards resolving the large constellation of claims in the US for responsibility for an epidemic that has been linked to the deaths of more than 500,000 Americans in recent years. two decades.

Other companies, such as business consultancy McKinsey and drug makers Endo, Mallinckrodt and Teva, have reached national settlements or a number of locations.

Teva Pharmaceutical Industries reached a $ 225 million deal in an opioid case in Texas in February over allegations that the Israel-based drug maker incorrectly marketed addictive pain medications, Reuters reported. The deal came after a landmark case in New York in December in which a jury found Teva responsible for contributing to the state’s opioid crisis.

Teva told CBS News at the time that he was preparing an appeal and seeking the annulment of the trial, alleging that the plaintiffs had “no causal link between Teva’s conduct, including its marketing, and any harm to the state public “.

OxyContin maker Purdue Pharma and a group of states are mediating through the U.S. Bankruptcy Court to try to reach an agreement nationwide. A judge in December rejected a Purdue Pharma bankruptcy agreement due to a disposition which would have protected members of the founding Sackler family of the company to face their own litigation.

Impact of the pandemic

The crisis has deepened during the coronavirus pandemic, with opioid-related deaths in the United States reaching a maximum of more than 76,000 in the 12 months ending April 2021, largely due to the spread of fentanyl and other laboratory drugs. A recent report by a commission in the medical journal The Lancet projected that 1.2 million Americans could die from opioid overdoses between 2020 and 2029 without policy changes.

John F. Kelly, a professor of psychiatry in addiction medicine at Harvard Medical School, said he wants the money from the settlements to be used not only for treatment, recovery and support efforts, but also to build systems designed to prevent let this kind of epidemic happen. again.

“Some kind of national board or organization could be created … to prevent this kind of lack of oversight from happening again, where industry can create a danger to public health,” he said.