On July 21, a group of state Attorneys General announced a tentative agreement with two opioid distributors and Johnson & Johnson Pharmaceuticals to pay $26 billion to settle lawsuits over their role in exacerbating the deadly and ongoing opioid epidemic in the United States. The largest of any opioid settlement thus far, it will potentially put billions of dollars into state coffers earmarked expressly for abating the substance use epidemic that has ravaged the country.  

The latest data from the CDC shows that over 92,000 people died due to drug overdoses in the U.S. in 2020. The need to fund prevention, harm reduction, and treatment programs is at an all-time high. This settlement could make some of that much-needed funding available.  

As we navigate this new terrain, it is crucial to follow the leadership of communities hardest hit by the War on Drugs, especially communities of Black, Indigenous, and People of Color. Per the agreement, the money is reserved for treatment, prevention, education, and other costs related to the opioid epidemic. However, jurisdictions need to opt in to receive the money. The full payment requires that at least 48 states sign on with all of their local jurisdictions currently involved in suits against these companies. Without enough participation, the companies, which aren’t admitting wrongdoing, can walk away from the settlement. If communities want to push for even higher reparations, individual state Attorneys General can decline this settlement and continue with their lawsuits.  

If enough states sign on, the funds will be allocated primarily based on the population size of each jurisdiction and the severity of the opioid crisis within that area. Already, states such as Washington and West Virginia are unsatisfied with the method of allocating funds or the amounts they will receive. They likely will not participate and will continue their litigation.  

This settlement is a potential resolution to just a handful of lawsuits related to opioids – various others involve different companies. There will likely be more money on the table in the future. With all these lawsuits in the works, why pay attention to this specific one?  

It’s the biggest settlement so far, and it’s important to ensure the money goes where it’s needed most. In 1998, the Tobacco Settlement similarly disbursed large amounts of money, but only 2.7% of it went toward smoking treatment and prevention, according to retrospectives.  

And that’s where community advocacy comes in. 

In advocating regarding the settlement, consider the elements of the agreement, including the amount of the award to your state (Vermont expects to receive up to $60 million, while North Carolina expects up to $750 million), the lengthy 18-year payout time, and whether your community will ultimately net enough money. However, if a state or its local governments rejects the settlement, the prospects for a future payment are uncertain.  

Whether a locale accepts the plan or not, this settlement provides an opportunity for advocates to tell officials what their community needs most to address addiction. Highlighting the need for accountability, equity, and innovation is an excellent place to start.  

Advocates should include a request for: 

  • Assurance that any money received will fund prevention, harm reduction, treatment, and recovery, rather than slush funds and state budget gaps; 

  • An oversight body including at least 51 percent people with lived experience of addiction and people from hard-hit and marginalized communities. 

The goals for use of settlement money should include: 

  • Innovative services that integrate physical care with comprehensive treatment and recovery supports for substance use disorders and mental health; 

  • Services and supports focused on meeting the expressed needs of people with substance use disorders and delivering outcomes that they identify; 

  • Prevention programs to help people avoid substance use disorders, and harm reduction programs that keep people safe; 

  • Expansion of availability of recovery supports, especially in low-income neighborhoods, rural areas, and other areas that often have limited access; 

  • Funding for treatment and recovery programs within communities of color severely impacted by the failed War on Drugs. 

Ultimately, whether states take this deal or litigate separate agreements, the results must help our communities. Racial, social and health equity, health care innovation and the needs of people with substance use disorders must carry the day. 

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