After the lawsuits, after the victories, after the billion dollar settlements - and after the toasts, with lawyers and plaintiffs congratulations themselves - then comes: not much.
John Oliver recently cast a funny, if sad, spotlight on the aftermath of lawsuit nirvana: not much. ()
City and state officials, anchored in Dante’s circle of government indifference tainted with ineptness, should be forced to watch the clip (available via the online version of this article). Oliver traces the opioid money. Opiates do alleviate pain; and a lot of Americans could present to their physicians with a litany of pains. But those pain-killers were so addictive that the pills became literally life-killers. The Centers for Disease Control and Prevention (CDC) estimates that more than 100,000 people die each year from overdoses.
The stream of opiate money started with the archetypal greedy producers — think the drug companies. We blame them. Next in line: the greedy physicians - cloaking their greed under their Hippocratic oath — who wrote the prescriptions, in some cases, many prescriptions for the same patients. From there, an easy step to the greedy pharmacies, eager to fill multiple prescriptions regardless of pharmacists’ qualms At that point the money stream might have ended, leaving a lot of organizations and people richer, but also leaving a lot of addicts. And as news article upon article detailed, those addicts — the ones who died, the ones on waiting lists for rehab, and the ones who faded in and out of rehab — left behind distraught broken families.
But a deus ex machina intervened: the justice system. Thanks to the courts, cities and states sued the malefactors. The damage was real; the plaintiffs could point to the obvious harm of opiates, foisted upon the public when the powers-that-be knew the dangers of addiction. The states, cities and towns won. Over the next 20 years, states, cities and towns can expect a total of $50 billion. By March 2024, states and towns found themselves with an extra $4.3 billion.
The money — a minimum of 70% —was supposed to go to “remediate” the harm. Drug rehab centers. Naloxone. Methadone. “Diversion” of people suffering from “substance use disorder” (SUD — lodged in the bureaucratic lexicon of addiction) from the justice system to treatment; in short, taking people arrested for crimes linked to SUD into treatment, not jail. Programs to target populations most vulnerable to SUD, like the homeless, pregnant women and their children, people abused for sexual orientation, people suffering from mental illness. Interventions to deter “vulnerable youth” (e.g., those in foster care, poor youth, suffering from mental illness, homeless youth …) from drugs. A lot of Americans could expect help, thanks to the victorious plaintiffs.
But secrecy has cloaked the victory money. Fewer than 20 states have pledged to make the allocation public, in spite of open meeting and open records laws on state books. When a dozen Democratic senators urged the Office of National Drug Policy to track the settlement money, the office responded that it lacked statutory authority from Congress to delve into states’ spending.
Investigative journalists (thank you, KFH Health News …) have probed into the black hole of money. You can track some of the money . Brown-Geer, the firm appointed to track the money uploaded it onto a website: (https://kffhealthnews.org/news/article/opioid-settlement-payouts-state-county-city-tracker/).
Some money is going to “remediate” the harm, to treatment centers, to naloxone, to diversion programs.
But most is not. Police departments have dipped into the stream for patrol cars, body cameras, phones. Ironically, the money was not to be used to shore up police departments. The money was to help, not arrest addicts.
Another winner for the opiate pot-of-gold: accounting departments of cities and towns. They have plugged budget shortfalls, in some instances substituted opiate money for regular budgetary allotments — a sleight of monetary hand.
Since the money will continue to stream into states, cities, towns, and counties until 2038, the public can rise up to scream: Enough. Spend the money where it might help. Sadly, the people who need help, those most vulnerable to SUD, are not adept at lobbying, with time and energy to plead their cause. Ditto for their exhausted families. So it behooves the rest of us to call our legislators, write our governors, speak up at town meetings.
Ask your legislators what is happening to the money, what the plans are for its use. Object to more police cruisers, more police dogs, more scanners. Object to using the money to fill potholes — not that potholes should remain unfilled, but cities should draw on other pots of money.
The victims and their families, the people at risk of addiction, the addicts awaiting treatment — the money is supposed to help them.
Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email joan.retsinas@gmail.com.
From The Progressive Populist, August 15, 2024
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