Opioid settlements coming to county

Tennessee communities have struggled with the economic and social costs of the opioid epidemic for decades.

Now, with millions in settlement funds awaiting distribution, Cumberland County leaders are considering programs that will provide treatment and prevention.

“What I hope to see is early age prevention and education,” said Cumberland County Sheriff Casey Cox, who is a member of the state’s Opioid Abatement Council.

Tennessee’s Opioid Abatement Fund is made up of payments from drug makers and distributors through settlement agreements. 

Tennessee was part of a coalition of states that reached a $26 billion settlement with Janssen, a subsidiary of Johnson & Johnson, and three pharmaceutical distributors: AmerisourceBergen Corp., Cardinal Health Inc. and Mc-

Kesson Corp. 

Tennessee expects to receive more than $600 million over 18 years from the February 2022 agreement.

The state has received more than $128 million in initial payments. These funds are to be divided among the state, counties and the Opioid Abatement Council. 

The settlement funds will be split between the state, 15%, and counties, 15%, and the Opioid Abatement trust fund. 

Cumberland County is slated to receive just shy of $300,000 in direct settlement payments.

Within the abatement trust fund, 35% of funds is set aside for counties and the remainder for grants to be distributed by the Opioid Abatement Council. The money must be used to abate the opioid crisis — harm reduction, treatment, and prevention. 

Dr. Stephen Lloyd, chair of the abatement council, said harm reduction is critical.

“We have to keep people alive,” said Lloyd during a webinar hosted by the council on the settlement funds. “We have to treat them. We have to support them in their treatment. There’s some who are going to need things around them to be successful, like housing and job training.

“And then, the big enchilada out there is prevention in the first place.”

Lloyd is himself in recovery for opioid and benzodiazepine addiction.

“I got help 19 years ago,” Lloyd said. He is chief medical officer at Cedar Recovery, an addiction treatment company.

“I’m a believer that solutions are local,” Lloyd said. But issues of addiction can be incredibly complicated, he said. 

The settlements included an agreement for abatement and remediation uses, which the settlement funds can be used to pay for. These include expanding training and access to naloxone or other drugs that reverse opioid overdoses, medication-assisted treatment, other opioid addiction treatment, expansion of recovery programs, treatment for incarcerated individuals, expanded treatment for neonatal abstinence syndrome, and expanding syringe service programs.

“We’re looking for innovation,” Lloyd said. “We’re looking for things we can measure outcomes and see improvement so we can scale those things to other parts of the state.”

Cumberland County stakeholders have launched discussions on how the funds could be used locally. The Trauma Informed Community Alliance hosted the conversations over two days last month.

The groups included representatives from law enforcement, treatment, public health, behavioral health, schools, public agencies and other interested individuals.

“We want to maximize our efforts as much as possible,” said Colleen Mall, with the alliance. 

Groups were asked to focus in sessions on preventative efforts and treatment efforts, but as ideas came forward, it was clear some ideas could impact multiple areas on the remediation list.

Potential ideas include a drop-in center where people could access mental health services or work with life coaches, syringe services to reduce disease from injection drug use, a recovery navigator at the hospital and a local in-patient detox facility. 

Other ideas included pregnant and post-partum addiction treatment, transitional housing, and a variety of child care services, from daycare to expansive summer programs.

Juvenile justice programs were mentioned, along with increased funding for law enforcement personnel. 

An issue in the community is the lack of mental health providers and waiting lists for treatment. 

Scott Hull, who leads the school system’s mental health counselors, said statistics found 50% of people who meet the criteria for a mental health diagnosis never receive treatment. 

There can also be a lack of services for individuals who have experienced trauma. Sheriff’s Investigator Jeff Slayton said many people turn to drugs after trauma. Early intervention in those cases could help prevent addiction issues later.

Others shared treatment models they’ve studied that include transitional housing and a campus-based recovery model, with services available for education, housing, mental health and more. This model allows families to remain together while a parent gets addiction treatment.

Treatment options could also be expanded to include medication like Vivtrol, which can block opioid receptions. Though approved in 2010, the medication is often cost prohibitive, treatment advocates said.

Counties should receive their allotment of funding in the coming weeks. The council hopes to open up a grant process in the next few months, with awards being made shortly after.

The state is continuing to seek monetary settlements from companies that profited from the opioid epidemic. 

In December, Tennessee was among states settling opioid litigation with CVS and Walgreens totaling over $10 billion. That followed a $3.1 billion settlement with Walmart and a $450 million national settlement with pharmaceutical maker Endo.