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Home//Local Coverage//Health


MASS. CITIES, TOWNS CAUTIOUS OR CONFUSED ABOUT HOW TO SPEND MILLIONS IN OPIOID
SETTLEMENT FUNDS

December 29, 2023
 * Martha Bebinger

facebookEmail
This 2018 file photo shows an arrangement of Oxycodone pills in New York. (Mark
Lennihan/AP)

Money from the settlements of opioid-related lawsuits continued to pour into
Massachusetts in 2023. While the state is spending its share on programs aimed
at reducing substance use and fatal overdoses, the majority of cities and towns
have not spent any of their funding.

The state collected $23 million in 2023, for a total of $106 million since 2021.
Municipalities began receiving their first settlement payments in the fiscal
year that ended in June, and have banked a total of $51 million so far. The
biggest cities — Boston, Worcester, Springfield and Cambridge — are receiving
the largest shares.

But forms filed by cities and towns show that most had not spent any of the
money received in the first of a nearly two-decade distribution plan. This has
frustrated some observers who urged faster action as opioid-related overdose
deaths hit and held at record highs.

Boston reported taking in $4.7 million, but made $0 expenditures. The city said
it was reviewing input collected from listening sessions and more than 400
surveys submitted by residents and addiction services providers. Boston plans to
announce spending strategies in early 2024.

Cambridge banked $1.9 million in settlement funds. A community survey about how
to use the money is still open, although a spokesman for the city said officials
have decided to buy an outreach van.

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Worcester is one of the few municipalities that spent all of its first-year
payments, worth $845,000. As the settlement dollars started to arrive, the
state’s second largest city was in the midst of a 34% increase in overdose
deaths from 2021 to 2022. A city spokesman said $500,000 of the funds paid for a
mobile crisis team to help respond to 911 calls involving mental health and
substance use. The balance of the funding covered staff that provides outreach
for people struggling with homelessness and substance use.

In New Bedford, officials received $1 million in first-year payments but didn’t
spend any of the funding. Stephanie Sloan, the city’s health department
director, said it will take time to determine how best to use the money.

“The amount and duration of the funding requires a deliberative and strategic
process as we all seek to build on the extensive work and programs already
underway to respond to the opioid epidemic,” she said in a statement.

Other cities with high numbers of fatal overdoses also reported no expenditures
even though they received substantial sums. They include Springfield, which got
$1.5 million, Lynn received $704,000 and Lawrence got $653,000.

Some municipalities said state accounting rules complicated their efforts to
spend the money, but they hope an exemption now in place will ease the process.

“Going forward we can receive these funds directly into the opioid settlement
fund account,” said Lindsay Hackett, Springfield’s deputy chief administrative
and financial officer. “So we can track exactly what’s going in and coming out.”

Hackett said Springfield used some general city funds for police staffing
and training for the police and fire departments on Narcan, a brand of the
overdose reversal drug naloxone.

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Some municipal leaders may have little or no experience with addiction treatment
and policies. A quick scroll across the state map shows dozens of smaller cities
and towns sitting on payments that total millions of dollars. That's frustrating
for many people who track opioid-related overdoses and deaths.

“It's disappointing and distressing to see so much money sitting on the
sidelines while we face this surging opioid overdose crisis,” said Jonathan
Stoltman, director of the Opioid Policy Institute, in a statement. “We know too
much about what works to not do anything.”

Dr. Kiame Mahaniah, Massachusetts undersecretary for health, said many
municipalities aren’t aware the money is coming in or that it must be used to
address the opioid overdose crisis.

“A city might think, ‘what can I do with $100,000,’ but this is something that
will continue for 20 years, so it does behoove a community to get involved
deeply on the front end,” Mahaniah said during a meeting where he shared initial
reports from municipalities.

The state has hired a consulting firm to assist cities and towns, but it doesn’t
control how they use the money from opioid distributors, manufacturers and other
companies that allegedly helped fuel the opioid crisis. Municipalities will
receive roughly 40% of the settlements reached to date.

The state is spending its share of settlement funds more quickly, with guidance
from an advisory council that includes physicians, public health leaders and
advocates for people affected by the drug overdose crisis. The group set five
priorities, which the Healey administration has tied to grant proposals with
specific dollar figures.

 * Equity — $10 million for community advisory boards, research and prison
   re-entry programs to address racial disparities in overdose deaths.
 * Treatment — $18 million for walk-in clinics and addiction specialists in 15
   hospitals that serve high need areas, and more money for a stimulant
   addiction treatment approach called contingency management.
 * Workforce Development — $15 million to support loan forgiveness and other
   incentives administered by the state’s Behavioral Health Trust Fund.
 * Family Support — $3.5 million for families coping with addiction and those
   who’ve lost loved ones to an overdose.
 * Data Collection and Analysis — $2 million for a dashboard that may expand to
   include real-time overdose data, opioid-related hospitalizations statewide
   and community-specific.

The state has received about 17% of the total expected over 18 years of
settlement payments. Municipalities have received about 13% of their expected
funding.

Some additional dollars could flow from lawsuits against members of the Sackler
family and Purdue Pharma. Those cases were consolidated in bankruptcy court, but
a settlement was appealed to the U.S. Supreme Court by parties that object to
immunity for some Sackler family members.

Addiction and the overdose crisis


RELATED:

 * Fatal overdoses in Massachusetts remain at grim record highs
 * Why a mom turned to supervising illegal opioid use at her home
 * 'It allows doctors to be human beings': Mass. hospitals will stop asking
   clinicians about past mental health and addiction

Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.

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