Recovery advocates and state lawmakers awaiting millions in settlement dollars from opioid manufacturers and distributors over the next two decades want to put that money to work fighting addiction.
Nearly 10,000 people have died of drug overdoses in Virginia since 2007, state data shows, with the bulk of those deaths stemming from prescription or illicit opioid drugs such as heroin or fentanyl. The rate skyrocketed last year during the coronavirus pandemic, rising by nearly 40% to approximately 2,250 deaths.
Every U.S. state has filed some form of legal action against pharmaceutical companies in hope of tamping down the epidemic in recent years. In 2019, Virginia Attorney General Mark Herring filed suits against Purdue Pharma; the Sackler family, owners of Purdue Pharma; and Teva/Cephalon, alleging that all bear responsibility for the opioid addiction epidemic.
A proposed state authority designed to channel money from the Virginia lawsuits had its first hearings in the General Assembly last week. It’s a great opportunity to beat back the epidemic, state officials said.
In a statement Friday, Purdue Pharma said it’s working toward resolving the myriad suits against it, noting that it has proposed a nationwide settlement valued at $10 billion. Teva/Cephalon representatives did not respond to requests for comment.
Money from state litigation usually flows into the state’s general fund. The legislation would instead direct money from the settlements or court-ordered judgments to a fund managed by a new opioid abatement authority.
Officials from the state Office of the Attorney General, which helped craft the legislation to create the authority, said there are no estimates available for how much money Virginia might get. But Michael Kelly, the attorney general’s chief of staff, said it could start coming in soon.
“When that moment comes, we don’t want the Commonwealth to have to delay the spending or scramble to figure out what to do with the money,” he said in an email. “We are proposing this structure now so that if judgments or settlements materialize, we can help get as much money out the door as quickly as possible to support prevention, treatment, and recovery.”
As proposed, the authority’s 11-member board of directors would include the secretary of health and human resources or a designee, two medical professionals with backgrounds in public health or opioid addiction treatment, and representatives from local and state government, law enforcement, community service boards and the recovery community.
The authority would decide how to use 70% of the revenue, splitting it evenly between regional projects and projects it deems effective. The state and localities would decide how the rest of the funds are used — with 15% shared among Virginia cities and counties.
Some private recovery organizations, however, worry they may be short-changed.
“Historically, bureaucrats and politicians squander these opportunities in regard to reducing the impact addiction has on our state,” said John Shinholser, president and co-founder of the McShin Foundation, which runs a recovery center and several sober homes in the Richmond area.
Shinholser and other advocates said their organizations are pivotal for ensuring long-term recovery, as they are more oriented toward helping people meet basic needs — food, shelter, transportation and community — after receiving acute care.
“We in the authentic recovery space producing upward of half the recovery outcomes are hopeful in this impending process we finally get our due,” said Shinholser.
Speaking in a House subcommittee meeting this week, Michael McDermott, a recovery advocate from Goochland County, said the legislation should be more specific about allocating some of the money to private peer-run recovery organizations.
“I think one of the antidotes to the situation we’re in is looking to those with lived experience and evidence-based practices,” he said. “What we’re doing now may be good, but it could be improved.”
With the exception of 2018, when fatal drug overdoses declined by 3.3% over the prior year, deaths attributed to overdose have increased each year since 2012.
They have been the leading cause of unnatural death in Virginia since 2013, surpassing motor vehicle crashes and gun fatalities, each of which account for about 900 to 1,000 deaths annually, according to state data.
The Virginia Department of Health says that there were 2,242 drug overdose deaths in 2020, which would be a record high for a single year, according to a new quarterly report released this week. It is also estimated to be the largest single-year increase since 2007, leaping 38% from 1,626 reported deaths in 2019.
David Rook, president of the Virginia Association of Recovery Residences board, said he worries that solely increasing funding for the same organizations may do little to mitigate the damage.
“I would love to see recovery support services or peer-delivered services as part of the language [in the bill] as well,” he said. “It seems that with the best of intentions we may throw good money after bad focusing on the status quo, which is failing Virginia.”
The Virginia Department of Behavioral Health and Developmental Services spent $166 million on substance use disorder services, working with state hospitals, VDBHDS training centers and 40 community services boards throughout the state, serving nearly 30,000 individuals in the 2018-19 fiscal year, according to an annual report from the state Substance Abuse Services Council.
Community services boards form the backbone of the state’s public mental and behavioral health system. The services council report does not include details about how much money was given to private organizations.
Jennifer Faison, the executive director of the Virginia Association of Community Services Boards, which supports the bill, said boards sometimes provide funding to private recovery organizations, but was unable to say how much.
“Virginia’s CSBs value their relationships with the private provider community,” she said. “Virginia has been deliberate from a policy perspective in ensuring that public dollars flow to the CSBs as the public safety net. In short, policymakers want a public touch on public dollars and recognize that the CSBs serve individuals who are uninsured or underinsured and use state general fund dollars to support their care.”
Del. Schuyler VanValkenburg, D-Henrico, questioned the composition of the new authority’s board of directors, noting that government officials would outnumber community advocates.
“I know that relationship can sometimes be a tense one, so I worry about tipping the voting scales,” he said in a House subcommittee meeting Thursday. “I don’t know if I have an amendment to change it ... but I do want to flag that as a potential concern.”
In an email Thursday evening, Kelly said the attorney general’s office would be willing to consider changes to the authority’s board, as long as its members’ “expertise and focus remains on using funds to do the most good as quickly as possible and to help address the crisis most efficiently and effectively.”
Legislation in both the House and Senate for the new authority advanced this week with bipartisan support.
Both chambers forwarded versions of the bill for consideration by money committees that will decide whether the bills can advance for a final vote to decide whether it should go to Gov. Ralph Northam for his consideration.