Opioid manufacturers, distributors, and other entities involved with the opioid epidemic will pay $56 billion over the next 10 to 20 years for their role in the crisis. That’s broken into several different settlement agreements, the largest being the $26 billion settlement involving the three wholesalers AmerisourceBergen, Cardinal Health, and McKesson, as well as Johnson & Johnson. Today, only about $3 billion has been distributed.
This settlement money comes after years of an ongoing opioid epidemic. Between 1999 and 2021, an estimated 645,000 people died from an overdose involving an opioid, according to the CDC.
Complexities in Accessing Funds
One of the complicating factors for providers looking to tap into the funds for patient care is that each of the settlements has slightly different parameters, and each state is distributing the funding differently. Still, some central themes run through all of the settlements. For example, the majority of the funding will be allocated for substance use disorder care, prevention, and opioid reversal medications. The bulk of the funding will also go towards Medicaid and uninsured populations.
One of the major use cases for those funds is covering uninsured patients to eliminate financial barriers to care. Only one in 10 people with opioid use disorder are in treatment, and financial obstacles remain a significant challenge.
Guidelines for Opioid Settlement Funding for Addiction Treatment
Guidelines for the allocation of opioid settlement funding for addiction treatment were outlined in a document called Exhibit E, which was attached to the two largest opioid settlements and could be linked to more in the future. This document provides guidance for how states and local entities should use these funds. Treatment will be a central focus, ensuring provider systems utilize medications such as buprenorphine and naloxone for treatment and recovery.
Some of that treatment funding can be used for special populations, including incarcerated individuals. Acadia Healthcare has historically worked with community stakeholders to address the needs of this population and may have opportunities to expand those efforts with opioid settlement funding for addiction treatment.
Expanding Mental Health and Recovery Services
Another major focus of the funding is caring for patients with mental health and co-occurring disorders. This includes ensuring providers screen for substance use disorder, funding crisis response programs, and developing hospital programs to transition patients with opioid use disorder and co-occurring mental health conditions into follow-up care.
The guidelines encourage wrap-around recovery services and highlight the importance of peer recovery coaches and other non-clinical support teams. Recovery support can be staffed with non-licensed personnel such as peer recovery coaches, addressing the low reimbursement rates for recovery support services.
Navigating the Funding Process
While providers have opportunities to utilize opioid settlement funding for addiction treatment, navigating the funding process is complicated. The money will be distributed differently in every state, making it challenging for multi-state operators. In general, states are advised to direct 70% of the settlement dollars to counties best positioned to evaluate local needs and opioid abatement activities.
Providers must research who is adjudicating the funds and ensure their voices are heard. Behavioral health providers have a responsibility to help guide decision-makers, many of whom are not healthcare professionals, to ensure the funds are used effectively.
Differences in State Allocation
Each state has variations in how they distribute the funds. For example, West Virginia directs 75% of its funding to a new foundation managed by a governing board, while Georgia administers 75% of its funds through the state Department of Behavioral Health.
Some providers, such as Acadia Healthcare, are collaborating with state and local governments to shape funding guidelines. Acadia recently partnered with the University of North Carolina to develop an open-access playbook to help public entities make informed decisions about opioid settlement funding for addiction treatment.
Learning from Past Settlements
Stakeholders can learn from past experiences, such as the tobacco industry’s settlement funding. A significant portion of that money was diverted away from health programs, emphasizing the need to ensure opioid settlement funding for addiction treatment remains focused on its intended purpose.
The settlement funds offer a rare opportunity to make a lasting impact on the opioid crisis and addiction treatment as a whole. While the primary focus is on opioid use disorder, the funds can also support broader addiction and mental health services. Effective allocation and strategic use of opioid settlement funding for addiction treatment will be crucial in mitigating the crisis and improving patient care across the country.
