Good news, bad problem

Robbinsville – N.C. Attorney General Josh Stein visited Robbinsville on April 28, formally announcing terms of an opioid settlement with the pharmaceutical industry in a county among the worst in the state affected by illegal narcotics.

Stein said corporate greed has amplified opioid addiction and helped lead negotiations for a $26 billion agreement with the three largest drug distributors (McKesson, Cardinal Health, and AmerisourceBergen), as well as manufacturer Johnson & Johnson.

Graham County Finance Officer Becky Garland was credited with playing a roll in the negotiations that Stein described as “integral.”

In July 2021, Stein announced a historic agreement that will help communities harmed by the opioid epidemic.

The state of North Carolina, its 100 counties, and 45 municipalities joined the agreement by January 2022.

Of the $26 billion in the settlement, North Carolina will receive $757.6 million – of which 85 percent will be distributed among the counties and larger municipalities.

Stein’s appearance in Graham County was among several he made in western North Carolina last week to discuss the settlement.

He spoke at the Graham County Community Building to a gathering of local elected officials, law enforcement and emergency service providers, among others.

“You all are the ones who have to deal with this at the local level,” he said.

Stein said COVID-19 resulted in increased isolation and depression, driving up North Carolina’s already high numbers of opioid addiction, overdoses, and deaths.

“It’s raging worse than ever,” he said of North Carolina’s opioid problem.

The agreement resolves litigation over the role of four companies in creating and fueling the opioid epidemic. The agreement also requires significant industry changes that will help prevent this type of crisis from ever happening again.

“This problem has been 20-25 years in the making; it is incredibly deep-seated,” he said.

“The opioid epidemic has torn families apart and killed thousands of North Carolinians. While no amount of money will ever be enough, these settlements will bring much-needed programs and services to North Carolina,” Stein is quoted on the state’s opioid settlement website at ncopioidsettlement.org.

The overdose death rate in Graham County was 47 out of 100,000 people in 2020. This represents 4 people in Graham who died from overdose in that year. Graham County is ranked among the worst 10 percent in opioid deaths in North Carolina.

Neighboring and nearby counties compare relatively better, with opioid deaths ranked lowest in Clay County, low in Cherokee and Macon counties, and middle in Swain and Jackson counties.

Between this year and 2038, Graham County will receive $1.181 million in settlement proceeds, starting with a $45,399 payment due this spring and another $99,842 in the summer, then annual summer installments through 2038.

Cherokee County will receive $5.04 million between this spring and 2038, Clay will receive $1.44 million, Jackson $3.27 million, Macon $3 million, and Swain County $1.81 million.

The flow of funds under the settlement is a two-step process, according to ncopioidsettlement.org.

First, the defendants make lump-sum payments to the national settlement administrator. Second, the national administrator makes wire transfers to the dozens of state governments and thousands of local governments set to receive payments under the terms of the national settlements and the various state-level agreements about how funds will flow to state and local governments (which differ substantially from state to state).

While the deadlines for the defendants to make lump-sum payments to the national settlement administrator are clear, the timing of the subsequent payments from the national administrator to state and local governments depends on complex logistical procedures to be established and implemented by the national settlement administrator.

Attacking the problem

Money from the settlement must be used to attack the opioid problem.

Option A, “high-impact opioid abatement strategies,” includes collaborative strategic planning, evidence-based addiction treatment, recovery support services, recovery housing support, employment-related services, early intervention, Naloxone distribution, post-overdose response team, syringe service program, criminal justice diversion programs, addiction treatment for incarcerated persons and reentry programs.

Under Option B, a local government engages in a collaborative strategic planning process involving an array of stakeholders and may then fund a strategy from the Option A list or a longer list of strategies included in the national settlements.

Stein urged county leaders to closely watch how other counties and municipalities are using the settlement money to see what works, but said Graham County leaders are already making progress.

“I can tell you’re all definitely, definitely, definitely on the right track,” he said.

“What we want is for this money to matter,” Stein added with the goal to “restore normalcy and happy and healthy families.”

He added that as for Big Pharma, he wants “them to be punished and feel the pain.”

Graham County Commissioner Dale Wiggins, who was present during Stein’s visit last week, told Stein the county will be brainstorming among key stakeholders to come up with a plan that best fits the county.

“I never met a 10-year-old who said he wants to be a drug addict,” Wiggins said.

He said Graham County has jobs to fill and should celebrate and embrace its residents who are going through recovery.

“These are somebody’s children, somebody’s mother, somebody’s father – we should not throw these people away,” he said.

Graham County jail officials said the jail – which is built to house eight inmates – had 25 in custody between it and other counties where Graham County has outsourced prisoners. Of those, every one of them were incarcerated due to drugs or property crimes related to drugs.

“We can’t give up on adults,” Stein said. “If we don’t break the cycle, there’s very little hope for the kids.”