Where to begin? Organizations, advocates weigh how to spend opioid settlement money

DELPHOS — Diane Urban remembers the day her sons finally asked for help: how difficult it was to find a doctor who could prescribe suboxone, let alone a long-term treatment center that was accepting new patients for substance-use disorder.

“They would keep you (for 15 to 30 days) and then you’re just cut loose and on your own,” said Urban, who founded the nonprofit Association of People Against Lethal Drugs after her son, Jordan Garmatter, died from fentanyl poisoning in 2019. He was 24.

Now that Ohio is starting to distribute the funds it won from historic settlements with the drug makers and pharmacies that started the opioid epidemic, which will bring at least $1 billion to the state over the next two decades, Urban is watching to see what local officials do with their portion of the settlements.

“Money seems to get lost a lot,” she said.

Still, Urban and other parents who have lost children to the opioid crisis want to see the bulk of those funds dedicated to treatment — detox centers, suboxone clinics, inpatient treatment and sober living facilities where those in recovery transition back to normal life — so that treatment becomes affordable and accessible for each stage of recovery, rather than the patchwork of services that parents like Urban enountered years ago.

“It takes a long time to unwire an addictive brain,” said Kelli Anderson, whose son, Wade, died in 2016. Two weeks of treatment is not enough, she said.

A settlement to end the epidemic

Ohio was one of the first states to sue drug makers and pharmacies for their alleged role in fueling the opioid epidemic, which has killed at least 110,000 Ohioans since 2007, Ohio Department of Health data show.

Attorney General Dave Yost, who succeeded Gov. Mike DeWine in negotiating the settlements, won his first settlement with three of the nation’s largest opioid distributors in 2021 for $800 million. He’s since won settlements from Johnson & Johnson ($185 million), McKinsey ($25 million) and Walmart ($114 million), totaling all told more than $1 billion.

“Anytime we can get a worldwide company like Walmart to implement systemic changes that will benefit Ohioans long-term, I’d say that’s a significant win,” Yost said in a statement last November.

Ohio was one of 16 states to sue the company, which operates 5,000 pharmacies nationwide, for its alleged failure to monitor opioid dispensing.

Thirty percent of settlement funds will be awarded directly to cities, counties and other local governments to support recovery efforts for the next 18 years, which are now working to identify gaps in treatment services.

Another 15% of those funds will stay with the state, while the bulk of settlement will be distributed by a private foundation, the One Ohio Recovery Foundation, which will review applications for regional projects.

Generations of trauma

In February, Allen County leaders met to discuss the settlement and identify gaps in treatment. But the problems span generations: grandparents are raising their grandchildren; a new syphilis epidemic is infecting infants as desperate parents trade sex for drugs.

“We’ve got a generation of parents who are using with their children,” Tammie Colon, executive director of the Mental Health and Recovery Services Board for Allen, Auglaize and Hardin counties, told leaders last month.

Prevention and education are needed to stay ahead of the next epidemic, she said.

But scare tactics won’t work, Colon told The Lima News, and youth tend to minimize the dangers of illicit drug use when they hear survivor stories. “They see it as an opportunity to survive,” she said.

Instead, Colon recommends teaching students how to cope with grief so they are less likely to rely on drugs, or screening students to identify those at risk of self-harm or substance use.

Even simple interventions like after-school programs can limit youth exposure to drugs and alcohol by providing a healthy, structure environment to replace unsupervised time at home, she said.

‘We have a decision to make’

“There is evidence-based prevention work out there … it’s just challenging to do that when you’re in the midst of a crisis and people are dying, because your first goal is to save them,” Colon said.

“So, we really have to make a decision. We’ve been battling with opioid addiction for several years and we’ve not made the progress, I don’t believe, that Ohio has wanted to make. And then the generations behind us aren’t getting better.”

Colon’s suggestion was one of several presented last month as the Allen County commissioners, Lima council and other municipalities determine how to use their first round of settlement dollars.

Others spoke of the need for case managers to oversee kinship placements, an alternative to foster care in which a child temporarily removed from their parents can stay with a grandparent, family member or close friend.

Lima Municipal Court needs ankle monitors and case managers for its jail diversion programs, and Allen County Public Health needs more naloxone, an overdose reversal drug, to distribute to the community.

While the group did not reach a consensus, the One Ohio Foundation will start accepting applications for regional projects in April, and municipalities are starting to see settlement checks.

Wait six weeks and ‘they may be gone’

Anderson remembers the day she wandered the halls of Mercy Health-St. Rita’s medical center in tears, searching for inpatient treatment for Wade. “There was nowhere,” she recalls.

Treatment has expanded since Wade’s 2016 death, including several outpatient clinics in Lima, where people can access suboxone, group therapy, counseling and social support. But the need for immediate, accessible and affordable treatment remains great, Anderson said.

“When they decide they need help, it’s right now,” she said. “It’s not wait, because in six weeks they may not think they need help anymore, or they may be gone.”

Anderson still sees the shame in her son’s eyes when he asked for help, the same stigma that kept her from telling Wade’s story for seven years. But she hopes her advocacy will prevent other families from experiencing her pain.

“Nobody deserves to die,” Anderson said. “They’re all somebody’s child. Somebody’s somebody.”