By Maralisa Marra
The City of Shinnston, which city officials have reported was set to receive nearly $70,000 in recent settlements against opioid manufacturers, is set to receive about $26,000 more, following another settlement with opioid distributors.
West Virginia counties and cities who participated in litigation against the “Big Three” opioid distributors, AmerisourceBergen, Cardinal Health, and McKesson, are still in the process of approving a $400 million settlement, according to Warren R. “Randolph” McGraw II, one of several attorneys who represent municipalities in lawsuits against the three branches of the opioid industry–manufacturers, distributors, and pharmacies.
The money, about $100,000 for Shinnston so far, must be spent “to abate the opioid crisis in West Virginia,” according to McGraw.
Dr. Patrick J. Marshalek, a psychiatrist who practices chronic pain management in the School of Medicine at West Virginia University, suggested communities devastated by the drug crisis can rebuild by focusing on general health and wellness to promote healthy living habits and repair fragmented communities.
“This is cliched for a reason: an ounce of prevention is worth a pound of cure,” Marshalek said.
Abating the drug crisis
For years, affected communities in West Virginia have argued that opioid companies willfully over-marketed highly addictive drugs, while pharmaceutical companies have defended themselves by saying they followed laws and were overseen by government officials.
Over the last several months, state officials announced several settlements with opioid manufacturers Endo Health Solutions, Janssen Pharmaceuticals, Teva Pharmaceuticals, and Allergan, totaling $290 million.
McGraw has previously said Shinnston’s share of the money is 0.0968%, or $280,720. Shinnston will actually recover 24.5% of that sum which equals around $68,800, McGraw said. Another 72.5% of the money will go to a regional abatement fund, which Shinnston could apply for funding from, while another 3% will be held by the state.
In previous interviews, McGraw had noted that Shinnston could still receive more money, as lawsuits against distributors and pharmacies were still underway.
This settlement money will be allocated across the local cities and governments the same way the previous settlement money from the manufacturers case has been distributed, according to McGraw.
“Everything will be governed by the memorandum of understanding,” McGraw said, “The distributor money will be a slightly higher percentage [for local municipalities] than the manufacturers and the pharmacists and the remnant defendants because Huntington/Cabell…is excluded from the distributor money.”
A trial in counties’ and cities’ lawsuit against the “Big Three” opioid distributors, AmerisourceBergen, Cardinal Health, and McKesson, was set to go to court on July 5, then postponed.
The day prior, July 4, Senior Judge for the Southern District of West Virginia David A. Faber had ruled in favor of the distributors, AmerisourceBergen, Cardinal Health, and McKesson, in a separate lawsuit, filed by Huntington and Cabell County. Those local governments, representing an area frequently referenced as the epicenter of the overdose crisis, had decided to file their own lawsuit instead of joining with other municipalities.
Then on Aug. 1, lawyers for cities and counties throughout the rest of the state announced the $400 million settlement with the companies.
McGraw said the settlement was agreed upon at about 5:30 a.m. July 5.
The settlement is “frontloaded,” according to McGraw. Over 12 years the $400 million has to be paid. The first payment is $50 million which has to be paid by the end of this year, said McGraw.
“It’s around double plus a little bit what West Virginia would have received under the national settlement,” McGraw said. West Virginia did not participate in similar litigation at a national level. West Virginia Attorney General Patrick Morrisey had already reached separate, smaller settlements with the companies. However, counties and cities, like Shinnston, collectively filed lawsuits of their own.
According to McGraw, Shinnston should receive about $26,000 from the settlement with distributors, although he noted that figure could slightly change. For instance, he said, the court may consider court fees the distributors pay as part of their settlement funds.
McGraw also said lawsuits against pharmacies, including Walmart and Kroger, among others, are set to go to trial in mid-September, and Rite Aid just settled last month for $25 million under threat of bankruptcy.
According to The Herald-Dispatch, “the settlement money is expected to be placed in the West Virginia First Program, a proposed opioid litigation fund,” and that “the foundation will include people from different sectors of state and local government to determine how the abatement money is spent.”
The foundation does not exist yet, but it is being built, according to McGraw.
“Hopefully, they are people who are attuned to the opioid problem and what needs to be done to try to abate those problems,” McGraw said. “I know that there are two [people] that I’d like to see get on there. One of them is a mental health worker, an administrator of a mental health facility in Southern West Virginia. All they do is deal with the opioid addiction, problems created and associated with it. And another runs a series of drug rehabilitation centers, so I hope it will be people like that [who fill the foundation].”
“Breathe life back in”
McGraw provided a list of approved uses for the money that is focused on prevention, treatment, recovery, research and law enforcement. Meanwhile McGraw has said municipalities could use the money to repay debts incurred due to the drug crisis, such as jail fees. City officials have said they’re still early in the decision-making process.
In a discussion about the best use of funds, Dr. Patrick J. Marshalek, a psychiatrist who practices chronic pain management in the School of Medicine at West Virginia University, pointed to the lack of “a well-defined front door for who do you go to or where do you [go] for addiction treatment.”
“In various stages of my career, that front door was the emergency department–not the best place to start,” he said. “I think we’ve made a tremendous amount of progress in this state over the last five years or so, but there’s still a lot more to be made.”
He also said with the settlement money, it will be important to continue to support, build, grow, and scale up the drug abatement programs already in place throughout the state.
Shinnston pharmacist Yvonne West and residents of the Clarksburg Mission previously suggested the money would go farthest if spent on social workers, peer recovery specialists and others to meet with and reach out to those still in active addiction. Marshalek agreed with those ideas.
He also suggested the money could be used on prevention. He referenced stable housing, transportation, childcare, and even broadband so people with substance use disorder can access telehealth.
He also suggested the addition of spaces available for people to go out and be active and the creation of more job opportunities.
“A lot of times, we’re talking about trying to breathe life back into these communities,” Marshalek added. “I think a big thing to not forget is the stigma that’s associated with these use disorders still. It’s better, but it hasn’t gone away.”