Last month, the U.S. Justice Department revealed a 2016 Fentanyl bust that resulted in 35 arrests from a joint operation between officers from Texas, North Carolina and Virginia and the seizure of 30 kilograms of Fentanyl, enough to kill 14 million people.
The criminals trafficking the drugs were no amateurs; they were well armed, carrying dozens of firearms, they switched their phones regularly and used encrypted messaging to cover their tracks, and they hid their drugs in compartments like a highly planned smuggling operation. And like the majority of modern day drug dealers, they received their Fentanyl, a powerful opioid so dangerous even first responders have to be careful when seizing it, from China through the US Postal Service.
Stories like these aren’t new or novel; the proliferation of Fentanyl in the United States has been well-documented for the last five years since they led to a dramatic spike in overdose deaths in the United States starting back in 2014 and ultimately are a significant contributor to the country’s falling life expectancy. Thanks to the rise of Fentanyl, and the soaring overdose death rate that accompanied it, the opioid epidemic was thrust onto the national stage and lawmakers finally began introducing legislation to address it. Just last year, Congress passed the Opioid Crisis Act of 2018 to crack down on drug shipments coming in through the mail with a goal of reducing the proliferation of Fentanyl across the country by 70 percent.
“If they can do what they said, reduce the flow of Fentanyl into the country by 70 percent, I think that will show an immediate impact,” Dr. Ted Bender, CEO of the Scurry-based addiction treatment center the Treehouse, said. “But that’s one piece of it. The other things we need to do are obvious; increasing access to care, preventative education, preventative measures, making Narcan more widely available, making medication assisted therapies easier to access and cheaper. Oftentimes it comes down to money, and money should not be the barrier that prevents people from getting into treatment.”
And for thousands of municipalities across the country, getting a piece of that money just became much more likely. Purdue Pharma, one of the pharmaceutical companies that pushed dangerous opioids over the last 15 years and helped contribute to the public health crisis that has left hundreds of thousands of Americans dead, is filing for bankruptcy and settling the majority of the nearly 2,000 cases against it from cities, states, and counties, including Kaufman County, across the United States.
As far as Purdue Pharma is concerned, these settlements aren’t an admission of guilt; it’s simply a means to an end enabling them to provide billions of dollars in funding to help treat those whose lives have been ravaged by the very drugs they produced and proliferated. The Sackler family, who owns Purdue Pharma, even released a statement comparing their situation with all of the other families across the United States who did not, in fact, produce or market dangerous drugs that have killed thousands.
“Like families across America, we have deep compassion for the victims of the opioid crisis,” the statement read. “This settlement is a historic step toward providing critical resources that address a tragic public health situation.”
Every state in the country has pending lawsuits against Purdue Pharma and about half of them, including Texas, have already agreed to the settlement plan which would also take $3 billion of the Sackler family’s personal wealth along with the dissolution of Purdue Pharma, though a similar company that will still sell opioids will replace it.
“We are proud to participate in the nation’s most significant step in addressing this deadly crisis,” Texas Attorney General Ken Paxton said.
Even some advocacy groups including the National Prescription Opiate Litigation Plaintiffs’ Executive Committee are voiced their support for the settlements despite their mandated bankruptcy filing for Purdue.
“As a result of these collaborative efforts, the bankruptcy filing will not prevent us from finalizing an agreement with Purdue to bring opioid recovery resources into the communities we represent,” a statement from the organization read.
However, others aren’t so pleased; critics of the settlement plan argue that the $3 billion settlement from the Sackler family (who are worth $13 billion in personal wealth not to mention the $81 billion in profits that Purdue Pharma raked in last year alone) isn’t enough to address the scope of the problem companies like theirs created. There’s also the possibility that the Sacklers may even be able to write off the settlements from their taxes if the money goes toward addiction treatment centers as it likely will in part.
“A deal that doesn’t account for the depth of pain and destruction caused by Purdue and Sacklers is an insult, plain and simple,” New York Attorney General Letita James said.
“My concern is we’re going to settle for pennies on the dollar when I know what the real cost is going to be,” Bender said. “If you’re asking me on a nationwide scale what we need, it’s $100 billion to $200 billion if we want to make a real impact in the next five years.”
Although the scale of Purdue’s settlement plan is unprecedented, this isn’t the first settlement that has been reached from pharmaceutical companies as a direct result of the opioid epidemic. Just last year, Purdue reached a settlement with Oklahoma, and a judge ordered Johnson and Johnson to pay $570 million to Oklahoma last month in the first courtroom victory for opioid-focused advocates in the country. Based on the outcome of that case, Bender isn’t surprised that Purdue quickly took steps to settle its cases on a grand scale.
“Often in law when you’re fighting a case, you’re looking for past cases to set precedents for future cases,” Bender said. “The biggest takeaway I see from this is it’s kind of going to be a blueprint for future cases. This is the precedent that provides a pathway for lawsuits going forward. It also showed that no matter how big you are, no matter how much money you have, no one is above the law. They’re being held accountable. They settled for a lot less than what Oklahoma asked for, but we could start seeing a tremendous amount of settlements coming out of this.”
As settlements are reached in Kaufman County and around the rest of the country, the most salient question becomes, where does that money go? As unprecedented as this situation is, Bender says the answer to that question remains unclear.
“I don’t think anyone really knows the answer to that just yet,” Bender said. “I pray that it doesn’t just get tied up in government bureaucracy. Are we going to use that money as the way we help treat people suffering, or is this payback for money the counties and cities have already spent, a debt that’s being repaid? It remains to be seen. What’s going to be important once those funds are acquired is there needs to be a really good plan in place for how to distribute it.”
This uncertainty has led Bender to question what the long-term effects of such settlements may be in the grander scheme of the opioid epidemic and the thousands of American lives lost year, particularly considering the scope of the funding he thinks is necessary to start making a significant dent in the overdose death rate. While the $570 million the Oklahoma judge ordered Johnson and Johnson to pay the state, it’s a far cry from the $18 billion the state requested.
“As good as it is that there’s some responsibility and they have to pay a tremendous amount of money, while $517 million seems like a lot, they asked for $18 billion to treat the state for 30 years,” Bender said. “Think about what we need on a national scale. My concern is that we get all of these settlements done and a bunch of money comes, hopefully that gets directed into treatment and helping people affected, but if we just settle and they write it off on the books and it’s back to business as usual, where are we going to be after all of the settlements? My concern is that once the money is out, a few years later we’re right back to where we started. What would be better than a one time payment is if they agreed to a covenant to provide treatment for the future.”
There also exists the double-standard that has always accompanied white collar crime like the Sacklers’ versus street crime like the 35 arrested for smuggling Fentanyl. While companies like Johnson and Johnson and Purdue Pharma may have to pay for restitution and even file for bankruptcy as a result, there are currently no criminal charges against the Sackler family or others who own and operate similar pharmaceutical giants.
“It’s not enough to just write off a payment,” Bender said. “If there was criminal negligence, should they be held accountable? Yeah, absolutely. The double standard is pretty clear.”
In the meantime, though, Bender is heartened by the potential short-term gains that can be made in communities like Kaufman. Alongside efforts from organizations like the Treehouse, Bender is hopeful that individual communities may begin to see declines in the overdose death rates and that this will translate to the continued downward trend of the such deaths across the country.
“I think the money is great and it will hopefully open up access to good treatment for people who can’t afford it,” Bender said. “Simple things like just having Narcan available to all first responders. Here in Kaufman County I found very early on when I got here that a lot of the first responders don’t have it. We raised a bunch and we’re going to be giving it out pretty soon. But if the money goes where it needs to and they include people in this industry to help guide that plan, it could be huge. It could have a major effect.”
In particular, Bender points to the gains made in Dayton, Ohio, one of the communities hit the hardest by the opioid epidemic. Over the course of a single year after the state pumped $1 billion in funding into the city and Montgomery County to increase access to care, put money into preventative education, increase access to medication assisted therapies, crack down on Fentanyl shipments and provide sober housing, the overdose death rate plummeted by 50 percent. Using this model, Bender believes the entire country can recover.
“I do see a lot of hope still,” Bender said. “It’s really hard in this business to just lose that hope. You’re kind of running around in circles and the overdose problem gets worse and worse day in and day out. But I’d be much more pessimistic if there wasn’t a plan in place that could fix it. And there is. We don’t have to figure out how to decrease the overdose deaths in this country; we know how to do it. And the CDC data shows that we’ve seen significant reduction in overdose deaths the hardest hit areas. Now we just need the funding to get it done.”