Lawsuits against opioid manufacturers and distributors have won billions of dollars in funds, but it remains to be seen where that money will go, and whether any of it will go to compensate the people who have lost loved ones to opioid addiction that resulted from the aggressive marketing, false information, and misuse of prescription opioid medications over the last 2 decades.

An opinion piece in JAMA by G. Caleb Alexander, MD, MS, and Omar Mansour, MHS, summarizes and discusses these settlement agreements and how those funds will be distributed.1

Alexander is professor of epidemiology at the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and affiliated with the school's Center for Health Services and Outcomes Research. Mansour is affiliated with the Department of Epidemiology at Harvard University's T.H. Chan School of Public Health in Boston.

So far, it appears that state governments will have discretion on how the funds are distributed and used in their respective states. For example, Ohio will receive $808 million in opioid settlement funds to be paid over 18 years as its settlement with Cardinal Health, McKesson, and AmerisourceBergen.2

That money will be overseen by a foundation created for that purpose. OneOhio Recovery Foundation, however, is now being sued by a local group that has accused the foundation of not being transparent about how it will use the funds, according to a news article reported by National Public Radio.3

According to a news release from the Ohio Attorney General, 85% of the settlement money is targeted for local distribution, with this general breakdown:

* 55% goes to OneOhio, the foundation created to disburse the money and fund programs that benefit Ohioans affected by opioids and/or prevent addiction;

* 30% is earmarked for community recovery programs at the local level; and

* 15% goes to the state of Ohio.

Elizabeth A.M. Frost, MD, clinical professor of anesthesiology, perioperative, and pain medicine at the Icahn School of Medicine at Mount Sinai and co-editor of Topics in Pain Management, said she is concerned the money will be eaten up in legal costs, bureaucracy, and political posturing before any of it trickles in for those who lost loved ones to opioid addiction.

"It seems to me there is a large amount of money awarded, but it is left up to the states, to the lawyers and others to work out who gets what," Frost said. "As soon as there is disagreement, there will be delay in distribution, or maybe none at all."

She said she doubted whether many families who have lost children, or children who lost parents, would get much compensation, if any.

"Also, those so badly in need of support programs to recover from addiction or to find jobs and be rehired after some disaster may also get little," Frost said.

"I would think it would be better to decide how the money is to be divided first, before the sum is known," she said. "Are any doctors, nurses, or other health care workers even asked their opinion?"

Frost said she fears it may be like the Camp Lejeune lawsuit over one of the worst water contamination cases in the United States. People can file a claim if they lived for at least 30 days in or around the US Marine Corps base at Camp Lejeune, North Carolina, from August 1953, through December 1987.

"There has been a huge advertising campaign paid for by the taxpayers with multiple lawyers involved," Frost said of the case, which led to the Camp Lejeune Justice Act of 2022. "Yet the compensation for any individual or family might not be worth the time to file claims. I spoke this week to someone who served there for years. He will not even apply, as he said it would be a waste of time to collect perhaps $35 and a tremendous insult."

References