By ANDREW SELSKY, Associated Press
McMINNVILLE, Ore. (AP) – The opioid epidemic has swept through this quaint Oregon town like a poisonous wind, leaving in its wake overdoses, addictions, homelessness and destroyed families.
In a humble one-story brick building, three blocks from the wine tasting rooms and cafes of downtown McMinnville, staff and volunteers from a recovery center called Provoking Hope come in. help the injured. The workers, who are recovering from drug addiction themselves, offer counseling, coffee and, for some, clean syringes.
McMinnville and thousands of other cities across the United States are set to receive billions of dollars in the second-largest court settlement in U.S. history. The $ 26 billion from three drug distributors and one pharmaceutical manufacturer would solve the damage caused by opioids, which the federal government declared in 2017 to be a public health emergency
States, counties and cities face a three-week deadline to sign the settlement, and most states have agreed to do so. But a few holdouts remain, including Oregon, where disagreements have arisen between state and local authorities.
Money is needed. In Yamhill County, where McMinnville is the county seat, this would expand counseling and treatment, including in prisons, expand residential treatment and recovery facilities and fund other programs, the Commissioner said. county, Casey Kulla.
As the director of the Provoking Hope office, Anne Muilenburg has seen the devastating effects of addiction and also experienced it firsthand. She says her addiction started, like many in America, after her doctor prescribed opioids. They were for a painful bone spur. Ten years later, using her prescription and buying prescriptions for two other people, she was taking 35 pills a day, far exceeding the maximum dose.
“It wasn’t even enough to get me high. It was just enough not to make me sick, ”Muilenburg said. She described opioid withdrawal – experienced when she ran out of pills – as “the worst feeling ever.”
“It makes you feel like someone is peeling your skin,” she recalls in her small office, decorated with posters with sayings like “be kind” and “stay humble.”
Muilenburg was eventually treated, but “the drugs switched” to alcohol and methamphetamine. She ended up losing her job at a car dealership, lost her husband (they have since reunited), traveled back and forth to jail and found herself living on the streets.
“Being homeless was one of the things that made me want to change my life,” Muilenburg said.
She has been drug free for four and a half years. Muilenburg said the settlement funds are needed to tackle drug addiction in the community.
“We need more treatment centers. Every place needs more treatment centers, ”she said. “It’s ridiculous that someone wants to undergo treatment and have to wait eight to ten weeks to get a bed.
In the United States, more than 500,000 deaths over the past two decades have been linked to opioids, both prescription drugs and illegal drugs.
Time is running out for the settlement, with a payment just after the more than $ 200 billion tobacco settlement in 1998 with the country’s four largest tobacco companies.
The three drug distributors – AmerisourceBergen, Cardinal Health and McKesson – and drugmaker Johnson & Johnson agreed in July to pay the combined $ 26 billion to resolve thousands of state and local lawsuits. But if the defendants feel there is a lack of participation from states and local jurisdictions, it could cause them to withdraw from the landmark deal or possibly reduce the amount of the settlement.
“The defendants have the final say in saying, ‘Do we have a critical mass to justify going forward,'” said Joe Rice, an attorney for the plaintiffs.
In return for the payment, participating states, counties and cities would drop any prosecution against the defendants and agree not to prosecute them in the future for the opioid epidemic.
“There are complex tradeoffs at play here,” said Caleb Alexander, drug safety expert at the Johns Hopkins Bloomberg School of Public Health. “On the one hand, the regulations would provide much needed funding to expand treatment and otherwise tackle the opioid epidemic. On the other hand, many parties believe that settlement is not enough.
At least 45 states have signed or signaled their intention to do so, and at least 4,012 counties and cities have also confirmed their participation, lawyers for the plaintiffs said on Friday.
Washington state has already ruled out participation, with Attorney General Bob Ferguson calling the settlement “woefully inadequate.” He is suing the country’s three largest drug distributors – the same in the national regulation – for $ 38 billion in a lawsuit that began in November.
In Pennsylvania, prosecutors in Philadelphia and Allegheny County, which includes Pittsburgh, sued the state attorney general to ensure their drug industry lawsuits could continue, saying shares of their communities in settlement would only cover a fraction of the finances of the epidemic. ring.
“We are not going to accept a settlement that is a surrender,” said Philadelphia District Attorney Larry Krasner.
Pennsylvania Attorney General Josh Shapiro said receiving settlement payments is a sure thing, unlike pursuing lawsuits against companies. Local governments can withdraw and continue to prosecute, he said, but the more it does, the less the state would receive.
New Mexico is still working on the details, “and we expect counties and local governments to respond soon,” said Jerri Mares of the state attorney general’s office.
In Oregon, lawyers for local and state governments recently resolved a deadlock over how the settlement would be paid, according to The Lund Report, a health care news site.
The state of Oregon had wanted local governments to apply for grants. Instead, local governments wanted more of the funds in the form of out-of-pocket payments. There is now disagreement over how much of the settlement should go to lawyers who sued on behalf of several Oregon counties.
Yamhill County Commissioner Kulla supports the opioid regulation but does not want the state to take excessive control.
“It is we in the counties who work with addicts and their families, and we bear the societal costs of those addictions,” he said.
Under the regulations, payments would be made over 18 years. Tobacco regulations were controlled by state governments, and most of the money was not used to pay the tobacco toll. In contrast, opioid colonies are structured so that most of the money goes to fighting the crisis.
Kulla recognizes that there will be no quick fixes.
“It will be long term,” Kulla said. “It’s really going to take generations to get us out of this. “
AP reporters Geoff Mulvihill in Cherry Hill, New Jersey, and Cedar Attanasio in Santa Fe, New Mexico, contributed.
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