By David Schweihs, Sr. Vice President, Healthcare Solutions:
A recent study from Johns Hopkins University reveals a sobering statistic: about one in three Americans have lost someone to a drug overdose. This alarming figure underscores the severity of the opioid crisis gripping the nation. Tackling the crisis is on the minds of the cities, counties and states most impacted, and as of June last year, more than $50 billion in national opioid settlements from pharmaceutical companies have been allocated to combat this epidemic. However, the misuse of these opioid abatement funds is a growing concern, threatening to undermine efforts to curb the crisis. Amid this misuse, there’s a unique opportunity for pharmacists to step in, apply for these funds, and utilize them as intended to make a genuine impact on their communities.
Approved Uses for Opioid Remediation
In order to curb the misuse of these funds, one must first understand all approved uses. Exhibit E of the final distribution settlement for opioid abatement funds from the attorney general outlines clear and impactful ways to use the funds, but not all states are sticking to the plan. The settlement divides this mandate into general approved uses (Schedule B) and core strategies (Schedule A).
The core strategies in Schedule A have funding priority:
- Providing naloxone or other FDA-approved drugs to reverse opioid overdoses
- Supporting medication-assisted treatment for those struggling with opioid addiction
- Offering specialized treatment programs for pregnant and postpartum women with opioid use disorder (OUD)
- Expanding care for newborns experiencing neonatal abstinence syndrome (NAS)
- Developing warm hand-off programs and recovery services to ensure continuous care
- Addressing the treatment needs of incarcerated individuals
- Implementing prevention programs in schools and communities
- Establishing syringe service programs
- Collecting and analyzing data to measure the effectiveness of these strategies
Schedule B covers a range of additional initiatives, but some states are using their funds for inappropriate expenses that don’t align with these priorities. For example, although these settlements are supposed to be used to expand, enhance, or create programs in service of those affected by OUD, funds are instead being spent on items like new police cars, which doesn’t address the root of the opioid crisis.
Some states are even using funds to supplant existing budgets — replacing money allotted for OUD programs with abatement funds, then using that program’s regular budget for unrelated government expenditure. This supplantation not only undermines the purpose of the settlement but also hinders the progress needed to combat the epidemic effectively. And yet, only thirteen states and Washington, D.C., have restricted this practice of substituting, rather than adding to, funds.
Pharmacies: Hesitant Yet Essential Players
Some pharmacies, many of which have directly contributed to settlement funds, are reluctant to apply for a portion of their state’s opioid abatement funds. The application process for these grants can be time-consuming, taking weeks to complete. There’s also concern over how the public might react to script-filling entities having the money they paid into these settlements returned to them. This has led some pharmacies to question whether applying for these funds is worth the effort. Considering the good that could be done, the answer is unequivocally yes.
Pharmacies are in a unique position to make a significant impact on their communities by utilizing these funds. They can install drug take-back receptacles, which provide a safe way for people to dispose of unused medications, thus reducing the risk of misuse at home. Pharmacies can also support mental health programs for individuals with OUD, recognizing the crucial link between mental health and opioid abuse. Even something as simple as providing their communities with free naloxone — which can cost the individual consumer around $50 to keep on hand for emergencies — could make a huge difference.
The Need for Coordination and Proper Oversight
Maximizing the abatement of the opioid crisis requires coordinated efforts across all levels of government. The needs far exceed the available funds, necessitating a collaborative process between states and local governments to make sure every penny is accounted for and used well. According to the terms of allocation, each of these governments must impose strict reporting requirements on fund recipients to ensure the money is used appropriately. However, misuse of these funds indicates a breakdown in this process.
Is this because reporting isn’t being done effectively, or are the fund distribution committees not composed of the right people? Some states have formed committees with knowledgeable members experienced in addiction crises, while others have opted for politicians or penal system employees, who may lack the necessary expertise. In some states, funds have barely been touched, regardless of the severity of the opioid crisis in their communities. This disparity in committee composition could be contributing to the delayed and improper use of funds. Pharmacies can be a part of the solution by staying up to date on available funds via the opioid settlement tracker.
A Call to Action for Pharmacies
Pharmacies are community healthcare providers and often well-versed in the needs of the specific populations they serve. They have the necessary knowledge to make better, more informed decisions on fund use. Therefore, pharmacies must step up and apply for their state’s abatement funds. By doing so, they can not only shed the specter of past script-filling decisions but participate in the approved programs that contribute to their communities’ recovery efforts. Installing drug take-back receptacles and supporting mental health initiatives are just two examples of how pharmacies can make a difference.
Fund misuse demands the involvement of all stakeholders. Pharmacies, by applying for and appropriately using opioid abatement funds, can play a critical role in this battle. It’s time for them to take action, uphold their commitment to public health, and help heal their communities.
Originally published in Healthcare Business Today