Opioid settlement to aid local drug services
HARRISBURG— Pike County was among 10 more Pennsylvania counties have signed on to the historic national opioid settlement, meant to hold large pharmaceutical companies accountable for encouraging the spread of highly addictive opioid drugs.
Wayne County joined the agreement in mid-December.
Each county that has signed on to the agreement is receiving an allocation, which is restricted in its use to help combat the opioid crisis, whether in money for treatment, recovery or prevention services and programs.
It is up to local governments who have signed on to the settlement to decide where the funds will ultimately be allocated, for this purpose. Each county will be required to account for how the funds are being used.
Pike County's estimated allocation is $1,468,646, Jamie Drake, Executive Director of Carbon/Monroe/Pike Drug & Alcohol Commission (CMP) said, adding that this is contingent on other factors. Rather than a lump sum, the funding will be distributed over a nine year period for the Johnson & Johnson manufacturing company, and 18 years for the distributor companies named in the suit.
The county contracts with CMP for drug and alcohol services. Based in Lehighton, CMP opened an office on Buist Road, Milford, a few years ago where clients are seen.
Class action suit
Approximately six years ago, Matthew Osterberg, Pike County Commissioner Chairman, was pressuring for litigation against the major drug companies. In addition, the county pushed for drop-off boxes at pharmacies, where anyone could safely deposit prescription medication that was no longer needed or had expired.
"We had a terrible epidemic of overdoses," Osterberg said, a problem he said has not gone away.
In May 2018, Pike County Commissioners filed a lawsuit with the state, joining several other Pennsylvania counties. Pike was one of the early counties to join the class action suit.
Osterberg said he didn't know how to define whether the settlement amount is appropriate, compared to all the people who have died of drug overdoses. He noted that the drug companies who are the defendants in this action are only a few of the players.
He said it was important that the counties signed off on the settlement, agreeing not to file individual county lawsuits. That would have risked the companies going bankrupt and then there would have been no settlement funds, or else the litigation would have gone on for years to come.
"Almighty dollar"
Basically, he said these major drug companies were pushing the use of opioids for pain relief prescriptions and treatments, not divulging that they are highly addictive. Osterberg recalled the case of a neurologist practicing in Milford who received federal charges in 2016 for unlawfully distributing controlled substances without a legitimate medical purpose.
"We're satisfied to reach a settlement; you don't know how it would go," Osterberg said. He added that these drug companies were well aware of what they were doing but were more concerned for the "almighty dollar" than the overdose victims who were being buried.
The lawsuit alleged that the defendants sought to create a false perception in the minds of physicians, patients, health care providers and health care payors that using opioids to treat chronic pain was safe for most patients and that the drugs’ benefits outweighed the risks.
This was allegedly perpetrated through a coordinated, sophisticated and highly deceptive promotion and marketing campaign – including unbranded messaging to evade extensive regulatory framework governing branded communications. These communications, which began in the late 1990s, became more aggressive around 2006.
Drake said that they don't have a lot of details yet. She said the funding is a good thing; county human service agencies have bee historically underfunded. She said the money will help assure that people get services. She anticipated meeting with the commissioners of the three counties CMP serves, in the spring.
MORE: Wayne County joins lawsuit to garner restitution for opioid epidemic
Wayne County Board of Commissioners joined the agreement December 16. The Wayne County commissioners noted they could receive more than $2 million with enough participation from other state and local governments, and spread out over time.
The minimum is expected to be $1 million. Wayne County plans to make use the funding to further develop opioid treatment provide at State Correctional Institute (SCI)-Waymart.
Crisis continues
Although the COVID-19 pandemic has drawn public attention away from the drug epidemic, they noted it has not gone away.
Osterberg said he suspected it was as bad as ever, if not worse. Drake said that the pandemic has increased the amount of alcohol abuse, with so many people isolated at home, locked down or on quarantine, upset and depressed over staying away from family members.
CMP has been able to continue offering their services through the pandemic, she said.
Attorney General Josh Shapiro's office reported overdose deaths rose approximately 30 percent to a record 93,000 in 2020. Pennsylvania alone saw overdose deaths increase to 5,172, which equates to 14 Pennsylvanians dying of a drug overdose each day.
The Commonwealth of Pennsylvania provides estimates of accidental and undetermined drug overdose deaths statewide and by county from 2012 to 2021 in an online dashboard. It states that preliminary data is showing a decline in drug overdose deaths, but with more work to be done. The data presented for fatal drug overdoses do not count those related to alcohol only. Wayne and Pike Counties remain in the lowest category among the 67 counties.
In 2020, there were an estimated 15 drug overdose deaths in each of Wayne and Pike. Provisional data for 2021 listed 10 deaths in Wayne and "under 10" in Pike. Finalized death records for overdose deaths are often delayed three to six months. Precise numbers are not given if under 10. Monroe County had an estimated 82 fatal drug overdoses.
Assuming there were at least nine in the low years, since 2012 there were at least an estimated 138 fatal overdoses in Wayne and 115 in Pike. Wayne County saw a peak of 19 in 2019 and has decreased from there. Pike County peaked in 2018 with 18, with declining numbers since.
Another map on the same site shows the annual estimate of persons with "drug use disorder" generated by mortality rates from the Centers for Disease Control & Prevention (CDC) and illicit drug use estimates from the National Survey on Drug Use and Health (NSDUH). This data does not include alcohol use disorder. Drug use disorder data is described by the state as an approximation for the prevalence of opioid abuse.
For the year 2019 there were 1,485 individuals in Wayne County, up from 1,231 the year before and 1,169 persons in Pike County, down from 1169 the year before, with drug use disorder. Monroe County had 3,034 individuals with this disorder, up from 2,403 from the prior year. Data was not listed for 2020 or 2021.
Sixty counties signed on
Shapiro on January 5 announced that 10 more Pennsylvania counties have signed on to the settlement, bringing the total to 60 out of 67 counties across the Commonwealth. Those 10 counties include: Blair, Centre, Crawford, Cumberland, Lycoming, Northampton, Northumberland, Pike, Somerset, and Sullivan.
As the Attorney General's office explains, the $26 billion global settlement with Cardinal, McKesson, and AmerisourceBergen—the nation’s three major pharmaceutical distributors—and Johnson & Johnson was announced in July. More than $1 billion is due to be distributed in Pennsylvania, with up to $252 million delivered in 2022.
The national sign-on deadline for local governments was recently extended from Jan. 2 to Jan. 26. Monroe, Carbon, Luzerne, Lackawanna and Susquehanna Counties also are on the list of those that had already joined the agreement.
What the companies must do
In addition to the restitution, the three distributors and J&J must also fulfill terms of a ten-year injunctive relief agreement.
Cardinal, McKessen and AmerisourceBergen will be required to:
Establish a centralized independent clearinghouse to provide all three distributors and state regulators with aggregated data and analytics about where drugs are going and how often, eliminating blind spots in the current systems used by distributors.
Use data-driven systems to detect suspicious opioid orders from customer pharmacies.
Terminate customer pharmacies’ ability to receive shipments, and report those companies to state regulators, when they show certain signs of diversion.
Prohibit shipping of and report suspicious opioid orders.
Prohibit sales staff from influencing decisions related to identifying suspicious opioid orders.
Require senior corporate officials to engage in regular oversight of anti-diversion efforts.
J&J will be required to:
Stop selling opioids.
Not fund or provide grants to third parties for promoting opioids.
Not lobby on activities related to opioids.
Share clinical trial data under the Yale University Open Data Access Project.
For more information
For more information about drug use statistics in Pennsylvania, visit https://data.pa.gov/stories/s/Pennsylvania-Opioids/9q45-nckt/
Carbon Monroe Pike Drug & Alcohol Commission http://www.cmpda.cog.pa.us/ For help in getting drug and alcohol treatment, in Pike County call 570-296-1054 during regular business hours, or 1-866-824-3578 after hours.
Wayne County Drug & Alcohol Commission https://waynecountypa.gov/157/Drug-Alcohol. Wayne County Crisis Hotline: Call 24 hours a day, seven days a week, 1-833-557-3224.
This article originally appeared on Tri-County Independent: Pike County was among 10 more Pennsylvania counties have signed on to the historic national opioid settlement.
