How can Utah effectively use opioid settlement funds to combat addiction?

SALT LAKE CITY — In an effort to address the state's opioid epidemic, Utah Attorney General Derek Brown held his administration's first virtual opioid task force meeting Tuesday morning, where nearly 60 people attended.

"The impact and prescription opioid deaths has gone down, which is phenomenal," Brown said. "Its highest point was 2014. ... Even though we're seeing that consistent decline, there's a lot left to be done."

Brown called the task force "multidisciplinary" due to its range of members, which include stakeholders such as legislators, attorneys, law enforcement, social workers, doctors, etc. During the meeting, the task force reviewed litigation Utah has been or is currently involved in and how the money from said settlements is being best allocated across the state.

Prior litigation has caused Utah to have more than half a billion dollars ($543 million) in settlement money to spend over the next 15 years to combat the opioid epidemic. Deputy Attorney General Douglas Crapo told the task force that the funds came from prior settlements and involved big names like Johnson & Johnson, CVS Pharmacy, Walmart, and McKinsey & Company, accused of a range of allegations — misrepresenting the risk of addiction, ignoring signs of diversion, assisting in marketing opioids that further addiction.

Crapo added that as the Legislature and the task force continue to decide how to spend the money, the state of Utah has received $81 million so far, and $14.5 million has been spent.

Utah's opioid-related settlements

Utah is currently in multistate litigation against the Sackler family and their former company, Purdue Pharma, that reached a settlement in January. The proposed agreement would financially aid communities marred by drug addiction and settle lawsuits across the country accusing both Richard and Kathe Sackler and their former company of causing opioid harm in Utah and across the nation.

Crapo said the global settlement requires the Sacklers to pay $7.4 billion, and Utah anticipates acquiring nearly $57 million over an eight- to nine-year period. He noted that agreements will be sent out sometime over the summer for subdivisions to sign.

"I hope it's enough to stop the opioid epidemic and truly bring down the number of overdose deaths to near zero. That's the ultimate goal," Crapo said.

The state is also involved in legal action against two pharmacy benefit managers, which is being handled in federal court.

"Pharmacy benefit managers work all the way from the manufacturers to the pharmacists and in between (and) with every insurer throughout the nation on deciding what medications would make it onto a formulary (and) which ones would get bonuses," Crapo said, emphasizing that these managers knew what they were doing by promoting certain opioid products.

He added that they "understand the entire industry, from cradle to grave, from manufacturing to dispensing." He hopes to have more details at the next task force meeting.

Legislative appropriation funding

In 2022, the Legislature began making appropriations out of the opioid settlement funds awarded to the state of Utah. Minority Assistant Whip Sen. Jen Plumb, D-Salt Lake City, said during the meeting that nearly $4 million in request for appropriation funding was given to the Legislature. Plumb noted that when appropriation funds are granted, they have a three-year lifespan where they will then be reviewed.

"We don't want to waste these funds. They're pretty precious, right? They came from the loss and the suffering of a lot of people that we care about," she said. "We want there to be thoughtfulness. I think this is both on the kind of bureaucracy and policy side as well as on the community side. We really want these dollars to be spent well, and there also to be transparency and accountability."

All funds are managed through the Office of Substance Use and Mental Health within the Utah Department of Health and Human Services, per utahopioidpriorities.org.

Funded items by category from 2022-2025:

• Recovery — 6.7%
• Expanded needed services — 9.8%
• Criminal justice — 25.1%
• Prevention — 25.2%
• Treatment — 33.2%

"In this state, all of these areas are going toward the goals of the settlements, which are to ameliorate the harms of the opioid crisis and of opioids that have been sent out into our states, as well as to prevent future harms," Plumb said. "But I think we've probably got a little bit of lens changing to do about how we make sure we get more directly to the people impacted, and not just funding agencies and efforts."

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