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home : most recent : vigo August 18, 2018

4/27/2018 12:29:00 PM
IU report: Opioid lawsuit settlements should go to fight crisis

Scott L. Miley, Tribune-Star CNHI Statehouse Bureau

After 46 states won massive settlements against the tobacco industry in 1998, many hoped the money would be used to educate the public about the dangers of smoking and to address addiction.

But, in 2015, only 1.9 percent of $25.6 billion in settlement money and tobacco taxes was earmarked for tobacco control programs, according to a state-by-state analysis by the Campaign for Tobacco Free Kids.

Indiana University researchers, in a set of recommendations released Thursday, emphasize that the same mistake shouldn’t be made with potential proceeds from lawsuits against opioid manufacturers, marketers and distributors.

The research team surveyed experts in the field of substance abuse about the effectiveness of state law and policy.

If settlement funds are awarded, perhaps after years of legal wrangling, they should be directed to treatment for Hoosiers suffering from substance use disorders, children born with Neonatal Abstinence Syndrome and preventative measures, the report recommends.

Ongoing opioid-related lawsuits are contrasted in one section of the report to tobacco settlement cases of the late 1990s.

“There was some discussion during the tobacco settlement days about where the money was going and what it was going to be used for, but when the rubber met the road, states tended to put almost all of the money into general revenue,” said Nicolas Terry, executive director of the William S. and Christine S. Hall Center for Law and Health.

“Maybe 25 to 30 percent [has been used for] health care, broadly defined, but most states are spending in the single digits of 3 to 4 percent on tobacco education or other issues to try to stop youth from smoking,” he said.

Between 1998 and 2017, Indiana received $2.4 billion from the settlement and tobacco taxes, the report notes.

In 2015, Indiana annually spent about 7 percent, or $5.8 million, of the Centers for Disease Control and Prevention’s recommended amount of $73.5 million on tobacco prevention.

“In some of the early lawsuits against opioid manufacturers from the states in the late 2000s, most of the settlement funds haven’t necessarily been used to address things in the opioid crisis, so we are already well on our way down the path of repeating some of those mistakes that we’ve made,” said Aila Hoss, visiting assistant professor and IU Grand Challenge fellow.

The Indiana State Department of Health did not respond to CNHI News Indiana’s request for comment Thursday. The IU study also suggests that policymakers recognize the critical importance of syringe exchange and similar safe-space programs, which can provide Naloxone and treatment options.

“The state’s syringe exchange program remains incoherent with major county- by-county variations,” the report states. “This is despite the clear evidence base for exchanges as recognized by, for example, the Surgeon-General’s Report (of 2016), their proven role in reducing the transmission of HIV/AIDS and overall cost effectiveness.”

Researcher Ross Silverman, professor of health policy and management, said that syringe and safe-space programs need to build trust with their communities. But policymakers, too, should evaluate Indiana law affecting those trying to seek help for addictions.

“The way that Indiana law is structured, when an individual can now be charged with a level 6 felony for possession of drug paraphernalia, sends a very contrary message to getting people to be actively involved in syringe exchange programs,” Silverman said.

The study was funded through a $50 million research initiative on addictions in Indiana, part of IU’s Grand Challenges project. The team consisted of researchers from the IU Robert H. McKinney School of Law and the IU Richard M. Fairbanks School of Public Health at IUPUI.

Among other measures for policymakers to consider, suggested by the report:

• Implement education campaigns not only for providers but the public to explain Naloxone and medication- assisted treatment (MAT). In July, the Indiana Supreme Court plans a program to explain MAT for court employees statewide. 

• Assess the knowledge of those working in the court system related to MAT. For example, some treatment programs use opioids that can affect a person’s blood or urine sample. 

• Evaluate requirements for entry into state drug courts, which vary because of knowledge of MAT and program access differences from community to community. 

• Extend drug overdose immunity laws to protect bystanders, who want to help, and the individual who is overdosing. Currently, Indiana’s immunity provisions do not apply to a person in need of medical assistance. More than 20 federal lawsuits have been filed by Indiana city, town and county governments against Amerisourcebergen Drug Corp., Purdue Pharma and other pharmaceutical firms alleging they misrepresented the risks of FDA-approved opioid medications.

Locally, the city of Terre Haute, Vigo County and the city of Sullivan are among entities filing suit or joining lawsuits. Other Indiana plaintiffs include the cities of Indianapolis, Kokomo and Howard County.

In the Indianapolis lawsuit, the city is asking for compensation to “abate the ongoing public nuisance caused by the opioid epidemic” and a monetary award in order to provide medical care for patients, including treatment for infants born with opioid-related disabilities.

Related Stories:
• HIV cases down, but stigma remains in Scott County
• New opioid treatment center opens its doors in Terre Haute
• New IU study: Opioid epidemic to cost state $4 billion in 2018
• Marion County declares hepatitis C epidemic, proposes syringe exchange
• IU study: In 2016, potential lost wages due to opioid misuse totaled $752 million

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