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News & Observer: Opioid settlement will bring nearly $20 million to NC. How should it be spent?

BY WILL DORAN
FEBRUARY 04, 2021 10:20 AM
UPDATED FEBRUARY 04, 2021 02:33 PM

RALEIGH

Corporate consultants who worked with the makers of OxyContin — and other painkillers that have fueled the opioid epidemic — have agreed to pay North Carolina nearly $20 million to avoid a lawsuit over their work.

That’s part of a nationwide $573 million settlement that the consulting firm McKinsey & Co. reached with 47 states, five U.S. territories and the District of Columbia. Thursday morning, N.C. Attorney General Josh Stein held a press conference announcing what it will mean for North Carolina.

“We are holding accountable the corporations that created and profited from the opioid epidemic,” Stein said, adding that he is still pursuing separate lawsuits on behalf of North Carolina against the maker of OxyContin, Purdue Pharma, as well as the wealthy Sackler family that owns the company.

Stein said the money from Thursday’s settlement will be able to be spent on many different pieces of the state’s response to the opioid epidemic, from the legal system to treatment centers, local paramedics and more. And while pills have largely been a rural issue, he said, heroin and fentanyl have seen more prevalence in urban areas. So the money is needed everywhere.

“The sad truth is there are many, many, many counties in North Carolina that have had devastating impacts from this crisis,” Stein said, adding that he wants “to make sure those funds get distributed across the state.”

KICKBACKS FOR PILLS AND OVERDOSES?
A New York Times investigation published in November revealed that McKinsey consultants told Purdue Pharma to “turbocharge” OxyContin sales, despite addiction concerns, and even suggested that Purdue consider paying pharmacies for each customer who overdosed on OxyContin.

Purdue recently pleaded guilty to crimes for paying illegal kickbacks to doctors to write more prescriptions. The New York Times reported that large pharmacies like CVS denied ever receiving payments for overdoses.

The legal settlement with McKinsey on Thursday allowed the company not to admit any wrongdoing, NPR reported.

More than 16,000 people in North Carolina have died from an opioid overdose since 1999, when the epidemic is considered to have begun. A large percentage of those deaths have been in recent years, even though the availability of painkillers has decreased under growing scrutiny.

In 2015 more than 2.2 million North Carolinians — nearly one in every four people — had an opioid prescription, according to state government data. In 2017 the General Assembly unanimously passed a new law called the STOP Act to more strictly regulate doctors and painkillers. By late 2020 the number of North Carolinians being prescribed painkillers had been cut nearly in half, to 1.3 million.

But deaths continued climbing, as people replaced pills with other opioids like heroin or fentanyl.

Just over 1,000 North Carolinians died of an opioid overdose in 2015, but that rose to more than 1,800 deaths in 2019, or around five overdose deaths per day.

HOW TO SPEND THE MONEY?
Stein, a Democrat, made the settlement announcement Thursday along with California Attorney General Xavier Becerra, who Democratic President Joe Biden has nominated to lead the U.S. Department of Health and Human Services. He hinted that more such announcements might be coming soon.

“It’s a big deal,” Becerra said. “But on top of that, it’s not the last deal.”

Stein said that of the more than $19 million promised to North Carolina in the settlement, McKinsey must pay $15 million within the next 60 days. The rest will be paid out over the next few years, Stein said.

That first and largest payment comes at a time when the state legislature is beginning to work on the first big budget bill since COVID-19 and the ensuing economic downturn.

Republicans and Democrats have recently gone to court over who gets to decide how to spend the money won by the AG’s office in two other multimillion-dollar settlements, one with Smithfield Foods and one with Volkswagen. It has been contentious since Republicans control the legislature and Democrats hold the attorney general’s and governor’s offices. But a spokesperson for N.C. House Speaker Tim Moore, Joseph Kyzer, said that in this case they’re already working with Stein.

“The state legislature will appropriate these funds to continue its commitment to opioid abatement under the terms of the settlement, and our office is already working directly with the Attorney General in that effort,” he wrote in an email.

Stein said the settlement requires the money to be spent on issues related to the opioid epidemic, but that there’s a wide range of options. As just a few examples, he and Beccera said the money could hypothetically be spent on specialty drug courts, addiction programs in jails, needle exchanges, local government budgets to help fund paramedics, or helping treatment centers stay afloat.

“It would be absolutely devastating if the few programs that exist in North Carolina to treat people with opioid addiction were to close,” Stein said.

He said the epidemic had actually been getting better; The News & Observer previously reported that in 2018, overdose deaths decreased for the first time in years.

But then the COVID-19 pandemic hit, Stein said, and drug use skyrocketed as people dealt with isolation and despair.

“We had achieved real progress in recent years to reduce the overdose death rate,” he said, but unfortunately 2020 saw North Carolina experience “a rise in addiction greater than ever.”

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