Payments from a massive class action lawsuit awarded to towns and counties hit by the opioid epidemic will be no more than a few thousand dollars a year.
But the state will reap hundreds of millions from the Opioid Multidistrict Litigation, which was settled in July. According to the settlement, the nation’s three largest drug distributors, Cardinal Health, McKesson, and AmerisourceBergen, and the manufacturer Johnson & Johnson must pay states $26 billion over the next 18 years.
Every Massachusetts town and county is eligible to receive a small portion of the settlement as compensation for coping with an epidemic of addiction and overdoses resulting from the pharmaceutical industry’s profiteering and false marketing of addictive opioid-based painkillers like OxyContin and Percocet.
Towns and counties must respond by Jan. 2 if they want to receive the funds, according to Vaira Harik, Barnstable County’s assistant administrator. The towns’ and counties’ share is 15 percent of the total allotted to the state.
On Dec. 8, the Barnstable County Commission agreed to accept the county’s portion of the $537 million awarded to Massachusetts. The county’s share is $51,630 over 18 years, or $2,868 per year.
Provincetown, Truro, Wellfleet, and Eastham also have opted in. The money is apportioned to towns according to a complex formula. The amounts are based on records of the distribution or shipment of opioid pills into the communities from 2006 to 2016, Harik said.
Barnstable, the largest town on the Cape, is due $692,163, the most for any Cape community. Provincetown will receive $72,604, or $4,034 per year. Eastham will receive $63,731, or $3,541 per year. Wellfleet will receive $54,050, or $3,003 per year. And Truro will receive $48,403, or $2,689 per year.
Aside from the incalculable loss of life, the costs incurred by the towns include hiring extra firefighters and ambulance runs.
Eastham Fire Chief Dan Keane said the number of opioid-related ambulance calls is not overwhelming, but is nonetheless part of his daily routine.
“We’re numb to it,” he said. “It’s almost a constant.”
Provincetown had 12 overdose calls in 2020; Eastham had eight; and Truro and Wellfleet firefighters responded to fewer than four calls, according to the Dept. of Public Health. There was one resulting death in Provincetown and two in Eastham in 2020.
Another 15 percent of the overall multidistrict settlement fund goes to the state government, and the remaining 70 percent will go into an Opioid Recovery and Remediation Fund. Mary Lou Sudders, secretary of the state Executive Office of Health and Human Services, will decide the uses of the $375 million going to the remediation fund. She also chairs the fund’s advisory council, a group of addiction experts and advocates, which will make recommendations on the best use of the money.
As of this year, the Massachusetts opioid remediation fund had about $12 million to spend. That’s mostly from the settlement of an earlier lawsuit against McKinsey & Company, the white-glove management consulting and marketing firm hired by Purdue Pharma to sell OxyContin, according to WBUR.
The money from the national opioid multidistrict lawsuit settlement has not come in yet. And Massachusetts also awaits the conclusion of a court battle with Purdue Pharma.
So far, the advisory council has recommended that the existing $12 million be divided into four categories: expanding “harm reduction,” that is, giving out safety supplies like clean needles to active drugs users; increasing access to methadone; providing more supportive housing programs; and boosting community outreach and engagement.
But some fear that when the grants are awarded to specific programs, they will end up in the hands of the same institutions that have provided lackluster and expensive treatment.
Eastham resident Susan Kinnane, whose son Daniel Vigliano died last year at the Brockton MBTA station at 35 years old, said safe housing and effective treatment is where that money ought to go.
“If I had to break it down in one sentence, I would say, ‘Where’s the proper treatment?’ ” Kinnane said.
As it is now, if you can even get a bed in a treatment center, “The first question they ask is what kind of insurance do you have,” she said. “It’s a revolving door. But if you can get it right the first or second time, people aren’t coming in over and over and over again.”
Vigliano was bipolar, his mother said. His journey included eight months in jail and so many treatment centers that Kinnane lost count.
Vigliano’s treatments were a mixed bag. Some institutions had kind, caring staff, Kinnane said. Others, she said, were “dope ’em and dump ’em.” That is, they provided some medication, then dumped patients back onto the streets.
Vigliano, who grew up in Sandwich, was quick-witted and energetic. To channel that energy, Kinnane got him involved in sports, from mountain biking to lacrosse, basketball, swimming, and skiing. He wrote songs and played the guitar. He had many high-paying jobs, but his successes were “cyclical,” due to his mental illness. His opioid use began in his early 20s. He needed help, and nothing worked.
In the last year of his life, Kinnane did not allow him to come home, a decision she feels deeply guilty about now. If safe and supportive housing had been available, she believes he would be alive today.
“If you think of Maslow’s hierarchy of needs, the first thing people need is food and shelter — and not a homeless shelter,” Kinnane said.
Maureen Cavanagh of North Reading is a member of the advisory council and the founder of Magnolia New Beginnings, an online support group for family members of people with addictive disorders. It has 25,000 online members.
“I represent patients and families,” Cavanagh said. “My hope is that the fund goes directly to the patients. I am not a political person. And I’m not embedded in government or the health-care system, so I am sure that there are things that I don’t understand.”
Cavanagh said she is advocating for housing for people not yet sober, a model called Housing First.
“You cannot make good decisions or plan your future if you don’t have some place safe to live,” she said.
Sudders sincerely wants the money to go to the best uses, Cavanagh said.
But so much of the treatment system, which has been underfunded for decades, needs major overhaul. It is tempting to tear it all down and just start over, she said.
“There is so much — to be honest, I don’t know where to start,” Cavanagh said.
Staff reporter Jasmine Lu contributed to this article.