MONTGOMERY, Ala. – Four Alabama state agencies, along with one private company, gave presentations Thursday in a bid for a piece of more than $270 million in opioid settlement money that the state is set to receive in the coming years.
The presentations, which included explanations as to how each state agency or company would best put the funds to use to combat the opioid epidemic, were given to the newly formed Opioid Settlement Oversight Committee. The 16-member body was established to make recommendations to the state Legislature on how to allocate the settlement money.
“We are very excited about this because we have the possibility of making a huge difference in the lives of the citizens of Alabama,” said committee member Kim Boswell, commissioner for the Alabama Department of Mental Health. “Obviously, opioid overdose and addiction is a huge issue, and part of our mission is to make sure we address that in our state.”
Nearly 200,000 Americans have died from drug overdoses in 2020 and 2021, 70% of them from opioids. As lawmakers have begun to lay culpability on drug makers in recent years for their role in the opioid epidemic, states have been receiving tens of billions of dollars in settlement funds.
Alabama, which is set to receive $249 million by the end of 2023 in settlement money, has been hit particularly hard by the opioid epidemic, which in 2015 had more opioid prescriptions than people. Emergency room visits for opioid overdoses have also been on the rise in the state, increasing by 76% from 2018 to 2022, from 2,483 to 4,375.
Of the more than $270 million in opioid settlement money the state has or is set to receive, $10 million has already been allocated; $1.5 million to the Alabama Department of Corrections and $8.5 million to ADMH, the latter of which will be awarded to companies in the private sector for services via grants.
The grants will target programs that address opioid abuse prevention and treatment for youth and underserved populations, groups that include veterans, those in foster care and rural areas, Boswell said.
With its existing budget, ADMH has served more than 9,000 Alabamians in medication-assisted treatment, more than 12,000 through its opioid use disorder treatment services and distributed nearly 14,000 kits of Narcan across the state.
The ADOC, as explained by Deborah Crook, deputy commissioner of health services, will use the $1.5 million – and any future allocations – toward expanding its existing drug use disorder treatment pilot program. With 81 inmates already treated through the program, Crook said that more funding would allow that number to grow substantially.
“Initially, in this first year, we’d like to put 500 (through the program),” Crook said.
“Over the course of the years, we would like to see us go from 500 in 2024 to 1,000 in 2025, so we want to continue to increase. Now, we’re not going to limit ourselves, certainly if we had the funding available we will expand that as much as possible, but in doing so, we also have to have individuals to monitor that program.”
Another state agency vying for opioid settlement money was the Alabama Bureau of Pardons and Paroles, whose director, Cam Ward, said the agency already supervises nearly 13,000 active offenders with drug-related charges. The ABPP also performed 31,624 drug screens in 2023, 12,307 of which saw the offender test positive.
As far as the ABPP’s ability to help combat the opioid epidemic, the agency currently operates 11 day reporting centers, as well as a residential transition center, all of which provide drug abuse disorder treatment ranging from cognitive behavioral therapy to workforce development.
Aside from saving lives, Ward also suggested that recidivism could be drastically cut were the settlement funds successful in curbing the opioid epidemic.
“When it comes to recidivism rates, at the end of the day, if you want to know the highest recidivism rates, it’s one particular crime: property,” Ward said.
“It’s not the murderers, it’s not the rapists, your biggest problem is property crimes, and nine times out of ten, I can trace (it back to) a substance issue, there’s somehow drugs involved. If you undercut the drug addiction, you undercut that willingness to commit a property crime.”
Nancy Bishop, assistant state pharmacy director for the Alabama Department of Public Health, suggested that were her agency to receive increased funding, they would expand their education and peer support programs, among other things.
While opioid-related deaths have continued to climb in Alabama, rising by roughly 150% from 2018 to 2021, Bishop said that both the number of opioid prescriptions and quantity of opioid prescriptions have been on a steady decline.
In 2018, just over 6 million opioid prescriptions were made in the state; in 2022, that number fell below 5 million, a 20% decrease. Those falling numbers, Bishop said, were due in large part to education initiatives.
“A lot of education has been done and is continuing to be done for prescribers and dispensers for pharmacists to talk to patients,” Bishop said.
“I know the Board of Medical Examiners has got their mitigation rules, so they’re required to talk to the patients about how mixing drugs can be (dangerous). One of the reasons you’re seeing the decline in prescriptions is because of all the education that’s been done, but we can’t let up on that.”
The only private company presenting during the meeting, Unite Us, as described by Unite Us Sales Executive Payton Shephard, is a “cross-sector care coordination platform that works to improve the outcomes of individuals with substance abuse disorder.”
“Unite Us is a company with a mission, to break down barriers for individuals to get the short-term help they need as quickly and efficiently as possible,” Shepherd said.
“We provide technology that fosters a long-term recovery and treatment journey for individuals. Our infrastructure connects clinicians, physicians, case managers and human service providers.”
Funding allocation recommendations from the committee are expected sometime before the next legislative session, which kicks off on Feb. 6, 2024. The next meeting of the Opioid Settlement Oversight Committee is Nov. 16.