Q&A: The opioid settlements, explained ...Middle East

Over the next 13 years, Mississippi is expected to receive hundreds of millions of dollars from companies that profited off Mississippians with opioid addiction. Public health workers and families who’ve lost loved ones to overdoses have said all these dollars should be used to prevent more overdose deaths, but they worry that the state’s plan allows spending dollars on other purposes. 

The way this money is being sent to Mississippi and will be spent is complicated, and both could change in the future. But here’s what we know now about the funds and how we expect them to be spent. 

In the 2000s and 2010s, towns, cities, counties, indigenous tribes and states across the country — including Mississippi — filed lawsuits against companies involved in creating, distributing, dispensing and advertising prescription opioid painkillers. They sued the companies for endangering their residents with predatory business practices, and in 2018, thousands of lawsuits started to be combined into a series of larger cases. 

They negotiated settlement agreements with 13 companies — Cencora (formerly AmerisourceBergen), Cardinal Health, Mckesson Corporation, Johnson & Johnson, Walgreens, Walmart, Kroger, CVS, Allergan, Teva Pharmaceuticals, McKinsey, Mallinckrodt and Publicis — in the early 2020s. Purdue Pharmaceuticals is in the process of finalizing a $7.4 billion settlement with states including Mississippi, but its declaration of bankruptcy has delayed its payment for years. 

Mississippi has been receiving a portion of the billions of dollars awarded from these settlements since 2022. The state and its local governments are expected to receive about $374 million through 2038. If Purdue and the states finalize the settlement, Mississippi is expected to receive an additional $41 million dollars over the next 15 years from the bankrupt drug company, according to the Mississippi Attorney General’s office.

The money will be split between the state and Mississippi’s towns, cities and counties. Eighty-five percent of the dollars are controlled at the state level, and 15% goes to the local governments that signed on to the lawsuits.

Originally, Mississippi Attorney General Lynn Fitch designed a plan to send the vast majority of the state’s settlement share to build a new University of Mississippi Medical Center addiction treatment center. She said she did this to satisfy requirements in the settlement that say 70% of states’ shares need to be spent to address the overdose epidemic. The remaining part of the state’s share, now estimated to be $56 million, would go into the general fund. 

But the Legislature controls how state settlement funds get spent, and it erased the plan to direct around $262 million to UMMC. Instead, lawmakers passed a bill this year that instructs an advisory council made up of state agency leaders, local officials, law enforcement and political appointees to develop a grant application process for those dollars. The council will make recommendations of which grants to fund, and the Legislature will approve or deny them. 

The Legislature will control the $56 million set to go to the general fund and set to go to the general fund and spend it without recommendations from the council. The local government plan remains intact.

It’s unclear how the Legislature will decide which advisory council recommendations will be approved. But the Republican supermajority leaders of the two legislative bodies, Speaker of the House Jason White and Lt. Gov. Delbert Hosemann, have lots of sway over how all state dollars get spent. And lawmakers will have even more control of the $56 million that doesn’t have to go through the advisory council.

Hosemann and White have not responded to calls about how they plan to approach spending the state’s opioid settlement share. 

For the $56 million spread across Mississippi’s local governments, county supervisors, mayors and city and town councils determine how their settlement dollars get spent. These funds have been trickling in since October 2022.

The national opioid settlements mandate that at least 70% of their dollars are spent to address the overdose epidemic, according to the Mississippi Attorney General’s office. Many states have agreed to use 100% of their settlement dollars for this, but Mississippi is not one of them.

The $262 million for which the advisory committee will make recommendations must be spent to address and prevent the harms of addiction through these specific strategies. For the remaining $111 million, state and local elected officials can use them the same as other “appropriation of public money,” according to Fitch.

Many parts of Mississippi’s opioid settlement expected distribution are different from other states’ plans. Had Fitch enacted her plan to send 70% of the funds to UMMC, Mississippi would have likely been the only state to use more than half its funds for one project. 

Additionally, Mississippi is one of a minority of states that does not require all its funds to be spent on addressing addiction and has the Legislature playing a decision-making role in how the settlements get spent, according to Vital Strategies and OpioidSettlementTracker.com’s state guides. Of the 20 states that task lawmakers with this responsibility, Mississippi’s representatives and senators are responsible for a larger portion of the settlement than their counterparts in any other state.

Mississippi has also been slow to use the majority of its funds. Its neighbors — including Alabama, Louisiana, Arkansas, Tennessee and Georgia — have all begun distributing the largest portions of their settlements. In contrast, Mississippi has not yet established a process for interested groups to apply for its state share. 

It’s unknown when the state’s portion of the money will be distributed. Department of Mental Health executive director Wendy Bailey, a co-vice chair of the committee, said the first meeting of the opioid advisory council will be held at the Walter Sillers building in Jackson on July 9.

With the passage of its opioid bill this regular session, the Legislature will likely be able to access its unrestricted share as soon as it wants to. And some local governments have already been spending the shares they’ve received. 

In its settlement agreement with counties and municipalities, the Attorney General’s office does not require them to publicly report how they spend their money. So it’s difficult to know how much each locality has received and how the dollars have been used. 

In May, Mississippi Today filed public records requests to see how Hattiesburg, Lamar County and Forrest County have been spending their shares. It came in the wake of Mississippi overdose prevention advocate James Moore saying he had not heard anything about his local governments’ settlement shares.

The records revealed that the three localities had received around $750,000. Hattiesburg and Lamar County had not spent any money, but Lamar County administrator Joseph Waits said his government will use their dollars for a new regional mental health facility. 

Forrest County has spent about $200,000 of its nearly $500,000. The county supervisors sent $100,000 to a local program that tries to divert people with nonviolent drug charges away from jails and prisons, and it’s allocated another $100,000 for the county sheriff’s department. His requests for these funds include a handheld X-ray device, a drug identification machine, pole cameras, a vehicle tracking device and weapons equipment. In June, he said he had purchased the first three items. 

Moore and other local parents who have lost children to addiction were upset when Mississippi Today told them about these developments. Jane Clair Tyner, whose son Asa Henderson died in 2019, said all the funds should be used to improve Mississippi’s public health and should be spent with the input of those most impacted by the overdose crisis.

“The fact that there wasn’t a public call for input on that money is really disgraceful,” she said. “It’s a slap in the face to the people who are still hurting from it, people who experienced devastating loss as a result.”

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