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Opioid Lawsuit Money: Where Does It All Go?

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2 years ago

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Johnson & Johnson and friends are paying out a lot of money for their misdeeds; even if they refuse to admit to doing anything wrong. In fact, every state in the US has at least one opioid lawsuit; with the question now of, where does all that settlement money actually go?

How much must be paid & by who?

There isn’t a finite answer to this question, as not every case against the major players like Johnson & Johnson has been settled. And we’re only talking about America right now anyway. So far, over 3,000 suits have been filed by different states and local governments over the pills which have caused a major death toll in America, Canada, and beyond.

The biggest payout comes in the form of a $26 billion settlement that was made between 46 US states and Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson. It was brokered in 2021, and dubbed the ‘National Settlement.’ This settlement does not include the four states that didn’t sign on, or anything previously decided or still ongoing. The number also doesn’t include separate lawsuits that have been waged against retailers like Walgreens.

Another of the big settlements has to do with the Native American population of America, a population hit very hard by opioids. This lawsuit was also against the four companies involved in the National Settlement, with a total of $590 million to be paid out to federally recognized tribes. It started as a settlement between AmerisourceBergen, Cardinal Health, and McKesson and just the Cherokee tribe for $75 million. This was then increased to $440 million, with a stipulation that it can be accessed by any federally recognized tribe member.

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For its part, Johnson & Johnson was also included and has two years to pay out $150 million in this particular case. Of that, $18 million is specifically for the Cherokees. To give an idea of the brazen ego of these companies; upon making this settlement, Johnson & Johnson said in a statement that “This settlement is not an admission of any liability or wrongdoing and the company will continue to defend against any litigation that the final agreement does not resolve.” I guess the company just likes paying out big sums of money.

Even more opioid lawsuits

It’ not just the pharma companies and distributors that are set to pay a lot of money. Even retailers got hit with lawsuits. CVS, Walgreens, and Walmart were staring down over 300 lawsuits over opioids, and settled for $13 billion in late 2022.

And what of Purdue specifically? The company that skyrocketed this whole issue with the creation of Oxycontin, and all the lies surrounding the usefulness and addictiveness of this drug? It also is in the process of dealing with the fallout of its blatant disregard for humanity. This company isn’t a corporation, and is privately owned by the Sackler family. The family was made to pay out $6 billion in a 2022 settlement, which goes mostly to local and state governments. And this as a part of a revised bankruptcy settlement, just to give an idea how much these little pills are hurting everyone…including those who made them.

Opioid lawsuit money
Opioid lawsuit money

Even the federal government, which allows the opioids through regulation, is a part of it. The US Justice department made an $8 billion settlement with Purdue, which was reported in October 2022. And who gets this money? It goes to the Treasury Department, which is allocating $1.775 billion for states, tribes, and local governments for the future. And only $225 million for a “public benefit trust” to state and local communities now. It’s thought that once its all told, approximately $50 billion will be paid out from opioid lawsuits altogether on the state and local level.

Opioid lawsuit money: How is it split?

The whole point of these lawsuits is that the drugs hurt (and are still hurting) a lot of people. Now, sure, you can also say the disability damages affect a wider audience, including governments, but the thing to really remember in this, is who the victims are. And that’s primarily people who started opioids for pain issues. When you think about it, these lawsuits have less to do with people who decided to take up the drugs on their own.

So how does the money get to them? Or does it even? States are bringing in millions and billions of dollars from these opioid lawsuits, so where does the money go? This is where things get a bit complicated. And where we have to hope that the created systems, actually use the money appropriately.

The National Academy for State Health Policy is interested in this question, and compiled data to help elucidate the situation by looking at “state legislation, opioid settlement agreements and spending plans, advisory committees, and other entities charged with disbursing state funding”. According to the agency, all the states are setting up regulated structures for money dissemination; some related to the settlements themselves, and some as a part of new policy.

As the biggest payout as of yet, the National Settlement includes both the ability for states to create their own policies, while also defining some aspects of the payment structure. For example, this settlement includes a timeline for payouts, which stipulates 18 months. The money is split due to factors like overall population; how many overdoes deaths the location had, as well as how many active use cases there are now; and how much of the medications made their way into the location.

What about once a state has the money? The settlement agreement goes on to stipulate a standard rate for dissemination past that point, with 15% of the payment going to a State Fund, 70% to an Abatement Accounts Fund, and the last 15% to a Subdivision Fund. Should a state want to change this policy, it can challenge it. While all this applies to the biggest lawsuit, many settlements have similar instructions.

Lawsuits over opioids
Lawsuits over opioids

The ’State Fund’ is money which is “awarded directly to the state, with final spending authority residing with legislative appropriation, attorneys general, the Department of Health, or the state agencies responsible for substance use services.” The Subdivision Fund (Local Share) is money paid “directly to participating political subdivisions, including participating cities and counties.” And the Abatement Fund is to “distribute funding across the state.”

Essentially, each state is tasked with coming up with “unique process and administrative structures for allocating funding across state and local entities, identifying abatement needs, obtaining input from the public and experts, providing guidance on priorities and spending activities, and promoting transparency around the use of funds.” And these processes can be used for any opioid lawsuit money from future or already on-going cases.

Opioid lawsuit money, and how it can be used

With the National Settlement as the example, there are some stipulations as to how the money can be used once a state takes it in. This is where we need to make sure that these avenues lead to something useful; and that they don’t get corrupted. Which means watching over the process from beginning to end.

The main point is that at least 70% of this money must be used for ‘opioid remediation efforts,’ which essentially means policies that target the problem and attempt to solve it. As per the wording of the agreement:

“Care, treatment, and other programs and expenditures (including reimbursement for past such programs or expenditures except where this Agreement restricts the use of funds solely to future Opioid Remediation) designed to (1) address the misuse and abuse of opioid products, (2) treat or mitigate opioid use or related disorders, or (3) mitigate other alleged effects of, including on those injured as a result of, the opioid epidemic.” It’s not, however, more specific than this, leaving the individual locations to figure out what these measures should be.

The money must also be used to set up Opioid Settlement Remediation Advisory Committees. These committees are designed to provide some guidance for the remediation process; they only deal with the 70% allocated to the Abatement Accounts Fund.

Lawsuit money allocation
Lawsuit money allocation

The problem is that such systems have shown to be corruptible time and time again. To combat this (in some form) there is a guideline set up to try to deter unrelated spending. It stipulates a requirement to report all use of the funding money, including unrelated costs like payments to lawyers, investigation costs, court fees, and administrative fees. However, a requirement to report, doesn’t mean the funds won’t still be used for these purposes. If reported unrelated costs are still covered, the simple action of reporting does not mean the funds won’t be misused. We’ll have to keep an eye out.

Moving forward

Will any of this work, or are we simply filling government coffers, to be blown like so much other government money? The way I see it, there are two ways to look at progress. The first is if those who have been hurt, get repaid for their losses. And the second is in how it works to change the current landscape. Considering most new regulation focuses on decriminalizing drugs and setting up safe use sites, instead of looking at alternatives like ketamine; its certainly hard to see a path for positive change. And realistically, so long as the doctor is the dealer, can we actually expect this problem to go away?

It’s best to remember that no state pursuing an opioid lawsuit has barred the sale of opioids in the state; even with lawsuit money rolling in. Not even one made a guideline for making them harder to get. Kind of a contradiction, and one that shouldn’t be ignored if people really expect that governments are working on their behalf.

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Can Psychedelics Treat Addiction and Alcoholism?

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2 months ago

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September 13, 2024

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Psychedelics, once associated primarily with counterculture and recreational drug use, are now being seriously studied for their therapeutic potential in treating drug addiction and alcoholism. Recent research has shown that substances like psilocybin, LSD, and ayahuasca may have profound benefits for individuals struggling with Alcohol Use Disorder (AUD) and substance use disorders (SUD). These compounds are being reconsidered not only for their ability to induce altered states of consciousness but also for their potential to address addictive behaviors and psychological trauma at the root of addiction.

Psilocybin’s Efficacy in Treating Alcohol Use Disorder

One groundbreaking study, conducted at New York University and Johns Hopkins University, demonstrated the potential of psilocybin in treating Alcohol Use Disorder (AUD). The researchers focused on individuals with severe AUD, administering two doses of psilocybin in conjunction with psychotherapy. The results were notable: participants reported a 50% reduction in heavy drinking days over an eight-month period, with some maintaining abstinence from alcohol even a year later.

The trial followed a double-blind, randomized approach and found that the therapeutic effects of psilocybin were superior to those observed with placebo treatments. Dr. Michael Bogenschutz, a lead researcher in the study, emphasized the importance of the psychedelic experience itself in breaking the cycle of addiction. Psilocybin appears to help patients break through entrenched mental patterns, often revealing deeper emotional connections and realizations that drive more meaningful behavior change​.

How Psychedelics Influence the Brain to Combat Addiction

The mechanism behind the efficacy of psychedelics in treating addiction is thought to involve neuroplasticity, or the brain’s ability to reorganize and form new connections. By interacting with serotonin 2A receptors, particularly in the prefrontal cortex and default mode network, psychedelics can enable profound shifts in perception and cognition. These altered states of consciousness allow individuals to confront underlying psychological issues, such as trauma or negative emotional patterns, which are often at the core of addictive behaviors​.

Many individuals undergoing psychedelic-assisted therapy report experiencing a “reset” of their mental state, facilitating a more open mindset that helps them engage with therapy in a deeper, more effective way. This contrasts with traditional addiction treatments, such as methadone or buprenorphine, which primarily manage withdrawal symptoms but do not address the psychological components of addiction.

LSD and Its Potential in Addiction Treatment

LSD (lysergic acid diethylamide) has also shown promise in treating addiction, particularly alcoholism. Early studies from the 1950s to the 1970s suggested that LSD might help reduce alcohol dependency, but interest in this line of research waned due to regulatory crackdowns on psychedelic research. However, more recent studies have reignited interest in LSD’s therapeutic potential.

A meta-analysis published in the Journal of Psychopharmacology reviewed data from six trials involving over 500 patients. It concluded that a single high dose of LSD, administered in a therapeutic setting, was associated with a significant reduction in alcohol consumption. The study found that LSD’s psychedelic effects could lead to lasting changes in personality traits, such as openness and emotional resilience, which are crucial for overcoming addiction​.

Ayahuasca and Addiction Recovery

Ayahuasca, a traditional Amazonian brew containing DMT (dimethyltryptamine) and MAO inhibitors, has been the focus of recent studies examining its potential to treat addiction. Researchers have found that ayahuasca’s intense psychoactive properties, combined with its ability to facilitate introspection and emotional healing, may help individuals overcome opioid and stimulant addiction. A study published in Frontiers in Pharmacology noted that ayahuasca led to significant improvements in mental health and reductions in addictive behaviors​.

Ayahuasca ceremonies, often conducted in a spiritual context, have been shown to promote healing through vivid and sometimes challenging visions. Participants often report gaining insights into the underlying causes of their addiction, leading to long-lasting psychological benefits.

Challenges in Psychedelic-Assisted Therapy

While the results of these studies are promising, the use of psychedelics in treating addiction is not without challenges. For one, the psychedelic experience itself can be unpredictable, and not all patients experience the profound mystical or emotional breakthroughs associated with positive outcomes. The effectiveness of psychedelic-assisted therapy appears to be linked to the quality of the therapeutic environment and the expertise of the facilitators, meaning that careful preparation and integration are key to success.

Moreover, while psychedelics like psilocybin and LSD do not appear to be physically addictive, their use must still be carefully regulated to prevent potential psychological risks, such as hallucinations, anxiety, or psychotic episodes in vulnerable individuals. Current research emphasizes the need for controlled settings where trained therapists can guide patients through their psychedelic experiences.

Ongoing Research and Future Directions

Given the promising early results, psychedelic research is entering a new phase, with larger clinical trials currently underway. The National Institutes of Health (NIH) recently allocated $2.4 million to explore the use of psychedelics in treating methamphetamine addiction, further solidifying the role of psychedelics in addiction therapy​. Similarly, ongoing studies are looking into psilocybin’s potential to treat opioid addiction and cocaine dependence, conditions that have been notoriously difficult to treat with conventional methods.

As research progresses, it is likely that psilocybin, LSD, and other psychedelics will become more widely recognized as effective tools for addiction treatment. While more research is needed to fine-tune these therapies and better understand their long-term effects, early indications are that psychedelics could revolutionize addiction and alcoholism treatments in the coming decades.

Conclusion

Psychedelics like psilocybin, LSD, and ayahuasca are emerging as potential breakthrough therapies for treating drug addiction and alcoholism. By promoting neuroplasticity and addressing the psychological roots of addiction, these substances offer an alternative to traditional addiction treatments, which often focus on managing symptoms rather than curing the disease. With ongoing research and increasing clinical trials, psychedelic-assisted therapy may become an essential tool in the fight against substance use disorders, offering hope to millions of people who struggle with addiction, such as alcoholism.

Sources

Johns Hopkins Medicine: Psychedelics in Addiction Treatment
Progress in Neuro-Psychopharmacology and Biological Psychiatry
National Institutes of Health (NIH) Research on Psychedelics
Frontiers in Pharmacology: Ayahuasca for Addiction Recovery
JAMA Otolaryngology – Head & Neck Surgery



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The Evolving Opioid Crisis in Europe: Heroin and Synthetic Threats

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2 months ago

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September 12, 2024

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The opioid crisis in Europe is growing in complexity, with heroin continuing to dominate the market while synthetic opioids, such as fentanyl and its analogs, emerge as potent new threats. The 2024 EU Drug Markets Report, released by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and Europol, provides a comprehensive analysis of the heroin and synthetic opioid market, detailing the health risks, evolving trafficking routes, and potential future challenges.

Heroin in Decline? Why Synthetic Opioids Pose a New Threat in Europe

Heroin’s Ongoing Impact in Europe

Heroin remains the most commonly used illicit opioid in Europe, with an estimated 1 million high-risk opioid users. The European heroin market is valued at over €5.2 billion annually, indicating the persistent demand for this drug. In 2021, EU countries seized 9.5 tonnes of heroin, the largest quantity in 20 years. These figures underscore the strong presence of heroin in Europe, despite the introduction of harm reduction programs aimed at curbing opioid use​.

The health consequences of heroin use are severe. In 2021, opioids were responsible for three-quarters of Europe’s 6,000 drug-related overdose deaths, with heroin being a leading factor. Long-term users are aging, adding complexity to public health strategies, as older opioid users present with more chronic health problems​.

Afghanistan’s Opium Ban: Future Implications for Heroin Supply

Nearly all heroin consumed in Europe is derived from opium produced in Afghanistan. However, Afghanistan’s opium production has seen a dramatic decline following the Taliban’s 2022 ban on poppy cultivation, which led to a 95% reduction in production by 2023. While the immediate impact on heroin availability in Europe has been minimal, the report warns that a sustained ban could lead to future heroin shortages. Such shortages could open the door for synthetic opioids to dominate the market.

The decline in Afghan opium cultivation from 233,000 hectares in 2022 to just 10,800 hectares in 2023 has raised concerns about the future of heroin availability in Europe. Should the Taliban continue to enforce the ban, experts believe the resulting heroin scarcity could increase the use of more potent and dangerous synthetic opioids, exacerbating the public health crisis​.

The Rise of Synthetic Opioids: Fentanyl and its Analogues

Synthetic opioids, such as fentanyl, are becoming more prevalent in the European drug market. These substances are far more potent than heroin, and even small doses can lead to fatal overdoses. The 2024 report highlights how these synthetic opioids are contributing to a growing number of overdose deaths and hospital emergencies across Europe. In countries such as Estonia and Sweden, fentanyl is responsible for a significant proportion of drug-related deaths​.

Fentanyl analogs are particularly concerning because they can be mixed with other drugs like heroin or cocaine, often without the user’s knowledge. The increasing presence of these synthetic opioids is a major public health concern, as traditional harm reduction measures, such as naloxone distribution and needle exchange programs, are less effective against these more potent substances.

Changing Trafficking Routes and Criminal Networks

Traffickers are increasingly adapting their methods in response to heightened enforcement measures and geopolitical developments. The traditional Balkan route, which brings heroin through Turkey and Bulgaria into Europe, has seen increased enforcement and stricter border controls, prompting traffickers to shift towards alternative routes.

The Southern route is becoming more prominent, with significant heroin shipments passing through Iran and Pakistan before reaching Europe via major seaports. The United Arab Emirates (UAE) has emerged as a key transshipment hub for heroin, providing both logistical support and avenues for money laundering. Meanwhile, the ongoing Russia-Ukraine war has prompted criminal networks to modify their trafficking routes, further complicating law enforcement efforts.

Public Health and Harm Reduction Efforts

Harm reduction strategies have had some success in mitigating the impact of opioid use in Europe. Programs such as opioid substitution therapy (OST) and needle exchange have helped reduce the number of new users injecting heroin, thereby lowering the risks of HIV and hepatitis C transmission. However, the growing prevalence of synthetic opioids poses new challenges. These potent drugs often require stronger overdose prevention measures, such as fentanyl test strips and more widespread access to naloxone, an opioid antagonist used to reverse overdoses.

Additionally, the report notes the importance of expanding data collection and improving early warning systems to monitor emerging trends in opioid use and trafficking. These systems allow public health authorities and law enforcement to respond more quickly to new synthetic opioids entering the market​.

Challenges in Treating Opioid Addiction

Treatment for opioid addiction, particularly heroin, is evolving. Europe’s aging population of opioid users presents new challenges, as older users are more likely to have complex medical conditions. Many long-term users require not just drug treatment but also social support and healthcare for chronic conditions related to long-term substance use. Furthermore, gender-specific issues are emerging, as women who use opioids face more barriers to accessing treatment and are more likely to present with co-occurring psychological or social issues.

Conclusion

The opioid crisis in Europe is evolving, with heroin still posing a significant threat to public health, while synthetic opioids like fentanyl are emerging as an even more dangerous force. The reduction in Afghan opium production and the shifting trafficking routes complicate the landscape further. To tackle this complex issue, Europe must continue to invest in harm reduction, international cooperation, and early warning systems to prevent more overdose deaths and manage the changing face of the opioid market. Without a coordinated response, Europe risks facing an even more devastating public health crisis in the coming years.



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Who Are Eating Dogs and Cats?

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2 months ago

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September 11, 2024

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The fact that some people are eating dogs and cats is a highly sensitive topic that crosses cultural, social, and ethical boundaries. In many regions, these animals are consumed due to cultural traditions and necessity, while in other cases, drug-induced behavior may lead individuals to engage in extreme or unusual dietary practices. This article aims to explore the distinction between cultural norms and the desperate, erratic behaviors driven by substance abuse, focusing on the need for cultural sensitivity while addressing harmful behavior.

When Culture Meets Addiction: Who Is Eating Dogs and Cats?

Cultural Practices and the Consumption of Non-Traditional Animals

In some parts of Asia and Africa, the phenomena of eating dogs and cats has historical roots that are tied to both cultural traditions and the availability of resources. In these regions, the eating of non-traditional animals is a normalized practice and is not connected to drug-fueled behavior.

  • Cultural Normalcy: In regions such as South Korea, China, and Vietnam, dogs have historically been consumed as part of traditional cuisines. This practice is not driven by addiction or desperation but by cultural norms that view these animals as a food source rather than pets.
  • Food Scarcity: In some communities, especially in impoverished or rural areas, consuming non-traditional animals like dogs or cats is a practical response to food scarcity. The decision to eat these animals is based on survival rather than personal preference or altered judgment.

Drug-Induced Dietary Choices: When Addiction Leads to Extreme Behaviors

In contrast to cultural practices, there are cases where individuals under the influence of drugs engage in extreme or bizarre behaviors, such as eating dogs and cats… This behavior is driven by impaired judgment, psychosis, or desperation caused by addiction, and often occurs in isolated or marginalized communities.

  • Methamphetamine and Erratic Behavior: Meth users are known to exhibit extreme and irrational behaviors, including eating animals they wouldn’t normally consider food. Meth-induced psychosis can blur the lines between reality and hallucination, leading to bizarre dietary choices such as consuming pets or strays.
  • Desperation from Heroin Addiction: Heroin addicts, especially those living in extreme poverty, may consume non-traditional animals out of necessity. Chronic malnutrition and impaired judgment, combined with isolation from society, can drive addicts to make choices they wouldn’t otherwise consider.

Understanding the Cultural vs. Drug-Fueled Divide

It’s crucial to differentiate between cultural practices and behaviors driven by addiction when discussing the consumption of non-traditional animals. Respecting cultural practices while addressing the harmful impacts of substance abuse requires a nuanced understanding of these different contexts.

  • Cultural Sensitivity: When discussing the consumption of non-traditional animals, especially in regions where this practice is accepted, it is important to approach the subject with cultural sensitivity. Condemning these practices without understanding their historical and social context can perpetuate stereotypes and breed intolerance.
  • Addressing Addiction-Related Behaviors: Conversely, when the consumption of animals like dogs and cats is tied to addiction, the focus should be on treating the root causes of drug abuse rather than criminalizing individuals. Rehabilitation, mental health support, and access to food resources are critical in preventing desperate behaviors.

Ethical Considerations and Animal Welfare

Regardless of whether the consumption of non-traditional animals is driven by culture or desperation, the ethical treatment of animals is a key concern. The dog and cat meat industries have come under scrutiny for their inhumane treatment of animals, and organizations worldwide are working to promote animal welfare and ethical eating practices.

  • Animal Rights in Cultural Contexts: While respecting cultural traditions, animal rights organizations are increasingly advocating for more humane practices within these industries. Campaigns to ban or reduce the consumption of dog and cat meat have gained traction, with a focus on reducing cruelty and promoting alternative food sources.
  • Animal Cruelty and Drug Addiction: In cases of drug-induced behaviors, the animals involved often suffer from neglect or harm. Providing support for addicts and ensuring animals are removed from harmful environments can help mitigate this issue.
Eating Dogs and Cats Tradition or Desperation
Eating Dogs and Cats Tradition or Desperation

How to Approach the Issue Globally

Addressing the issue of non-traditional animal consumption, whether cultural or drug-fueled, requires a global approach that balances respect for cultural practices with the promotion of humane treatment for animals. Public health initiatives and cultural sensitivity training can help bridge the gap between different viewpoints while ensuring that animals and people alike are treated with dignity.

  • Promoting Cultural Understanding: Efforts to educate the public on the cultural contexts of eating non-traditional animals can help reduce prejudice and promote more respectful global dialogues. Cultural exchange programs and educational campaigns can provide a more nuanced view of these practices.
  • Addressing Substance Abuse: On the other hand, combatting the desperation and irrational behavior caused by addiction requires investments in mental health, addiction treatment, and public welfare systems. Providing addicts with support, housing, and access to food can reduce the likelihood of harmful or extreme behaviors.

Conclusion

While the consumption of non-traditional animals like dogs and cats may be culturally accepted in some regions, drug-induced behaviors that lead to similar actions must be understood in a different light. It’s important to address addiction-related behavior with compassion, focusing on rehabilitation and support rather than punishment. At the same time, promoting animal welfare and humane practices in regions where these animals are consumed can create a more ethical global community. By approaching these issues with respect for cultural diversity and a commitment to reducing harm, both animals and humans can benefit.



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