The Dalles to receive funds from opioid settlement

More funding for substance abuse treatment is coming to The Dalles and other eligible Oregon jurisdictions who opt in to a nationwide opioid settlement with Kroger. In a regular meeting on July 8, The Dalles City Council approved joining the settlement, which will earmark a yet unknown amount of funds for the use of drug addiction treatment and rehabilitation.

The city has previously participated in three other similar settlements, one with McKesson Corporation, Cardinal Health, Inc., and AmerisourceBergen Corporation, a second with Johnson & Johnson, Janssen Pharmaceuticals, Inc., Ortho-McNeil-Janssen Pharmaceuticals, Inc., and Janssen Pharmaceutica, Inc., and a third with Walmart, Walgreens, CVS, Allergan, and Teva.

In 2020, The Dalles and Wasco County officials created an Overdose Prevention Task Force to oversee the use of an estimated $1,068,344 that Wasco County and the City of The Dalles jointly expect to receive over the next 14 years.

On July 15, the application period closed for an Overdose Prevention grant distributed by this task force, with $485,000 available over four years. “In this case, Kroger agreed to pay about $1.2 billion to the states and municipalities. They also agreed to some injunctions governing some opioid marketing, sale and distribution and some of their dispensing practices and effectively releasing them from future claims on this issue,” said City Attorney Jonathan Kara.

According to the Oregon Department of Justice, Oregon jurisdictions will receive up to $40 million of the total settlement funds.

In 2022, Oregon lawmakers created an Opioid Settlement Prevention, Treatment and Recovery Board to administer the 45% of this settlement money to collect, analyze and publish data about substance use prevention, treatment and recovery services. The other 55% of this money goes directly to Oregon cities and counties, such as the amount to be earmarked for The Dalles.

“Opioid manufacturers, distributors, dispensers and consultants all had a hand in creating the opioid crisis, and they have a responsibility to pay for the devastating results of their reckless behavior,” said Oregon Attorney General Ellen Rosenblum. Rosenblum’s team led negotiations with the grocery giant.

Kara said the total dollars the city can expect to receive in the Kroger settlement will depend on how many Oregon cities, counties and other jurisdictions opt in to the settlement before the Aug. 12 due date.

“If a city doesn’t opt in, it cannot directly share in those opioid funds,” he explained.

In the previous three settlements, The Dalles was earmarked $340,000.

According to City Finance Director Angie Wilson, The Dalles has spent $4,250 of previous opioid settlement dollars on a one time, 50/50 split with Wasco County to purchase a $8,500 fentanyl testing machine. In addition to the machine, Notice of Funding from the Overdose Task Force also mentions a certification for yoga in recovery instructor, bringing the total spent to $11,234.67.

Wilson explained the money has been growing as the task force has determined a use that aligns with the settlement’s terms.

“It’s kind of like the COVID money at the beginning,” she said. “There’s all these parameters and things that you can’t do with it. So it’s still very new.” Uses for the settlement funds are listed in the final agreement, which contains both a broad overview of substance abuse remediation programs and strategies and a list of core strategies.

The agreement gives priority to the following core strategies:

Naloxone or other FDA-approved drugs to reverse opioid overdose, including expanded first responder training and increased distribution to those who don’t have this service covered by insurance.

Medication-assisted treatment distribution and other opioid-related treatment, which includes inpatient and outpatient treatment services and therapy, community education about medication-assisted treatment, school-based and youth-focused programs aimed at preventing misuse, and increased distribution to those who don’t have this service covered by insurance.

Pregnant and postpartum women, including expanded screening, brief intervention and referral to treatment and expanding treatment and wraparound services including housing, transportation, job placement/training and childcare.

Expanding treatment for newborn babies impacted by substance abuse, including recovery support and expanding services for long-term treatment and monitoring.

Expanding “warm hand off” programs and recovery services, in which healthcare providers include the patient in their conversation about the patient’s health status and treatment plan. This allows the patient to clarify information and increases patient understanding and buy-in.

Treatment for incarcerated populations including medically-assisted treatment and increasing funding for jails to provide treatment for inmates.

Prevention programs including funding for media campaigns to prevent substance abuse, programs in schools, medical provider outreach for best prescribing practices, community drug disposal programs, training for first responders for overdose response, pre-arrest diversion programs and connecting at-risk individuals to services.

Expanding syringe service programs which collect used needles, provide sterile syringes and connect individuals with wrap-around substance use disorder treatment programs and treatment of infectious diseases.

Data collection and research which analyze the effectiveness of the abatement strategies within the state.

Debby Jones of YouthThink and chair of the Overdose Prevention Task Force told Columbia Gorge News that five organizations have applied for funds out of the $485,000 Overdose Prevention Grant, including YouthThink. As the director of YouthThink, Jones has recused herself from the grant adjudication process.

Jones said the task force is prioritizing funding organizations that prevent opioid use, reduce harm for individuals using opioids, treat opioid use disorder, and provide long-term recovery services.

“That’s the only way to really try and attack this epidemic,” she said, “whether today it’s fentanyl and tomorrow gonna be something else we need to get the infrastructure in place.”

Currently, the task force is screening the applications and creating a review committee to create a matrix for scoring the applications before they are sent back to the task force for final review.

Members of the Overdose Prevention Task Force include Debby Jones of YouthThink representing Primary Prevention; Jason Whitley of Adventist Health representing Columbia Gorge Medical; Lupita Castillo of Eastern Oregon Independent Living representing Harm Reduction; Neita Cecil of North Central Public Health representing Public Health; Scott Williams of Wasco County Sheriff’s Department representing law enforcement; Jamie Carrico of City of The Dalles Police representing law enforcement; Victor Veloz representing Lived Experience; Fritz Bachman of Wasco County Community Corrections representing parole/probation; Gaby Swisher of Pacific Source representing CCO; Rebecca Garrett of One Community Health representing Medical; and Nicole Beaman of Wasco County Youth Services representing Juvenile Detention.

When speaking about the epidemic of substance use disorder, Jones emphasized upstream prevention and addressing behavioral and mental health crises in youth.

Over the past two decades, overdoses among children have increased, the Overdose Task Force reported. Half of those experiencing a substance use disorder today began using before the age of 14. “We never ask somebody who comes in for a cancer screening, ‘It’s at stage one, come and talk to us when you’re at stage four,’ but we treat behavioral health issues that way,” Jones said.

More information about the Overdose Task Force and the Overdose Prevention Grant can be found on the Wasco County public notices page.

Why Kroger?

Kara explained the courts found Kroger to be liable for the opioid epidemic because the pharmacies were “effectively looking the other way or otherwise not investigating the over-prescription of opioid-containing drugs by physicians.” When Councillor Tim McLoughlin asked for more explanation about the specifics of Kroger’s alleged wrongdoing, Kara outlined an example situation.

“Somebody comes in on a Monday and fills out a prescription for 20 oxycontin pills produced by Purdue Pharma, and then they come in on Tuesday with a prescription from a different doctor for another 20 pills,” he illustrated. “... Instead of flagging that for the authorities, these pharmacies apparently decided that if they don’t fill this prescription, one of their competitors will, and so they might as well take the money and fill prescription; ‘Hey, a doctor wrote this, who are we to second guess a doctor?’”

Kara said the argument for Kroger’s liability didn’t seem creative or legally strong to him. “But nonetheless, one after the other, these pharmaceutical companies have looked into their crystal ball of legal finances and determined that it’s much cheaper to settle this case for $1.2 billion than to end up paying 10 times that when they lose,” he said.