The advertising and marketing pitches are daring and arriving quick: Make investments opioid settlement {dollars} in a lasso-like machine to assist police detain individuals with out Tasers or pepper spray. Pour cash into psychedelics, electrical stimulation units, and different experimental remedies for habit. Fund analysis into new, supposedly abuse-deterrent opioids and splurge on costly, brand-name naloxone.

The cash is coming from an array of firms that made, offered, or distributed prescription painkillers, together with Johnson & Johnson, AmerisourceBergen, and Walgreens. 1000’s of state and native governments sued the businesses for aggressively selling and distributing opioid medicines, fueling an epidemic that progressed to heroin and fentanyl and has killed greater than half 1,000,000 Individuals. The settlement cash, arriving over practically 20 years, is supposed to remediate the results of that company conduct.

However because the {dollars} land in authorities coffers — greater than $4.3 billion as of early November — a swarm of personal, public, nonprofit, and for-profit entities are eyeing the gold rush. Some individuals worry that firms, particularly — with their flashy merchandise, strong advertising and marketing budgets, and starvation for income — will now gobble up the windfall meant to rectify it.

“They see a money cow,” stated JK Costello, director of behavioral well being consulting for the Steadman Group, a agency that’s being paid to assist native governments administer the settlements in Colorado, Kansas, Oregon, and Virginia. “Everyone seems to be .”

Costello receives a number of emails every week from companies and nonprofits looking for steering on find out how to apply for the funds. To maintain up with the inflow, he has developed an ordinary response: Thanks, however we will not reply to particular person requests, so here is a hyperlink to your locality’s web site, public assembly schedule, or software portal.

KFF Well being Information obtained electronic mail data in eight states that present well being departments, sheriffs’ workplaces, and councils overseeing settlement funds are receiving the same deluge of messages. Within the emails, advertising and marketing specialists provide cellphone calls, informational displays, and conferences with their firms.

Alabama Lawyer Normal Steve Marshall just lately despatched a letter reminding native officers to vet organizations that attain out. “I’m certain that a lot of you’ve got already been approached by a wide range of distributors looking for funding for opioid initiatives,” he wrote. “Please proceed with warning.”

After all, not all advertising and marketing efforts ought to immediate concern. Emails and calls are a technique individuals in energy study progressive services. The nation’s habit disaster is simply too massive for the general public sector to tame alone, and lots of stakeholders agree that partnering with trade is essential. In spite of everything, pharmaceutical firms manufacture medicines to deal with opioid habit. Companies run remedy services and telehealth companies.

“It is unrealistic and even dangerous to say we do not need any cash going to any non-public firms,” stated Kristen Pendergrass, vice chairman of state coverage at Shatterproof, a nationwide nonprofit targeted on habit.

The important thing, agree public well being and coverage consultants, is to critically consider services or products to see if they’re mandatory, evidence-based, and sustainable — as an alternative of flocking to firms with one of the best advertising and marketing.

In any other case, “you find yourself with a number of shiny objects,” Costello stated.

And, finally, failure to do due diligence might go away some jurisdictions holding an empty bag.

Take North Carolina. In 2022, state lawmakers allotted $1.85 million of settlement funds for a pilot mission utilizing the primary FDA-approved app for opioid use dysfunction, developed by Pear Therapeutics. There have been excessive hopes the app would assist individuals keep in remedy longer.

However lower than a 12 months later, Pear Therapeutics filed for chapter.

The state hadn’t paid the corporate but, so the cash isn’t misplaced, based on the North Carolina Division of Well being and Human Companies. However the division and lawmakers haven’t determined what to do with these {dollars} subsequent.

$1 million for drug disposal pouches

Jason Sundby, CEO of Verde Environmental Applied sciences, stated the Deterra pouches his firm sells are a low-cost method to stop costly addictions.

Clients place their unused medicines in a Deterra pouch and add water, deactivating the medicine earlier than tossing them, guaranteeing they can’t be used even when fished out of the trash. A medium Deterra pouch prices $3.89 and holds 45 tablets.

The aim is to “get these medicine out of individuals’s houses earlier than they are often misused, diverted, and other people begin down the trail of needing remedy or naloxone or emergency room visits,” Sundby stated.

Sundby’s firm ran an advert about spending settlement {dollars} on its product in a Nationwide Affiliation of Counties publication and featured related info on-line.

It might be paying off, as Deterra is about to obtain $1 million in settlement funds from the well being division in Delaware County, Pennsylvania, and $12,000 from the sheriff’s workplace in Henry County, Iowa. The corporate additionally has partnerships with St. Croix and Milwaukee counties in Wisconsin, and is engaged on a deal in Connecticut.

A number of different firms with related merchandise have additionally used their product websites to induce jurisdictions to contemplate the settlements as a funding stream — they usually’re seeing early success.

DisposeRx makes a drug deactivation product — its model prices a couple of greenback every — and acquired $144,000 in South Carolina for mailing 134,000 disposal packets to a program that educated highschool soccer gamers, coaches, and fogeys about habit.

SafeRx makes $3 capsule bottles with a locking code to retailer medicines and was awarded $189,000 by South Carolina’s opioid settlement council to work with the Greenville County Sheriff’s Workplace and native prevention teams. It additionally gained smaller awards from Weld and Custer counties in Colorado.

Not one of the firms stated they’re depending on opioid settlements to maintain their enterprise long-term. However the funds present a short lived enhance. In a 2022 presentation to potential buyers, SafeRx referred to as the opioid settlements a “progress catalyst.”

Critics of such investments say the merchandise should not worthwhile. Right this moment’s disaster of deadly overdoses is essentially pushed by illicit fentanyl. Even when research recommend the businesses’ merchandise make individuals extra more likely to safely retailer and dispose of medicines, that is unlikely to stem the file ranges of deaths seen in recent times.

“The believable mechanism by which they’d even be capable to cut back overdose is a thriller as a result of prescription medicines should not driving overdose,” stated Tricia Christensen, coverage director with the nonprofit Group Schooling Group, which is monitoring settlement spending throughout Appalachia.

Secure storage and disposal might be completed with a locking cupboard and bathroom, she stated. The FDA lists opioids on its flush listing for disposal and says there isn’t a proof that low ranges of the medicines that find yourself in rivers hurt human well being.

However Milton Cohen, CEO of SafeRx’s dad or mum firm, Caring Closures Worldwide, stated holding prescription medicines safe addresses the basis of the epidemic. Fentanyl kills, however usually the place individuals begin, “the place water is coming into the boat nonetheless, is the drugs cupboard,” he stated. “We are able to bail all we would like, however the precise factor to do is to plug the outlet first.”

Merchandise to safe and dispose of medication additionally present a possibility for training and destigmatization, stated Melissa Lyon, director of the Delaware County Well being Division in Pennsylvania. The county shall be mailing Deterra pouches and postcards about stopping habit to three-quarters of its residents.

“The Deterra pouch is to me a direct correlation” to the overprescribing that got here from pharmaceutical firms’ aggressive advertising and marketing, she added. Because the settlement cash is to compensate for that, “it is a good use of the funds.”

Instruments for legislation enforcement that superheroes would envy

Different companies making pitches for settlement funds have a much less clear relationship to opioids.

Wrap Applied sciences creates instruments for legislation enforcement to scale back deadly makes use of of power. Its chief product, the BolaWrap, shoots a 7½-foot Kevlar tether greater than a dozen ft by way of the air till it wraps round an individual’s limbs or torso — virtually like Surprise Girl’s Lasso of Reality.

Terry Nichols, director of enterprise improvement for the corporate, stated the BolaWrap can be utilized as an alternative choice to Tasers or pepper spray when officers have to detain somebody experiencing a psychological well being disaster or committing crimes associated to their habit, like housebreaking.

“If you wish to be extra humane in the best way you deal with individuals in substance use dysfunction and disaster, that is an possibility,” he stated.

The corporate posts physique digicam footage of officers utilizing BolaWrap on YouTube and says that out of 192 subject reviews of its use, about 75% of conditions had been resolved with out extra use of power.

When officers de-escalate conditions, individuals are much less more likely to find yourself in jail, Nichols stated. And diverting individuals from the prison justice system is among the many steered investments in opioid settlement agreements.

That argument satisfied town of Brownwood, Texas, the place Nichols was police chief till 2019. It has spent about $15,000 of opioid settlement funds to purchase 9 BolaWrap units.

“Our aim is to keep away from utilizing power when a citizen is in want,” stated James Fuller, assistant police chief in Brownwood. “If we will take somebody to get assist, the very last thing we wish to do is poke holes in them with a Taser.”

After Brownwood’s buy, Wrap Applied sciences issued a press launch wherein CEO Kevin Mullins inspired extra legislation enforcement businesses to “take the chance afforded by the opioid settlement funds to empower their officers.” The corporate has additionally despatched a two-page doc to police departments explaining how settlement funds can be utilized to purchase BolaWraps.

Language from that doc appeared practically word-for-word in a briefing sheet given to Brownwood Metropolis Council earlier than the BolaWrap buy. The council voted unanimously in favor.

However the course of hasn’t been as easy elsewhere. In Hawthorne, California, the police division deliberate to purchase 80 BolaWrap units utilizing opioid settlement funds. It paid its first installment of about $25,000 in June. Nonetheless, it was later knowledgeable by the state Division of Well being Care Companies that the BolaWrap shouldn’t be an allowable use of those {dollars}.

“Bola Wraps is not going to be bought with the Settlement Funds sooner or later,” Hawthorne Metropolis Clerk Dayna Williams-Hunter wrote in an electronic mail.

Carolyn Williams, a member of the advocacy group Vocal-TX, stated she would not see how the units will deal with the overdose disaster in Texas or elsewhere.

Her son Haison Akiem Williams handled psychological well being and habit points for years. With out insurance coverage, he could not afford rehab. When he sought case administration companies, there was a three-month wait, she stated. Police charged him with misdemeanors however by no means related him to care, she stated.

In February, he died of an overdose at age 47. His mom misses how he used to make her chuckle by calling her “Ms. Carol.”

She desires settlement funds to assist companies she thinks might have stored him alive: psychological well being remedy, case administration, and housing. BolaWrap would not make that listing.

“It is heartbreaking to see what the federal government is doing with this cash,” she stated. “Placing it in locations they actually don’t want it.”