Colorado experts recommend opioid settlements mostly go towards treatment and recovery

A newly released survey offers a potential roadmap for money from lawsuits against drug manufacturers.

County Commisioners John Kefalas (right) and Hilary Cooper, and substance abuse expert Rob Valuck (left), prepare to speak about divvying up opioid settlement dollars at the Hilton Denver Inverness Hotel on Dec. 5, 2019.
Larimer County Commissioner John Kefalas (right). San Miguel County Commissioner Hilary Cooper, and substance abuse expert Rob Valuck (left), prepare to speak about divvying up opioid settlement dollars at the Hilton Denver Inverness Hotel on Dec. 5, 2019.

Colorado should spend most of whatever settlement money it receives from prescription drugmakers in the opioid crisis on treatment and recovery services, two dozen experts told the Colorado Health Institute.

In response to a survey, experts in public health, intervention and recovery, local and state government officials and law enforcement said at least 40% of any settlement money should go toward treatment and recovery; 20% to prevention, such as funding a more robust prescription drug-monitoring program; about 20% to criminal justice, including jail-based addiction treatment and law enforcement; and most of the rest to harm-reduction strategies like needle exchanges and family support services. 

The findings were presented Thursday at a panel discussion with experts and county commissioners at CHI’s Hot Issues in Health Conference at the Hilton Denver Inverness. 

According to the Colorado Department of Public Health and Environment statistics compiled by CHI, close to 5,900 Coloradans died from opioid overdoses between 2000 and 2018 in an opioid crisis that has birthed litigation nationwide. 

One lawsuit, filed by former Colorado Attorney General Cynthia Coffman in September 2018 targets Purdue Pharmaceuticals, and accuses the drug giant of deceptively marketing opioids despite knowing the risks to the public. Current Attorney General Phil Weiser expanded the lawsuit in July to include former executives and members of the Sackler family, which owns the company. Nearly every state has filed suit against Purdue, with a federal judge putting nearly 2,700 more lawsuits on hold in November, as the company settles in bankruptcy court in New York, the Associated Press reported. 

Another set of more than 2,000 lawsuits have been filed collectively against drug manufacturers, pharmacies and distributors by counties, municipalities and Attorneys General — including Colorado’s — across the nation. 

No one knows how large Colorado’s settlements might be. In a similar suit against Purdue, Oklahoma won $270 million earlier this year. CHI’s used a hypothetical settlement of $100 million for the experts to divvy up. 

The University of Colorado’s Colorado Consortium for Prescription Drug Abuse Prevention, also known as the Consortium, asked CHI to survey experts on how exactly to spend any dollars awarded as damages against prescription drug companies. With those responses, CHI created a “blueprint,” recommending funding areas and percentages.  

CHI also was part of drafting a statewide five-year plan, released in August, offering policymakers suggestions to strengthen recovery services for people with substance use disorders. 

The blueprint is an effort to avoid conflict down the road. José Esquibel, the Consortium’s executive director, said some states, including Oklahoma, did not have plans in place to allocate their settlements, leading to infighting and confusion. 

Rob Valuck, former executive director of the Consortium, said it makes sense that treatment and recovery be a priority, but he emphasized that prevention is critical. 

As the panelists discussed the findings John Kefalas, a former state lawmaker and current Larimer County commissioner, said settlement dollars should be divvied up at the local level. He even prepared a top-10 list of reasons for local control.

“Any dollars that we receive we can use more effectively, more efficiently, with greater transparency and accountability, if we’re making those decisions locally,” Kefalas said. 

Funds won by Colorado counties involved in the collective lawsuit would go directly to local governments, but funds won by the Attorney General’s office will be allocated by the office with the help of a 13-person advisory committee created by the legislature last session. 

Esquibel said the Consortium will begin presenting the findings to county commissioners and local municipalities, where he hopes the survey questions and recommendations can serve as a model for local governments to use in spreading settlement dollars.