Arizona will receive $108 million from the opioid settlement. How this will help the state crisis

All 50 American states, plus D.C. and some territories earlier this month reached a settlement with Purdue Pharma, the maker of the pain-killer Oxycontin. NPR reports the $7.4 billion settlement will be paid out over the next decade-plus, and comes as the result of lawsuits over the drug-maker’s role in the ongoing opioid epidemic.

Arizona has been hit hard by this crisis. The state health department says more than five Arizonans die every day from opioid overdoses. So how much might this settlement — and the money that comes with it — help mitigate that?

To find out, The Show spoke with Swapna Reddy, clinical associate professor in ASU’s College of Health Solutions and started with where are we right now, in terms of the ongoing opioid epidemic.

Arizona State University

Full conversation

SWAPNA REDDY: Yeah, absolutely. So the opioid crisis is nothing new in the United States and it's nothing new in Arizona either. We're certainly one of the states that's been the hardest hit with the crisis, and you know, we've seen kind of ups and downs in the last few decades, but where we are right now is Arizona has the 12th-highest drug overdose mortality rate in the U.S. We are in active crisis mode in the state of Arizona. We are also 12th in the U.S. for misusing or abusing prescription drugs, and the stats kind of go on and on like that as it relates to this crisis.

BRODIE: To the extent that there has been some improvement, to what do you attribute that? Like what seems to be working?

REDDY: Yeah, you know, what's really interesting and what's really important here is in the second half of 2023, we actually saw opioid overdose deaths starting to decline. And that includes in Arizona as well. That was sort of a national trend. And by the end of 2023, so around December 2023, they were about 20% fewer than they were. Just, you know, the year before in 2022.

So it's unclear if there was one sort of special magic bullet that we can attribute to what was working, but we have to note that there were sort of a wide variety of harm reduction principles that were, that were going on. So, you know, we're, we're really looking at the supply of fentanyl. Absolutely. You know, there's a reduction in the supply of fentanyl and of Focus on reducing the supply of fentanyl, but we can't really stop there because that's just one piece of the puzzle.

There was a lot more sort of focus and investment in, in treatment and medications for treatment, for, for addiction treatment, and improving access to harm reduction principle, sort of supplies like opioid overdose, reversal medication, kind of loosening, you know. Naloxone availability, using things like leave behind principles, you know, there's sort of a, a wide variety of harm reduction principles that we were, that we were utilizing. Lots of public health approaches that we're really focusing on treatment and making things safer and less on punishment.

And, you know, from a public health perspective, I'm always very focused on the public health sort of approach here. But look, you know, when we look at what was working, what seemed to have been working, we've been working towards sort of a more harm reduction model for many years. And what we really saw in the end of 2023 is many of those kind of harm reduction principles coming together and making a difference.

BRODIE: So when you look at some of those harm reduction techniques and everything, I would imagine that those cost money to some extent. So given that, does the settlement reached with the Sackler family in Purdue Pharma, does that in your mind help those efforts in the sense that states are going to have this additional pot of money from which they can draw to fund some of these programs?

REDDY: Well, that's the intention of the settlement, right? So, for instance, you know, it's a $7.4 billion settlement that is a sizable amount of money, and Arizona will get about $108 million of that settlement, and that primarily goes to state and local communities.

So again, what we know and what we've known from other states and what we know nationally over at least the last decade, is these harm reduction principles really seem to be when they're working together, when we're not just looking at sort of one magic bullet, but when we're trying to address lots of different aspects of why we have this crisis, how we address the addiction piece, how we reduce the stigma piece, how we stop looking at this sort of from a punishment perspective, but more like, how can we support folks that are afflicted with this addiction? How can we support communities?

That's when we're really seeing sort of the biggest increase in effect size and impact, right? So the best thing to do would be to take this sizable amount of money and say, what can we do to really focus on harm reduction.

BRODIE: So as you mentioned, some pretty big dollar numbers as part of the settlement, both overall and to Arizona, how far will that go? Like how much harm reduction will $108 million get you?

REDDY: Well, it can do quite a bit, right? I mean, so when we think about what are we talking about when we're saying harm reduction principles. I named a few earlier, but, you know, we can, things like treatment centers and making medications that seem to be effective in addiction treatment more easily accessible, either whether they're covered by insurance or provided for those that do not have insurance coverage or uninsured, right?

Community health workers really focusing on those targeted community health workers that come from the communities that are most afflicted, that are placed in the communities that are most afflicted, and really funding and enabling those community health workers, prescribing guidelines and integration and EMRs, you know, what we know is we have up to 29% of people are prescribed opioids misuse them.

So there's, there's, there, there's sort of a lot of space there and wiggle room in terms of what do our prescribing guidelines look like, how, what can we do in terms of education and awareness, even for our health care professionals and health care workers. Some of those are more expensive than others. Some of those are actually fairly cost effective, and I think it's more about thinking about this from a targeted perspective thinking about this again, less from a punitive piece, less where there's stigma and more about, you know, how can we support these individuals, how can we support these communities? How can we make it safer?

I'm naming lots and lots of different harm reduction principles. And, like I mentioned, some are, some are less expensive than others, but it's really about that focus and being extremely targeted.

BRODIE: So I guess at the end of the day then, how big of a dent do you think that the money from the settlement can put into the crisis that we've been facing? You mentioned that, you know, things are starting to get a little bit better. Do you think this will continue that trend? And if so, to what extent?

REDDY: I definitely think so. You know, hard to quantify exactly what that amount of money will and won't do for the opioid crisis. But what we know is Arizona is not new to combating the opioid crisis. Governor Ducey declared our state in a state of emergency before the pandemic, and then that was renewed right again right before the pandemic. So we have been battling the opioid crisis in this state and we have definitely seen some successes, right?

We have absolutely seen some successes, especially utilizing opportunities with sort of mobile care, working with law enforcement, right? Law enforcement as a partner, but there's a lot of work to be done. And when we look at, especially for certain communities. In our Native communities, we've definitely seen an increase in usage among certain age groups, we've seen an increase in usage. We're definitely still at a very high level in Maricopa County. Now, maybe that's not that surprising because that's a population center, but definitely much higher than we should be and amongst the higher, highest rates in the country.

So I think It's hard to quantify how exactly far this money will go, but this is a sizable amount of funding, and I think when you put that in combination with the funding that we've had and the efforts that we know work for Arizona communities, I think if we take a very targeted approach, it can make a make make a serious serious dent in the issue here in Arizona.