Editorial: The opioid crisis settlement isn’t over yet

There is a bigger fight ahead

Editorial Board

More people in Cuyahoga County died of opioid overdoses than homicides, suicides and car crashes combined in 2016. While deaths increased again the following year, 2018 saw a decrease to 560 deaths. However, that number still represents hundreds of people who are dying each year due to a mostly man-made problem. In Ohio, opioid deaths have increased 1,000 percent in the last 19 years, and nationwide, over 70,000 people have died of a drug overdose, totaling more than all American deaths in the Vietnam and Iraq wars combined. 

At the beginning of October, medical device and pharmaceutical company Johnson & Johnson settled with Cuyahoga and Summit counties for $20.4 million, split up between a straight cash payment, legal fees and contributions to opioid-related nonprofits and programs. The same lawsuit pursued three other drug distributors, Walgreens Company and five drug makers, hoping to attain some semblance of justice for all the victims of the opioid crisis. 

Last week, on Oct. 21, four additional companies settled to avoid what would have been the first federal case regarding the opioid crisis. Instead, the corporations together pledged $260 million. 

While there is no amount of money these corporations could pay to repair the damage—that  has already happened and that which has yet to come—of the opioid crisis, this could mark a step in the right direction. It holds some of the responsible companies accountable financially. However, nowhere in the settlement do any of the companies have to admit fault for worsening the crisis. All of the defendants suggested they were victims of libel and slander, while making billions of dollars off of the lives of Americans. 

The privately-owned pharmaceutical company Purdue Pharma released the painkiller OxyContin in 1996, relying on the persuasion of the owners, Mortimer and Raymond Sackler, to assure the healthcare community that it was the safest option for long-term pain, regardless of any evidence-based research. The Sacker family personally made $13 billion from the success of these deadly drugs. 

The settlement is the first step in changing the projection of the opioid crisis. Local professionals  are optimistic that the Cuyahoga/Summit settlement will start to address the disease—both the addiction and the failure to hold greedy corporations responsible—that has been plaguing our communities for over 20 years. Now, however, it is important to consider the distribution of settlement money in Ohio and across the country, as well as campaigning for a health care system that would support addiction prevention, education and treatment. 

Over 2,000 lawsuits have been filed against pharmaceutical companies across the country. For many Americans, the growing movement to hold Big Pharma accountable evokes memories from the late 1990s of lawsuits against tobacco companies. The 1998 Tobacco Master Settlement Agreement held companies accountable for fueling tobacco addiction and paid states nearly $250 billion over a quarter of a century. However, only eight percent promoted tobacco prevention and treatment programs. A large quota instead went to fill holes in the budget. Given the stark similarities between Big Tobacco and Big Pharma, community members are concerned settlement money from pharmaceutical lawsuits will again be used for political incentives, rather than to address the opioid crisis. Public pressure, especially from local hospitals, universities and other prominent institutions, could be significant in ensuring settlement money is used to help the thousands of families who have suffered because of the crisis. 

Additionally, we need to reiterate that no amount of money can repair the trauma of the opioid crisis. More people die from opioid addiction than breast cancer, and opioid-related deaths are nearly at the same threat level as diabetes. Around our community, there are dozens of nonprofits, hospital centers and additional services to provide resources and support research for cancer and diabetes. Yet, we are not seeing the same type of support and assistance for the opioid crisis and its victims. We need proper prioritization of this crisis as a serious problem in our society, requiring adequate capital and commitment.

The opioid crisis is affecting all areas of society. Prior settlement money has been distributed to nonprofits and centers working in underserved communities, hospitals with notable detox centers, coroner’s offices (in order to hire more staff due to the number of deaths) and foster care programs (as children are being orphaned as a result of the crisis). Additionally, capital needs to be re-invested into all these areas, with special consideration to communities hit hardest by the crisis. As with most medical issues, the opioid crisis intersects with other social determinants of health. In our efforts to address the crisis, we have failed to provide the same support to black Americans as we have to Caucasians, which also speaks to larger issues in our society.

Addressing the larger issues of our society as it relates to the opioid crisis means examining our broader health care system, or rather, lack thereof. Beyond public awareness, supporting a national health care system would help create an infrastructure to address the opioid crisis and other social and medical problems. To date, over a dozen states have failed to expand Medicaid and offer greater health coverage. And further, the Affordable Care Act, implemented under the Obama Administration to provide safer and more accessible health care, is being attacked daily by the current administration.

Attacks on the fraction of a national health care system we currently have only do opioid crisis victims a greater disservice. To follow the lead of nearly every other developed country in the world and consider health care as a human right would inevitably build an infrastructure to provide prevention, treatment and education programs. In Germany, a universal health care system guarantees safe and accessible health care to all people. Because of the organization of this system around the belief of health as a human right, the country has not had an opioid crisis that needed to be solved. Instead, because Germans have access to reliable primary care, physicians are able to offer more preventative medicine and carefully monitor any patients prescribed opioids. 

The settlement between Cuyahoga/Summit Counties and major pharmaceutical companies is the first step in holding corporations accountable. However, the opioid crisis is emblematic of broader issues in our society. We must carefully distribute settlement money to support victims of the crisis and prevent additional addiction, and prioritize a health care system which would establish infrastructure to address the crisis. 

Among all of these settlements, we need to remember that each day, another 130 people die from opioid overdose in America. The longer we ignore the problem, fail to hold companies accountable and restrict health care access to those who can afford it, the more blood we will have on our own hands. However, it will not be as much blood as there is on the hands of the corporations who have fueled the crisis.