To help respond to the opioid epidemic in Cumberland County, county officials are allocating opioid settlement funds to provide services for those addicted to opioids, often prescribed as pain-reducing medications.
Last summer, a majority of states, including North Carolina, made a $26 billion settlement with the nation’s largest opioid distributors: McKesson, Cardinal Health and AmerisourceBergen. Opioid manufacturer Johnson & Johnson is also a part of the lawsuit.
In all, 46 states have reached an agreement with the three distributors, while 45 states have settled with Johnson & Johnson. North Carolina has come to an agreement with all four companies and will receive more than $750 million from the national lawsuit.
Cumberland County alone will get $17 million of that state sum in annual payouts until 2038, Carolina Public Press previously reported. That is the seventh-highest payout among all of North Carolina’s 100 counties.
The opioid epidemic has spread through communities all over the country in the past 20 years, resulting in the deaths of over 564,000 people nationwide from 1999 to 2020, according to the national Centers for Disease Control and Prevention.
According to the U.S. Department of Health and Human Services, doctors started increasing opioid prescriptions for patients in the late 1990s, resulting in widespread addiction. These addictions developed despite reassurances from pharmaceutical companies that the drugs were not addictive.
Opioids have been involved in the deaths of more than 25,000 people statewide since 2000, according to the N.C. Department of Health and Human Services.
In Cumberland County, nearly 1,230 have died from opioid overdoses, according to data from NCDHHS. Cumberland’s opioid-related deaths in 2021 occurred at a rate of 60.5 per 100,000 people, well above the statewide rate of 35.8 per 100,000 people.
Annual deaths in the county increased sharply in 2020 and 2021, from 163 to 203 deaths, compared with 2019, when 97 died from opioid overdose.
To help prevent overdose deaths, Cumberland County received an initial sum of $1.8 million from the settlement in two payments from this past spring and summer.
In August, the Cumberland County Board of Commissioners unanimously approved the recommended use of over half of the initial $1.8 million from the settlement funds.
The Cumberland County Health Department presented the recommended uses of the funds to the board after holding community meetings with county residents in Fayetteville, Spring Lake, Eastover and Hope Mills throughout the summer. There was also an online survey that residents used to submit recommendations to the county.
“The top three priorities that were selected were addiction treatment for incarcerated persons, early intervention programs and recovery support services and housing,” Jennifer Green, Cumberland’s public health director, said.
As a result, the state issued a list of core strategies for local governments to follow as guidelines for use of settlement funds to fight the opioid epidemic. The strategies are separated into two broad categories: short-term and long-term uses.
Addiction treatment for incarcerated people and intervention programs are short-term strategies under the state guidelines.
In Cumberland County, nearly all of the short-term treatments for opioid addiction are in place, Green said, but they need more funding.
“They need more capacity, they need more staff, they need more time,” Green said.
In response, the Board of Commissioners approved the use of up to $800,000 from the initial settlement payments to fund early intervention treatment, including those who are uninsured or underinsured.
The only short-term strategy Cumberland is not using, Green said, is county-operated medication-assisted treatment, or MAT, a combination of counseling and behavioral therapies used to treat opioid addiction.
To meet that need, specifically for those incarcerated, the board approved $200,000 from the $1.8 million to go toward MAT at the Cumberland County Detention Center.
For County Commissioner Jimmy Keefe, longer-term strategies, such as education of the harms of opioids, should take priority.
“This is not a short-term fix. This is a generational educational problem,” Keefe said.
In response, Green said that future payments could be used for more longer-term solutions, such as education initiatives.
While there is strong interest in the funding of a community recovery center, the board did not approve the plan because it is unclear if the settlement funds could be used to operate it. Green said such a facility would help with coordinating and providing services such as peer support groups, reentry programs, job readiness training, professional education and transitional housing.
Loren Bymer, director of Cumberland County Public Information, said in an email that county officials are in talks with the N.C. Association of County Commissioners and the N.C. Department of Justice to determine if the guidelines under the settlement permit the construction and operation of a recovery community center.
In addition to funding MAT and early intervention, the board approved the use of up to $70,000 to be used to purchase naloxone, the medication that can reverse an overdose from opioids.
Since opioids can slow or stop breathing and cause death from overdosing even hours after taking the medication, naloxone is important because it can save someone’s life. Naloxone is not addictive and does not reverse overdoses from nonopioid drugs.
Residents can get free naloxone kits from the first floor of the Cumberland County Health Department while supplies last. There are also free kits at a vending machine in the county detention center. Green said some kits are also given to first response teams that treat overdose victims in emergencies.
The funding from the settlement will double the amount of available naloxone in the county, Green said. In total, just over $1 million of the settlement funds was approved for use, leaving about $800,000 from the initial $1.8 million the county received from the opioid settlements.
The money was left over intentionally, Green said, to fund longer-term plans to fight the opioid epidemic.
“We can’t just fund a recovery. We can’t just fund treatment,” Green said. “We can’t just fund prevention, we need to fund programs along the continuum.”