Opioid Settlements: Last Week Tonight with John Oliver (HBO)

our main story tonight concerns the

opioid crisis if you take out one eye

it's actually an anagram for Rich idiot

posy which should make a pretty good

sweatshirt at the next sacka family

reunion the opioid crisis is still

raging despite varying efforts to combat

it over the years including This

brilliant plan from then president Trump

the best way to prevent drug addiction

and overdoses to prevent people from

abusing drugs in in the first place if

they don't start they won't have a

problem if they do start it's awfully

tough to get off so we can keep them

from going on and maybe by talking to

Youth and telling them no good really

bad for you in every way but if they

don't

start it will never be a problem yeah

it's hard to believe that message didn't

land from Trump talking to youth with

the words no good really bad for you in

every way to milania staring ically into

the distance as she Burns another day

waiting patiently for coronary artery

disease to do its job the point

is the opioid crisis is nowhere near

over in fact we're currently what's

being referred to as the fourth wave of

it the first wave uh began with

increased prescribing of opioids in the

'90s the second began in 2010 with

Heroin followed by a third wave around

2013 involving synthetic opioids like

Fentanyl and this fourth wave is

characterized by overdose deaths

involving fenal plus a stimulant like

cocaine or meth which can sometimes be

spiked without the user's knowledge in

fact most of these street drug Supply is

apparently now adulterated that is how

pervasive this problem is but to the

extent that there is any good news here

is that the companies most implicated in

that first wave drug makers and other

players in the supply chain that pumped

pills into communities have finally been

forced to pay a price for their actions

as you probably know if you've seen

stories like these Walmart has agreed to

pay $3.1 billion dollars to settle

lawsuits Nationwide over the impact of

prescriptions aty filled for opioid

painkillers two of the largest Pharmacy

chains will pay about 10 billion do in

prescription opioid lawsuit settlements

four us corporations will pay a combined

$26 billion to settle claims over their

role in the opioid epidemic Johnson and

Johnson and three major drug

Distributors agreed to the settlement

while insisting it was not an admission

of guilt oh it wasn't an admission of

guilt was it that makes sense 26 billion

is exactly how much you pay when you're

not guilty of anything who Among Us

hasn't surrendered the entire GDP of

Iceland just cause when you put all

those settlements together collectively

these companies have agreed to pay out

more than $50 billion over 18 years to

State and local governments and getting

to this point wasn't easy it involved

consolidating thousands of lawsuits

filed by various government entities and

has been called the most complicated

litigation in the history of complex

litigation and I think this goes without

saying but boner alert that is a bat

signal for this show something so boring

it's genuinely kind of hot and people

have understandable complaints about

these settlements first that the dollar

amounts are too small which they

absolutely are putting aside the loss of

hundreds of thousands of lives over the

years the opioid crisis didn't estimated

1 A5 trillion dollars in damage in 20120

alone and second almost none of the

money is going to the individuals or

fam's heart instead it's going to

governments theoretically to be used to

mitigate the damage that opioids are

doing and there are Back stories behind

both of those decisions including that

for a bunch of complicated legal reasons

governments tend to get better outcomes

in lawsuits like these than individuals

and that the most appropriate punishment

for these companies throwing them into

the sun is sadly currently

unavailable to us though I am working on

a design for a catapult and I'm

tantalizingly close and know I I could

talk more about all of that but the

truth is those decisions have now been

made they're in the past and for this

story I'd like to do something slightly

different which is to mainly talk about

the future and the decisions that

haven't been made yet because while 50

billion is clearly not enough to undo

the damage here it's also not nothing

it's double NASA's budget and five times

the revenue of an NBA season and you

should know this is also the bulk of the

money governments are likely to get out

of these companies because under the

terms of their settlements they're being

released from future claims so when it

comes to restitution this is basically

all the blood money we're getting making

it feel especially important that we

spend it well but there have already

been troubling signs that at least in

some places the decision process on how

to do so can be deeply flawed which is

particularly frustrating for those

who've lost loved ones to this crisis

like this woman a dozen New York parents

descended on Albany this week to

complain the governor's budget is not

being open about where the money is

going one Long Island mom Ventura

carried her son's ashes in a tupperware

container I will remain a pain in in New

York state because no one should join

the club that these parents are here for

that is a brave thing for that woman to

do and a powerful message for her to

send my name is Linda I'm going to be a

pain in the ass for you and in case you

sons of forgot why we're here I

brought along a tupperware of my son and

I know that that sounds worrying but the

thing is because we're only 3 years in

to what will be 8 years worth of

payments there is still time for us to

correct course but that is why we need

to talk about this right now so tonight

let's look at the opioid settlement so

let's start with the fact that this

isn't the first time governments have

received a huge pile of money after

companies caused a Public Health crisis

back in the 1990s there was eight

similar wave of lawsuits against big

tobacco that ended with a settlement of

an estimated 246 billion and at the time

everyone took a Victory lap finally we

are going to begin to hold the tobacco

industry accountable for decades of

marketing their products and selling

their products to our kids the states

will receive the largest financial

recovery in history we've arrived at our

final destination and that's the

destination of tobacco Justice ooh

tobacco Justice and look it did sound

great not only were tobacco companies

paying a huge amount of money the

settlement also imposed restrictions on

cigarette advertising including Banning

cartoon characters like Joe Camel

although personally I never found a sexy

camel that persuasive it seemed

ridiculous to me to think that oh my God

how the did you just do

that but interestingly that settlement

is now seen as a prime example of what

not to do because at the time the

expectation was that a significant

portion of the funding would be set

aside to reduce tobacco use but there

were no binding requirements on how the

money should be spent so in practice

Most states just used it as a slush fund

to cover budget shortfalls subsidize tax

cuts and support General government

services in fact within just a few years

stories like this were starting to hit

the news here in North Carolina the

nation's number one tobacco producer not

a penny of the state's $4.6 billion

share has been spent on anti-smoking

programs so where's the money going

$200,000 to improve this horse Park

$15,000 for this tobacco Museum to help

produce a tobacco history video and 400

,000 toward the engineering of this

plant that will one day process

tobacco yeah that's not great and look I

realized that spending other people's

money in a dumb way could well be my

exact job description but even I know

building a tobacco processing plant with

tobacco settlement money is a very bad

idea and that's not the only cautionary

tale there's actually another example

from early in this current wave of

opioid settlement specifically the one

between state governments and McKenzie

in New York State once that money

started rolling in some Public Health

Advocates were shocked at where most of

it seemed to be going $21 million went

into New York State's general fund to

build Bridges and tunnels and to fill

budget caps and that's absolutely

inexcusable I will be damned if I see a

dollar go to fixing a pothole do we need

potholes fixed absolutely that's not

what this money is about yeah he's right

he's also perhaps the most New York guy

to ever exist a man name Anthony rosuto

ranting about potholes on behalf of an

organization called fist a man like that

isn't born someone in masipa rubbed a

meatball palm and he appeared in a puff

of smoke like a genie now carefully this

current 50 billion in settlement money

has rules on how it can be spent

unfortunately they're both very

complicated and not nearly strong enough

for instance most of the settlement

agreements say that at least 85% of the

money has to be used for opioid

remediation which sounds good but that

term is broadly defined and while they

include a long list of what could fit

into that category they also note that

the list is non-exhaustive meaning

governments could attempt to justify

almost any purchase as for the remaining

15% that's a free for- all making it

basically a multi-billion dollar slush

fund but also as this legal expert who's

been closely tracking the settlements

points out there are worryingly few

rules requiring state or local

governments to report how they spend any

of the money public reporting of opioid

settlement expenditures is not required

by the settlement agreements themselves

so we're in um Wild Wild West territory

mini found only 16 States promised to

publicly report 100% of their opioid

settlement spending another 16 have not

agreed to report any spending publicly

at all and the rest only a portion of it

okay first shout out to the states

promising to report on how they spend

some of the money I'm not sure that much

better than not reporting it at all oh

don't worry we'll report on every dollar

that doesn't go into our mysterious

money hole and I should say a few more

states have since agreed to disclose at

least some of their spending so it's now

only these seven who are doing zero

public reporting but the point remains

there can be shockingly little

transparency about where this money is

going or in some cases not going because

despite the fact that we are 3 years in

some states haven't even started

spending for instance Iowa State

Legislature recently couldn't come to to

an agreement on how to spend its

settlement money and then simply

adjourned for the year leaving more than

25 million unspent until 2025 but that's

fine I guess it's not like this is a

life and death situation or anything

meanwhile other states seem to be

engaging in accounting tricks to get

around restrictions New York's Governor

Kathy hokel proposed cutting cutting the

budget of the state's office of

Addiction Services and supports by more

than 133% and it's believ that her plan

was to then replace that funding with

money from the P settlement but that's

not increasing Services is it it's just

moving the money around so you can use

it for whatever you like which is

infuriating it turns out it's a lot less

entertaining to watch someone try to

laund a millions in drug money when it's

not Brian Cranston who's doing

it and while so far I've mainly talked

about states it is worth knowing more

than half this money is actually going

to local governments it's actually being

divided up among cities and counties as

this local news report explains with

some top tier graphics

every single County in Michigan will get

some money but it really depends on how

much the smallest amount just

$173 in Union Charter Township the

biggest amount nearly 70 million in

Wayne County here in West Michigan Kent

County is getting more than $18 million

so how are they actually going to use

that money all of the experts I spoke

was said it needs to be poured into four

different buckets prevention harm

reduction treatment and Recovery okay I

know she's telling us that the money

should be going to things like harm

reduction and Recovery there but it kind

of feels like it's going to local news

Graphics departments because that is

excellent but she is right that experts

generally agree that there are good ways

to spend this money for instance we

could hire and train more counselors and

peer Specialists to work with those

struggling with addiction we could also

increase access to medication assisted

treatment using drugs like methadone

berer andorine and nxone we could also

better fund interventions for those

continuing to use drugs from overdose

prevention centers which we've discussed

before on this show to Distributing the

lock Zone detecting fentanyl through

testing strips providing sterile

syringes and connecting people to

adequate housing all of that is a great

use of settlement money but it's

sometimes been hard for Advocates to get

that message across given local leaders

often simply don't have the experience

with addiction or health policy to guide

them in using the money well and that

can be understandably very frustrating

for those with personal experience of

this crisis people who use drugs are not

being included at all Trish Perry is a

county coordinator for Ohio can a

nonprofit started by family members of

individuals battling addiction every

Saturday they hand out food clothing and

the overdose reversal drug Narcan in

Newark Ohio vental testing strips but

Perry says her organization has so far

encountered stigma and hurdles when

applying for funding from opioid

settlement money that's earmarked for

local government

if you don't Supply people with clean

use supplies and fentol testing strips

they die and if they die they never get

to be a productive citizen in the in the

community that seems like a pretty good

use of settlement money honestly all

other options tend to pale in comparison

to if people don't get the stuff I'm

handing out right now they'll

die and when you see that the idea of

using this money to fill potholes starts

to sound like second deegree murder as

This Magnificent New York stereotype

will undoubtedly tell you and I will say

there are places that are spending this

money wisely on prevention harm

reduction and the other things written

on those CGI buckets but places without

the expertise or good guidance can

become easy targets for companies

looking to take this sudden surge of

money off their hands companies that

make pill disposal products safe pill

storage or even products for law

enforcement like speed ray guns are

pushing municipalities to use their

settlement funds for their products and

even have tab on their websites to track

your State's settlement money that's

true salesmen are going to small towns

trying to convince them that they're

selling the cure for the opioid crisis

it's like an insanely dark remake of the

music man there's trouble folks right

here in River City trouble with a

capital T and the rhymes with p and that

stands for

painkillers thousands are dead one of

those products is detera drug disposal

pouches which apparently contain

activated carbon and cost about $4 each

the way they work is customers has

placed their unused medications in a

detera pouch and add water deactivating

the drugs before tossing them ensuring

that they cannot be used even if fished

out of the trash now if you thinking

wait hold on it it's just essentially

then throwing away pills in water can't

you already do that with a toilet yes

you can this might be news to people but

unlike most drugs the FDA lists opioids

on its flush list for disposal which is

bad news for detera but another huge win

for the toilet the greatest invention in

human history thank you

toilet but but despite that tera's

manufacturer has promoted it heavily to

local governments even buying Google ads

to get their attention because when you

search for opioid settlement related

terms you can get served sponsored ads

for detera with headers like how to use

opioid settlements get the detera grant

guide and it seems to have worked as

it's one a bunch of contracts including

a million dooll order from the health

department in Delaware County

Pennsylvania which seems like a huge

waste of money assuming that that county

has toilets and if they don't have

toilets then find money to spend on that

stop in buckets in one of

these they're a real treat thank you

toilet but most upsettingly in many

places the money's going somewhere that

could do the exact opposite of reducing

harm the police and that is despite

explicit warnings against doing that

last year 130 Public Health Advocates

issued an an open letter to local

government saying no opioid settlement

money should be spent on law enforcement

Personnel overtime or equipment which

does make sense because if we learned

one thing from the War on Drugs is that

Nancy Reagan and Mr T produced The

Single strangest photo in the history of

cameras but if we learn two things is

the policing drug use does not make it

stop and yet in some places sending

opioid money to police is actually

mandatory Louisiana decided to allocate

20% of its funds directly to sheriffs

with no obligation for them to report

how they spend any of it and many

smaller municipalities are funing it to

law enforcement too Sullivan County New

York is using some of their settlement

funds to pay for police overtime oana

West Virginia is using some for a new

police cruiser bib County Alabama spent

over $120,000 on two new cheffy pickups

for the sheriff's office as well as new

lights Sirens radios and roadside

cameras and as for Brownwood Texas it

spent $155,000 of its settlement funds

to buy nine bowler wrap devices now a

bowler wrap is a restraint device which

fires a cord around a suspect and I

could describe it to you but instead

I'll show you a video that the company

made

[Music]

just like we do in the field

[Music]

one cool you know just a second ago I

thought Sirens were the least helpful

thing to spend opioid money on but then

I saw something that makes targets walk

slightly slower away from you still bow

wrap is another useful tool for cops to

add to their belt along with a bunch of

way more lethal tools that they'll

definitely reach for instead and it's

not just high-tech lassos we also found

multiple police departments pitching

local governments on something called

the truear drug analyzer arguing that it

will increase officer safety here is a

cop in kosha County Wisconsin doing

exactly that at a County finance

committee meeting so without having to

open a package of a suspected narcotic

we can shine this point this equipment

at that product and it will tell us what

the makeup was of whatever is inside it

so we've all seen the videos of the

staff all over the law enforcement all

over the country opening a bag which we

don't do anymore and uh breathing in

that substance and passing out was fun

that what's the word not passing

out

yeah going

unconsciousness from from an OD

okay for the 10 thousandth time it is

all but impossible for a cop to just

encounter fenel in the field and

overdose to quote one expert there has

never ever ever ever ever ever been a

confirmed case of that happening that is

two more never Evers than Taylor Swift

uses for getting back together so you

know they're not around but

again that argument worked he said we

need the magic drug flashlight and that

was good enough for the council to spend

$30,000 on it but honestly I do have

some sympathy for the people making

these decisions you can imagine town

councils full of members who feel

enormous responsibility to spend this

money well but don't know where to start

in that situation if a police official

shows up and says give it to us we know

what to do with it that's almost a

relief take Vienna West Virginia a city

in a state absolutely hammered by the

opioid crisis their Council was

approached by their police chief with a

request for $113,000 from their opioid

settlement fund to spend on a new police

dog because their current one was

getting old the council unanimously

agreed to it even as one member made a

pretty revealing comment this is the

first time Council has kind of been

informed that we've even received those

funds um

and not entirely sure how we're going to

use the rest of it but we should

definitely you know have a plan in place

not that this isn't a good need um but I

would hate to see that money get Whitted

away 135,000 at a time without being

thoughtful about the impact this money

could have for the city of Vienna right

when you don't have a plan for your

money it can be easy to spend it in a

thoughtless way it's a lot harder to

break into your savings when it's

labeled college funds and not holy

look at all this free jar money and that

impulse of not wanting the settlement to

be Whitted away without serious thought

is a good one but here's the thing just

3 months later the same guy returned to

that same room to show her photos of the

new police dog they bought and make a

new request and here is the mayor

announcing that request to the council

the next item on our agenda this evening

is a resolution to authorize the

purchase of two midsize or full-size

SUVs for the Vienna Police Department

using opioid settlement funds no don't

do it the police already have multiple

funding sources they could use for cars

we're constantly throwing money at them

they're basically your Rich friend that

Veno request you

$245 after splitting a popcorn at the

movies Tristan this would be unhinged

Behavior even if your mom's name wasn't

blue on Wikipedia now to their credit a

council member spoke up again to express

reservations about how little

consideration seemed to be going into

how they were spending this money I

think we need to sit down and have a

broader conversation about what we want

to do with this money some and get more

voices at the table obviously yes we're

going to take care of the police

department in the ways that we can but

it's a bigger thing it's about

prevention and we want to see that th

those prevention dollars filter into our

community I think that Council we just

need to put our heads together and have

some time to figure out how we're going

to direct that money most effectively

and efficiently exactly and that was

only slightly undermined by the fact

that just 10 seconds after she was done

speaking the council voted unanimously

to spend the money on the SUVs anyway

which is just maddening even Oprah would

watch that and think hey guys you can't

just give people cars that way because

the sad truth is even if every penny

from the settlement did go to

alleviating the opioid crisis it would

still just be scratching the surface but

anytime you watch this money go toward

policing drug users instead of helping

them it just feels like adding insult to

injury especially to communities of

color who are so used to being overp

policed and underserved so what can we

do well again the good news here is that

we are still pretty close to the

beginning of this process so we're at a

point where we can change the Arc of

this story and there ways to do that for

instance states can decide what counts

as an allowable expense California has

said that local governments may not use

money from the abatement fund to

purchase many of the law enforcement

toys that you've seen tonight they even

put out a list explicitly stating the

money can't be spent on Kines Bower app

or the truear analyzer which is good

States could also be more transparent

about how they're spending their funds

and some are doing a good job of that

North Carolina and Colorado are

currently the gold standard with each

having online portals providing

up-to-date information on where their

money is going but it's clearly not

enough for the decisions to be

transparent they also have to be good

there are tools that we know work here