How much will it cost to abate the opioid crisis in Maine? It’s an open question. But if settlements with drug manufacturers will likely be one source of the funds to address the crisis, there may be lessons to be learned from the long history of the 1998 tobacco settlement and the Fund for a Healthy Maine.
Last week a judge ordered drug company Johnson & Johnson to pay the State of Oklahoma $572 million, a fraction of the $17 billion the state’s attorneys had asked for, based on an estimated cost of abatement for one year.
It was the first decision in the hundreds of pending cases on the issue. To date, the action in Maine has been at the city and county levels. That’s one difference from the tobacco litigation years ago; in that case, the state was the actor in the Master Settlement Agreement.
Washington County is among the plaintiffs in a suit brought against Purdue Pharma, AmerisourceBergen Drug, CVS, Walgreens, Walmart and other pharmaceutical manufacturers, distributors and retailers. That action is expected to be combined with others in a federal case in Ohio, which is a disappointment to the attorneys representing Maine cities and counties; they argue residents would be better served if the suit were heard in state court. The drug companies argue that the case deals with questions of federal law and state court decisions could create inconsistencies.
The three Maine law firms retained by the state for work on the tobacco litigation were paid a combined $10 million for their work on the tobacco suit; if the opioid suits continue piecemeal, it’s worth asking whether legal fees won’t climb much higher than that.
The way the current cases are designed has also had unfortunate consequences. Northern Light Eastern Maine Health (at the time Eastern Maine Healthcare Systems) announced last May it would end partnership programs with the cities of Bangor and Portland on substance use treatment and prevention because former EMHS doctors were named as defendants in the cities’ lawsuits.
Healthy Acadia was created as a program of MDI Hospital when the Fund for a Healthy Maine was established and is now an independent nonprofit. It tackles many of the categories of public health work specified under the rules for the Fund for a Healthy Maine, including smoking prevention, cessation and control; substance abuse prevention and treatment; and school health and nutrition programs. Healthy Acadia has been central to the current collaborative efforts to address substance use disorder and is well-positioned to continue in that role.
Maine has done relatively well making sure tobacco settlement funds are used for promoting public health. And while officials should make room for programs that effectively address root causes of addiction and provide support for recovery, any future settlement from the pharmaceutical industry will need similar, or even stricter, guidelines to keep that track record going.