Cherokee County is set to receive more than $5 million out of North Carolina’s share of a major settlement with opioid manufacturers.
The funds are part of a $26 billion national settlement from which North Carolina will receive more than $750 million over 18 years, stemming from the opioid epidemic. The ongoing crisis is estimated to have resulted in the unintentional deaths of more than 16,500 North Carolinians from 2000-2019 alone, with the current death toll believed to be in excess of 20,000.
The settlement funding must be used to support a variety of strategies to fight the opioid crisis.
“Basically, what they want the counties to use the money toward is to help support addiction recovery, to help with addiction prevention, but also to work with mental health because this is a mental health issue,” Graham County finance director Rebecca Garland said.
Garland, a former Graham County manager, was part of the “555 Committee” that represented North Carolina’s far-western counties. The committee negotiated how the money would be distributed after Johnson & Johnson and the “big three” opioid distributors – McKesson, AmerisourceBergen and Cardinal Health – agreed in July 2020 to resolve their liabilities in more than 3,000 opioid crisis-related suits nationwide.
In 2020, 18.9 percent of Cherokee County residents were dispensed opioids, as compared to the state average of 13.4 percent, according to N.C. Department of Health & Human Services statistics. Meanwhile, rural children have been forced to bear an especially hard burden during the epidemic. In Cherokee County, 49.4 percent of children who came into the foster system in 2020 did so due to parental substance use, compared to the state average of 45.1 percent.
Cherokee County is expected to receive its first payment of $193,677 this spring, followed by a sum of more than $425,000 in the summer. After that, Garland said the payments will settle into an annual distribution of about $200,000 through 2038.
The U.S. Centers for Disease Control & Prevention estimates the total economic burden of prescription opioid misuse at $78.5 billion per year in the U.S. alone, including costs on health care, criminal justice involvement and other areas. With that in mind, Garland said she fought to give local governments access to the bulk of the funds.
“We were presented with the model that local governments would get 15 percent of the share, the state government would get 80 percent of the share and then 5 percent would be up for grabs,” she said. “Me being the finance beancounter that I am, I said, ‘Not no, but heck no.’
“That’s not how this needs to roll because the problem is not in Raleigh, per se, it’s not in the General Assembly, it’s on the streets of our local towns and counties. Our local governments need to have some level of control over how these funds are distributed and used.”
The distribution plan ultimately flipped on its head, with 80 percent of funds now set to go to local governments, 15 percent to the state and another 5 percent up for grabs. This is the second-largest attorney general settlement in history, trailing only the Tobacco Master Settlement Agreement of 1998.
North Carolina counties have two options when deciding how to disburse the settlement money:
- Under Option A, a local government may fund one or more strategies from a shorter list of evidence-based, high-impact strategies to address the epidemic, including evidence-based addiction treatment, recovery support services and collaborative strategic planning.
- Under Option B, a local government engages in a collaborative strategic planning process involving “a diverse array of stakeholders and may then fund a strategy from the Option A list or a longer list of strategies included in the national settlements.”
More information is available at ncopioidsettlement.org/resources.