Mass. panel signs off on a plan for some of the opioid settlement money

As money comes in from legal settlements stemming from the opioid crisis, a Massachusetts advisory council has made some decisions about how to spend some of the funds.

The Opioid Recovery and Remediation Fund Advisory Council has approved how to use almost $10 million currently in a special state trust fund. The plan would address four initial categories: expanding what's known as "harm reduction," which provides safe supplies and resources to active drugs users; increasing access to methadone; providing more supportive housing programs; and boosting community outreach and engagement.

There is close to $12 million in the fund now, most of it from a national settlement with McKinsey & Company, which Purdue Pharma hired to help boost sales of its opioid painkiller Oxycontin. Massachusetts is expected to receive $90 million from another settlement with Purdue.  The Council will review spending those funds as well. The vote Thursday indicates some of the Council's priorities in using settlement monies to mitigate the opioid epidemic.

State Health and Human Services Secretary Mary Lou Sudders, who chaired the panel, said the four categories of spending approved at a meeting Thursday were based on feedback from the council members. The money, Sudders said, should be used for some "immediate needs," such as focusing on a spike in overdose deaths among Black men. The state reported a 73% increase in overdose deaths among non-Hispanic Black men from 2019 to 2020.

"This is initial in what's going to be a long journey together," Sudders told the council "These proposals expand on existing initiatives and introduce some innovative approaches."

One recommendation calls for spending $3.4 million annually on harm reduction programming at syringe services programs in the state. Those programs provide and dispose of syringes, offer testing for diseases such as hepatitis C and offer the overdose reversal drug naloxone. The additional trust fund dollars would help pay for staffing, offering non-injection harm reduction supplies such as fentanyl test strips and training for engagement in high-risk populations.

Another $3.1 million will go toward increasing access to methadone by purchasing mobile methadone vans or trailers, with priority given to sites working with underserved patients. Deirdre Calvert, Director of the Massachusetts Bureau of Substance Addiction Services said 2,000 new patients started taking methadone when some restrictions on it were released during the pandemic.

Calvert also said the services are needed in rural areas as well as Boston. She said there about 3000 slots for methadone treatment in Boston for 600,000 people compared to Springfield which has 4000 methadone slots for 100,000 people.

"It feels like there is a methadone saturation in Boston but there is not," Calvert said. "What we have is long lines and traffic jams of trying to get to the clinics."

"I'm thrilled to see the inclusion of mobile vans," said Jennifer Tracey, Director of Boston's Office of Recovery Services. "There is tremendous pushback in some communities to brick and mortar sites."

Another $2 million from the trust fund will go toward supportive housing or "low-threshold " housing where sobriety is not a requirement. The money will also help pay for case management for those who utilize the housing and require treatment for substance use and mental health disorders. The funding will be focused on three historically underserved communities: Greenfield, Fall River and Pittsfield.

"Where is the assurance that these funds will get to the affected groups?" asked Dr. David Rosenbloom from the Boston University School of Public Health, "Each of these proposals relies on the existing networks and we've seen that the existing networks are not providing adequate access to these high priority populations. So I think it's a matter of significant concern."

Rosenbloom also suggested measuring how the programs are reaching the underserved, rewarding those that do and reevaluating those that do not.

Sudders said the council can continue to work to monitor equity in the programs receiving funds and in the procurement process.

In the final category of spending, $1.5 million will go toward community outreach and engagement, where multi-disciplinary teams would offer treatment, rehabilitation, and other services to adults with mental illness
and substance use disorder. The proposal says the services would be offered in home and community settings, and to those experiencing homelessness.

At the Council's next meeting in December, it will review how to focus on programming for those incarcerated and recently incarcerated, who have a higher risk of overdose death.