North Carolina recently reached a multibillion-dollar settlement with Purdue Pharma, the producer of the addictive painkiller oxycontin, as the latest in a series of targeted efforts over the past few years to combat the state’s ongoing opioid crisis.
North Carolina was among 15 states to reach the $7.4 billion settlement in January with Purdue Pharma and its owners, the Sackler family, for their alleged culpability in the national opioid crisis. Of this figure, North Carolina is set to receive up to $150 million, according to a Jan. 23 statement from Attorney General Jeff Jackson.
Under the North Carolina Memorandum of Agreement, which sets guidelines for opioid settlement fund distribution, 85% of the funds will go to local governments, and the remainder will be allocated to the N.C. General Assembly for disbursement. Durham County will receive around 1.8% of those funds, with the potential to gain more from a shared County Incentive Fund. The City of Durham is also slated to receive around 0.38% of the funds.
In 2023, Durham County’s overdose death rate was 40.7 out of 100,000 residents, marking a 3% increase from 2022 and placing the county among those with the highest death rates across the state. Between 2000 and 2022, over 36,000 North Carolinians died from overdosing on opioids.
January’s settlement follows a similar 2022 settlement, courtesy of which North Carolina is set to receive $1.4 billion over the course of 16 years from the nation’s top pharmaceutical companies. Of this total, $21.7 million will be allocated to Durham County.
The Durham Public Health Department, a county-level office, is in the process of developing a long-term spending plan for the funds. In 2024, the department hired Jaeson Smith — former health education program manager for Durham County — for the newly created position of opioid settlement manager, tasked with determining that plan.
The money from the Purdue Pharma settlement will be added to the bank created by the 2022 settlement, which is projected to roll out in waves over ensuing decades.
“This will be the first year where we actually are spending money from the opioid settlement fund,” he said. “We are really just at the starting point of the race.”
Much of the preliminary work has consisted of hiring specialists and ensuring compliance with the North Carolina Memorandum of Agreement, which mandates that the state must only use the funds for a strictly defined set of approved “opioid remediation activities.” In fiscal year 2024, Smith’s team began disbursing the 2022 funds by spending less than $100,000 to distribute uncontaminated syringes.
“Our goal was not to rush and spend money,” Smith said. “Our goal was to have a plan that’s viable, and then … start rolling out some things.”
With millions of dollars now supporting their efforts, Durham’s local government is committed to making a tangible impact on remediation by investing in strategies proven to work.
“We have epidemiologists [who] are constantly collecting data across our activities,” Smith said. “There’s also a workbook that we utilize that has different measures … to capture process measures, quality measures and also outcome measures.”
Smith and the department have developed a three-pronged plan to fund prevention, treatment and recovery programs. So far, they have partnered with local pharmacies on syringe distribution and worked to increase the effectiveness of naloxone — a medicine that rapidly treats opioid overdose — by raising awareness of its use and funding vending machines to make it more widely available.
The department also plans to distribute funds to existing local remediation initiatives, such as the longstanding Community Linkages to Care program, which connects those in recovery with peer support specialists.
Smith said the team is currently assembling and onboarding a “community-drawn” advisory committee to guide the allocation process, which will consist of specialists in addiction medicine, as well as members working in public health, law enforcement and local government. The department expects to introduce the advisory committee and more detailed plans for the funding at their annual meeting in May, which will be open to the public.
To increase communication with residents, the department intends to launch an email newsletter and create a public-facing dashboard tracking how funds are spent.
“Let’s test. Let’s evaluate. Let’s see how much impact [we’re making] and [if] we are being efficient,” Smith said regarding the county’s approach. “Is the community getting what it needs? I think that we start there, and then we move forward.”
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Claire Chen is a Trinity first-year and a staff reporter for the news department.