Millions of dollars from several large legal settlements are beginning to flow into Connecticut to help combat the state’s deadly opioid epidemic, and the organizations that work on the front lines battling the state’s mounting addiction crisis are preparing to apply for a portion of that money.
But how and where most of the settlement funds will be used has yet to be determined, and with opioid overdoses currently claiming the lives of more than 100 Connecticut residents a month, the stakes could not be higher.
All together, Connecticut’s state and local governments are expected to receive an estimated $600 million over the next decade and beyond, increasing the resources that are available to counteract the ongoing public health crisis.
That figure may seem like a lot on paper, but advocates expect the decisions on how to spend the money could grow contentious in the coming months and years considering the vast need for additional prevention, intervention, treatment and harm reduction services.
At the state level, Connecticut leaders formed a special committee this year to oversee the distribution of the settlement funds, a step that was meant to prevent the money from being diverted to other governmental purposes, like the tobacco settlements of the 1990s were.
Meanwhile, the elected leaders in Connecticut’s 169 towns and cities are formulating their own plans for how to utilize their share of the money, which includes up to 15% of the proceeds from several of the lawsuits that were filed against nationwide pharmacy chains, pill manufacturers and the country’s largest drug distributors.
The stream of cash that is now pouring into the state offers a unique opportunity to expand prevention programs, educational campaigns, drug treatment capacity, overdose response strategies, harm reduction systems and a host of other related services that are needed to support people who are dealing with opioid use disorders, many of whom are also struggling with other mental health diagnosis.
Some of the professionals who assist people with addictions to heroin, fentanyl and prescription painkillers in Connecticut said the influx of money is more necessary than ever.
Mark Jenkins, the executive director of the Connecticut Harm Reduction Alliance, a group that provides naloxone, sterile syringes, hepatitis and HIV testing and host of other services to people with drug addictions, said he has seen the need for organizations like his grow exponentially in recent years.
“There’s huge unmet needs across the board,” Jenkins said.
The opioid epidemic has been ravaging the United States and Connecticut for nearly three decades at this point. Yet the death toll has continued to rise in recent years, fed by an increasingly lethal supply of illicit narcotics.
There have been more than 9,000 documented overdose deaths in Connecticut since 2015 that have been linked to some type of opioid. And those numbers have continued to surge over the past three years, as Connecticut averaged more than 1,300 fatal opioid overdoses annually, the majority now connected to fentanyl.
Data collected by the U.S. Centers for Disease Control for 2021, the most recent year available, shows Connecticut recorded nearly 40 overdose deaths for every 100,000 state residents. That placed Connecticut just behind states like Ohio, Maine and Kentucky.
It’s with that backdrop that state and local officials are deciding about how to put the new settlement money to use, and many people who lost family members and friends to the epidemic in recent decades are closely monitoring those decisions.
Dita Bhargava, whose son, Alec, died of overdose on his 26th birthday in 2018, said the settlement amounts may seem like a lot, but with the money stretched out over more than a decade, she said it is only a “drop in the bucket” compared to what is needed to confront the ongoing crisis.
Bhargava, a former candidate for state treasurer and an ambassador for Shatterproof, a national organization working to end stigma around addiction, said that makes it essential for the pool of settlement money to be spent appropriately.
“This is not just a moral obligation, it’s a long-term existential crisis in our country,” she said. “It’s very important that every dollar from the settlement be used for prevention, treatment and recovery.”
Confronting the crisis
Attorney General William Tong, whose office represented the state in the litigation against the opioid manufacturers, shippers and retailers, met with the members of the new state Opioid Settlement Advisory Committee in March, and he reminded them of the weight of the decisions they are being asked to make.
“We are here to confront the worst public health crisis in America,” Tong told the committee during its first meeting. “Your charge is to make sure this money is put to its most effective use.”
State lawmakers voted to establish the state opioid advisory committee in 2022 in order to provide a transparent and equitable process for spending the settlement money. They followed the advice of President Joe Biden’s administration by passing a bill that would ensure the settlement funds were not redirected away from their intended purpose of reducing opioid addiction and saving lives.
Those legislative measures were implemented largely to avoid the mistakes that were made with the tobacco settlements, which many states — including Connecticut — siphoned off to fill budget gaps, build roads and fund other programs.
The advisory committee, which is made up of state officials, public health experts, treatment providers, local elected leaders and people who have lost family and friends to the epidemic, has met three times this year, but the committee is still developing its priorities and laying out a process for how to allocate the money.
That process, according to state documents, could include a nine-step approval process before any money is actually allocated.
John Lally is one of the people who is working to set the agenda for the committee, and he is personally aware of the needs that persist in Connecticut.
Two of Lally’s sons coped with addiction in the past decade. His younger son is now in recovery after several years of treatment. But Lally’s eldest son, Tim, died of an overdose in 2016 five days before his 30th birthday.
Lally, who worked as a psychiatric nurse practitioner for 39 years, now runs a nonprofit called “Today I Matter,” which is focused on reducing the stigma surrounding addiction and mental illness. He joined the state advisory committee, he said, in order to dedicate his time in memory of his son.
“It’s how I handle my grief and how I honor my son,” he said.
The nearly 40 members of the state advisory committee, Lally said, are committed to setting up a process that will ensure the settlement money is spent on services and programs that are proven to work.
But the committee, he said, also recognizes the need to get some of the money out into the community in the near future, especially at a time when Connecticut is losing dozens of people every week to fatal overdoses
“This is happening to people that we know: our friends, our family, our neighbors,” Lally said.
The committee expects to launch a website in the coming months that will allow treatment centers, prevention programs and groups that are providing harm reduction services like needle exchanges to apply for portions of the settlement funding. The website could also allow members of the public to submit ideas for how the money could be used.
From there, the members of the committee will decide where the funds might do the most good.
The municipal share
There is a far less regulated and formalized process at the local level for spending the municipal share of the settlement money.
Connecticut’s mayors, first selectmen, city councils and town representatives have discretion over how to spend those funds, as long as they stay within the broad terms of the settlement agreements.
It’s unclear how much of the local settlement money has been spent to this point. And the public is unlikely to get a full picture of how that portion of the funding is being used until later this fall, when towns and cities are required to file an annual report with the state detailing their spending.
Members of the state advisory committee noted earlier this year that some municipalities were uncertain how to utilize the money, since drug treatment, prevention and recovery was not something that most local governments have frequently overseen.
Sen. Cathy Osten, a Democrat who is a member of the state advisory committee, said she was contacted earlier this year by the leaders of several small towns in Connecticut who wanted more information about how to manage the settlement money that was arriving in their bank accounts.
Osten, who represents Norwich and several smaller neighboring towns in eastern Connecticut, said the local leaders wanted guidance from the state on how to put the new financial resources to use. And she suggested the state advisory committee develop a handful of proven strategies they can recommend to municipal leaders.
Waterbury Mayor Neil O’Leary, who is helping to chair the state advisory committee, said he heard similar concerns from towns in his area of the state.
“Some of our smallest communities aren’t really sure what to do with this money, because it is just so unique and odd that they are receiving this funding, and they are really anxious to make a difference,” O’Leary said.
The CT Mirror contacted the 15 towns and cities in Connecticut with the highest overdose rates over the past five years to get a sense of how those municipalities are putting the first wave of settlement funding to use.
Some of them, including Chaplin and New Haven, said they don’t plan to spend the money until they receive more information on best practices for using the funding.
But other municipalities are already spending the settlement proceeds on life-saving drugs and new public programs focused on curbing addiction in their communities.
The city of Norwich, for instance, spent roughly $30,000 on training for its city staff, advertising, and recovery-related assistance for community members.
New London, where 127 individuals have fatally overdosed on opioids over the past five years, spent all of the funding it received thus far on naloxone, the overdose-reversing medication also commonly known by its brand name Narcan. The city purchased 355 naloxone kits, which were distributed to city residents and emergency responders.
And in Hartford, the first wave of opioid settlement funds was directed toward a housing program for men returning to the city after prison. Community Partners in Action, which runs other programs for formerly incarcerated individuals, oversees that effort.
Beth Hines, the executive director, said the group is renting a building along a bus line, which could house up to nine formerly incarcerated men. The program, which launched in June, so far has eight residents.
The participants pay a monthly fee for rent and must attend relapse prevention groups on-site each week. They have up to two months to find employment, and a housing specialist will be available to help the men plan for an eventual transition into independent housing.
Hartford focused the first round of funding on formerly incarcerated individuals because many people leaving prison struggle with addiction, and that population makes up a significant portion of the overdose deaths every year.
The likelihood of many formerly incarcerated individuals overdosing in the first two weeks, Hines said, is “astronomical.”
“They may have used while they were in prison, but they get out … and the stuff here on the street is pretty potent,” she said. “In our houses, we have Narcan hanging on the walls.”
Making the connections
Some smaller towns were also eager to put the settlement money to work assisting people who were slipping through the gaps.
Griswold, a small town located near the border with Rhode Island, used the first installments of its settlement money to create a new program to connect repeat drug users with recovery coaches and treatment programs.
Dana Bennett, Griswold’s first selectwoman, and the town’s other elected leaders directed roughly $37,000 from their settlement funds to Griswold PRIDE, a small organization that was already working in the community on issues surrounding substance abuse.
Miranda Mahoney, Griswold Pride’s project coordinator, used the money to purchase naloxone and prepaid cell phones that will be handed out to people who overdose and are transported to a hospital by the local paramedics with American Ambulance Service.
The care packages, which Mahoney copied from a program in South Carolina, will give recovery coaches that work with Reliance Health a way to contact individuals once they leave the emergency room and help educate those individuals about the treatment options that are available to them.
“It’s hard to reach people here who need the help,” Mahoney said. “This has really changed what we can do.”
Mahoney was able to pull together the plans so quickly, she said, because of her existing connections in town, where she has led prescription drug-take-back events and prevention programs in local schools.
She said it will likely take towns without those pre-existing relationships a little more time to figure out what to do with their settlement money.
“If you don’t have the infrastructure in place, like we do here in Griswold, you will be starting from nothing,” she said.
There are resources already available for towns and cities that may not know where to direct their settlement funding.
In Connecticut, there are five different groups that are known as Regional Behavioral Health Action Organizations, or RBHAOs.
The organizations operate as arms of the state Department of Mental Health and Addiction Services, and coordinate planning, education and advocacy surrounding addiction and mental health in their regions.
Pam Mautte is the president of the CT Prevention Network, which represents all five regional organizations at the state level. Over the past year, Mautte said some of those organizations have fielded questions from municipal leaders about how they can use the settlement money to help in the fight against the opioid epidemic.
Mautte said she and the other leaders of the RBHAOs are willing to help towns and cities to develop local or regional plans to put the money to use. Those strategies, Mautte said, need to include a mix of prevention, intervention, treatment and harm reduction to be successful.
It would be easy, she said, for every municipality to spend the money arming local firefighters, police and first responders with naloxone to help counteract overdoses. But she said that, alone, won’t make a dent in the addiction crisis in Connecticut.
“We need to do more to address the opioid epidemic than Naloxone training and distributions,” Mautte said. “That’s one piece of the puzzle, but we need to keep doing more.”
This story is part of an ongoing series on opioids in Connecticut. Want to share what you know? Send your tips and personal stories to email@example.com