Since the start of Donald Trump’s second presidency, we have been bombarded with news of reductions in federal funding for programs that provide critical services to Connecticut residents. These include cuts to disaster response, Medicaid, libraries, job programs, and more.
As the federal government pulls back funding, the General Assembly and Gov. Ned Lamont will be tempted to move funds from the hard-won opioid settlements to fill the gaps. This temptation should be resisted. The opioid crisis is ongoing and devastating.
Over the last decade, Connecticut has averaged over 1,000 overdose deaths a year. Treatment of opioid addiction and harm reduction are proven interventions that can reduce overdose deaths, yet only one in five receive evidence-based care. Behind these numbers are lives lost, families broken, and communities left struggling. Today, many of these patients still face barriers to care. These barriers will increase with the actions of the Trump administration and Congress to decrease funding for Medicaid and addiction services.
Connecticut will receive $720 million dollars from settlements prosecuted by Attorney General William Tong against drug companies, distributors, and retail pharmacies. These settlements are meant to serve a clear purpose: reduce opioid-related deaths and invest in prevention, treatment, and substance use recovery. The explicit goal is to address the continuing harms from an earlier era of opioid overprescribing and support people suffering from addiction and their families.
To guide use of the funds, the state established by statute an Opioid Settlement Advisory Committee. As a group of addiction physicians and researchers, and by invitation of the Committee, we generated a report summarizing the best evidence on efficacious interventions to address the harms of opioid use. To date the Committee has funded increases in harm reduction services, a statewide naloxone saturation plan, mobile treatment vans, recovery housing, and other interventions. Early signs show these efforts are making a difference. In 2024, Connecticut saw a decline in overdose deaths. This is a hopeful sign, but only the beginning, as every day we still lose, on average, three to four people to opioids. Now, this budding progress is in jeopardy.
Guardrails were built into the settlements negotiated by Attorney General Tong, and enshrined in state law, to avoid a replay of the Tobacco Master Settlement Agreement, which brought more than $2 billion to the state. Only 10% of those funds went to anti-smoking efforts, while Connecticut lawmakers siphoned the rest away to non-tobacco related services to balance the state budget. Today, while tobacco still kills 4,900 people annually in Connecticut, the state spends none of its tobacco funds on tobacco control. The change in federal funding puts us in danger of repeating the same mistake with the opioid settlements.
This threat is not abstract. During the last budget negotiation Governor Lamont proposed dipping into the opioid settlement to circumvent the Opioid Settlement Advisory Committee. While Lamont’s proposal was ultimately unsuccessful, similar efforts to supplant funds by lawmakers in New Jersey successfully diverted $45 million dollars into state hospital systems for services unrelated to addressing the opioid crisis. Nationally recognized guidance on the appropriate and ethical use of opioid settlement funds expressly recommends the prohibition of supplantation. Furthermore, supplantation undermines settlement terms which specifically call for their use to remediate the harms of opioid use and threatens to erode public trust.
To be sure, federal funding decisions will force hard decisions in our state on how to fund crucial services, but the opioid settlements were never meant to be a pressure relief valve for the state budget when general fund deficits arise. These settlements are a form of justice. It is through investing in harm reduction and addiction treatment that lives will be saved and a stronger public health system built. The stakes could not be higher. The opioid crisis is not over. As the drug supply continues to evolve and overdoses remain a leading cause of death, politics cannot be allowed to interfere with progress. The opioid settlement funds should be utilized for the purpose they were created: helping the people who were harmed by the opioid crisis.
Today, Connecticut has a second chance at correctly utilizing settlement funds. This is not a moment for business as usual. It is a test on whether the state has learned from the past or whether it is willing to allow history to repeat itself.
Benjamin Howell MD is on the faculty of the Yale Program in Addiction Medicine, Yale School of Medicine. He co-wrote this piece with Alyssa Cheng, Emma Biegacki, and David Fiellin – all of the Yale Program in Addiction Medicine.