The bill is finally due for businesses that have benefited from addiction and death. State officials announced on Wednesday that four companies are on the verge of becoming one $ 26 billion in comparison with more than 3,000 local governments for their role in fueling the overdose crisis. Purdue Pharma is mostly absent, but the infamous company and the Sackler family who own it are into one separate bankruptcy case in which they’re likely to pay out $ 4.5 billion. It could be approved next month.

The impending settlements raise pressing questions: How will the funds from Purdue and other companies that fueled the overdose crisis be spent, and how can we end the grave suffering and loss they caused?

Some lawsuits may be over, but the overdose crisis isn’t. It has over 930,000. claimed Life since 1999. Millions of Americans who have lost friends and family members see little hope for justice and few safeguards to prevent such a crisis from occurring again. And those struggling with substance use disorders are overwhelming Barriers to treatmentputting them at serious risk of overdose and death.

A flood of resources is coming

In many ways the crisis is worse than ever. Mainly due to the COVID-19 pandemic, drug overdoses of all kinds took drug more than 93,000 lives last year – an increase of 29% compared to 2019. The future looks bleak, but there is still cause for hope. The opioid settlements and several ongoing lawsuits could ultimately lead to too $ 50 billion or more, floods struggling communities with resources. These resources cannot compensate for our tragic collective loss, but they can be used to help those who suffer. Where should the money go?

Those of us who remember the tobacco settlements in the late 1990s know that financial gain doesn’t always go to those in need of help the most. States received $ 206 billion, almost none of them went Reduction in smoking damage.

Plaintiffs in opioid cases have promised that opioid comparison funds will help prevent and treat opioid use disorders. This strategy sounds good on the surface, but a deeper dive suggests that it may not have the desired result.

The story goes on

Protesters leave pill bottles in front of Purdue Pharma headquarters in Stamford, Connecticut, in 2018.

States serious about reducing overdose deaths should devote most of their resources to harm reduction and evidence-based treatment. Harm reduction strategies – those aimed at meeting people where they are and promoting positive change – have been shown to be effective in reducing overdose deaths. These approaches include syringe delivery programs, naloxone distribution programs, and monitored consumption services.

Congressman Trone: Spend the opioid settlement funds to prevent more deaths like my nephew’s

States also need to overcome barriers to medical treatment. Two of the most effective treatments for opioid use disorder – buprenorphine and methadone – are largely inaccessible. Less than 10% of primary care practices in the US are licensed for Prescribe buprenorphinewhile having access to methadone severely restricted by law.

Research has shown that access to buprenorphine can be expanded through the involvement of health care providers such as nurses and pharmacists, and access to methadone can be expanded through the relaxation of strict laws. States should focus their efforts on expanding access to functioning care.

Put money into programs that work

However, states make a grave mistake by simply funding existing programs without regard to their quality or effectiveness, and by removing proven programs. The treatment industry is large and diverse. In addition to evidence-based programs, there are predatory, for-profit treatment centers. And some treatment programs are worse than failure – they don’t provide real treatment and discharge patients with decreased drug tolerance that increases the risk of overdose.

We are unlikely to lower overdose rates when ineffective or harmful programs receive the same amount of funding as evidence-based treatment programs.

At the same time, many cities and federal states are working on a cross. They promise to use settlement funds to save lives while dismantling programs that do just that. The latest wave of Shutdowns of the syringe provisioning program threatens to undermine efforts to contain deaths from overdose.

Not responsible enough: Purdue Pharma and the Sacklers shouldn’t get out without paying more

For example, commissioners in Scott County, Indiana, voted last month to Close a syringe deployment program which was created in 2015 to contain an HIV outbreak. This one step forward and two step back approach lets us step on water rather than dragging us onto dry land from treacherous tides.

Investing in harm reduction and medical treatment pay off for lives saved. But if we don’t act now, we will have a bigger problem. We can only address this problem by expanding access to harm reduction and evidence-based treatment and building on existing programs rather than destroying them. Billions of dollars cannot bring back those we lost, but we can still demand that funds reclaimed from those who mediated death to save lives.

Elizabeth Chiarello, Ph.D. (@Liz_Chiarello), is Associate Professor of Sociology at Saint Louis University and a former Radcliffe Fellow at Harvard University. Her book, Policing Patients, is under contract with Princeton University Press. Allan M. Brandt, Ph.D., is Kass Professor of Medical History at Harvard University and author of author “The Century of the Cigarette: Rise, Fall, and Persistence of the Product That Defined America”. “

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This article originally appeared on USA TODAY: Opioid settlements come as the overdose crisis is worse than ever