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Courtney Allen is the policy director of the Maine Recovery Advocacy Project.
For decades, the waves of the addiction crisis — driven significantly by opioids — have wreaked havoc on Maine. Rates of overdose and addiction first started to uptick in the late 1990s, when opioid manufacturers and distributors marketed opioid drugs as safe and non-addictive. Since then, the tides of this storm have crashed into every Maine community and family.
In 2019, Maine’s Attorney General Aaron Frey joined more than 3,000 plaintiffs in filing a suit against these companies to hold them accountable for their role in the opioid crisis — in what would become one of the largest and most complex legal cases in national history.
In July, after years of judicial and political back and forth, a $26 billion settlement offer was made by opioid manufacturer Johnson & Johnsons and the three largest distributors to resolve their liabilities in the case. This was soon followed by a settlement from Purdue Pharma and the Sackler Family for $4.3 billion. Maine is expected to receive $20 million from the Purdue Pharma settlement fund and even more money from Johnson & Johnson.
Finally, the companies most responsible for creating this storm are being forced to contribute. While no amount of money will ever match the devastation they have caused, it does provide a starting point to turn the tides and transform our public health response to addiction — if used correctly.
So how can Maine ensure we get the distribution of tens of millions of dollars in opioid settlement funds right?
Thankfully, there’s already a proposal in Augusta that seeks to do just that.
LD 1722, introduced by Rep. Charlotte Warren of Hallowell and co-sponsored by Senate President Troy Jackson, would create what I have come to call the Substance Use Response Fund (SURF), a fund to separate the monies from the general treasury. The SURF should be designed to respond to the ever changing tides of the addiction crisis in Maine and only be used to expand prevention, treatment, harm reduction, and recovery support services – the four pillars of the U.S. Department of Health and Human Services 2021 Overdose Prevention Strategy.
To put it simply, preventing substance use disorder is the first step towards addressing overdose. Harm reduction is critical to keeping people who use drugs alive and as healthy as possible. High-quality treatment must be available without delay when a person is ready. And recovery support services led to better long-term outcomes.
This fund should be overseen by a SURF Commission, consisting of a diverse representation of stakeholders with the power to approve funding decisions. Building on lessons of the Ryan White Program, which distributes HIV funds to affected communities, this commission should have at least one-third of the members who identify as having lived experience with using drugs or being in recovery. Each member of the commission who is not otherwise compensated by their employer for attendance at the commission meetings should be entitled to receive a stipend of $80 for each meeting of the commission. This compensation is vital to ensure representation by people who may not otherwise have the financial resources to participate on the commission.
Finally, in order to make sure that the money is being used effectively and getting to the communities that need it most, transparency will be key. Mainers affected by the opioid crisis have the right to know how this money is spent — and that it is going to prevent future deaths. Under no circumstances should any of the money be spent until all stakeholders and community leaders are at the table and have a chance to agree on the programs and strategies that it is being spent on.
This is an all-hands-on-deck moment, with a unique opportunity to chart a new course as we surf the waves of the addiction crisis. The only way to lead our state through this storm is by facilitating collaboration, communication, advocacy, and — ultimately — action.