The Public Isn't So Confident in Effectiveness of Opioid Settlements

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As states and local governments spend tens of billions of dollars in opioid settlement money from pharmaceutical companies and retail pharmacy chains, the public is not confident the funds will actually help the country’s drug epidemic, according to a new Morning Consult survey.

44% of Americans are not confident that settlements will hold drug companies and pharmacy chains accountable

• At least 2 in 5 U.S. adults said they were not confident the settlements would help with each of the public health strategies surveyed that are intended to improve the U.S. opioid epidemic. That included about half who said they were not confident the money would help combat the societal stigma of drug use or reduce opioid deaths and overdoses.
• While 43% said they were confident the settlement money would help provide education and awareness about drug addiction — the most of any measure surveyed — a roughly equal share said the opposite.
• About 2 in 5 adults said they were confident the settlements would help hold pharmaceutical companies and pharmacy chains accountable for their role in the opioid crisis, compared with 44% who said they were not confident. Ensuring that companies are held accountable is likely important for the public: Nearly 3 in 4 adults support doing so as a way to address the opioid crisis, and majorities blamed pharmaceutical companies (70%) and pharmacies (58%) for the epidemic.

Majority of states are not yet reporting how settlement funds are spent

States, local governments and tribal groups have reached multibillion-dollar settlements with drug manufacturers and distributors including Johnson & Johnson, AmerisourceBergen Corp., McKesson Corp. and Cardinal Health Inc., as well as retail pharmacy chains such as CVS Health Corp., Walgreens Boots Alliance Inc. and Walmart Inc. 

Purdue Pharma LP — the maker of the opioid drug OxyContin, which fueled the epidemic for years — reached a tentative settlement agreement of $6 billion in March of last year. However, that money has not yet been paid out to groups who brought the lawsuit as an appeals court weighs whether the agreement can protect members of the Sackler family, the owners of Purdue, from other lawsuits.

Meanwhile, the Justice Department has opened a criminal investigation into Rite Aid Corp., alleging that the retail giant knowingly filled hundreds of thousands of illegal prescriptions and intentionally deleted internal notes about suspicious prescribers. Associate Attorney General Vanita Gupta said in a March statement that the “practices opened the floodgates for millions of opioid pills and other controlled substances to flow illegally out of Rite Aid’s stores.”

There have been over $54 billion in global opioid settlement agreements, according to OpioidSettlementTracker.com, which monitors settlements and how states use the money.

There is pressure — and legal requirements — on states and local governments to use the settlement money on public health strategies and programs that directly address the opioid epidemic, such as measures to help reduce drug overdoses and deaths, expand access to treatment and raise awareness about drug use and combat societal stigma.

States reached similar settlements with Big Tobacco in the 1990s but have spent a fraction of the money on treatments and smoking prevention programs. Instead, states have reallocated the funding throughout their budgets or used it to pay off debts.

Just 13 states have promised to publicly report 100% of settlement spending, and 18 states have not yet committed to report any spending, according to the opioid settlement tracker.

The March 31-April 2, 2023, survey was conducted among a representative sample of 2,204 U.S. adults, with an unweighted margin of error of +/- 2 percentage points.