The opioid epidemic has cost Texas tens of thousands of lives and billions of dollars over the years, with jurisdictions like Dallas County picking up big shares of the bill.
Now they’re beginning to see some restitution from companies tied to the manufacturing and distribution of the lethal drugs.
Dallas and several other Texas counties, the state and governments across the country sued companies tied to the opioid crisis. Those in litigation include drug manufacturing companies, such as Johnson & Johnson and Allergan, and CVS, Walgreens and Walmart, who sold the addictive drugs.
Most of the lawsuits have resulted in settlements, and the dollars are starting to be dispersed. The Texas Comptroller of Public Accounts estimates that Texas as a whole will receive about $1.6 billion over the next 18 years.
Thus far, Dallas County has been allocated about $31 million in settlement funds and county commissioners are beginning to distribute these settlement dollars with a clear strategic plan in place: Help those affected by opioids.
Among Dallas’ initial plans is an opioid drug testing program for county courts and medical services, a court diversion program with a quick turnaround time and an expansion of existing substance abuse treatment programs.
More money is coming. Dallas County Judge Clay Lewis Jenkins said the county is likely to receive a total of $131 million over the next 18 years.
While these dollars are intended to address the repercussions of addictive drugs that have killed thousands, Lewis Jenkins said the epidemic has cost Dallas County billions in economic toll.
“It’s unlikely that you’re going to get even a drop in the bucket of the true out-of-pocket expense of opioids,” he said. “You can’t really put a value on all the broken lives at home: moms and dads, sons and daughters, brothers and sisters lost from opioid deaths, destroyed lives, destroyed marriages, destroyed homes.”
A first step
Commissioners approved one of the first distributions Nov. 7, authorizing up to no more than $1.1 million for Dallas County Health and Human Services to purchase lab equipment for and staff a drug testing program. Currently, the health department does not have the capability to test for opioids, said DCHHS Director Philip Huang.
The Dallas Morning News reported inconsistent and infrequent fentanyl drug testing in medical and judicial systems.
Dallas County and its criminal courts have relied on third-party labs to process drug tests, but Huang said it’s important to speed the process along and reduce costs.
“It’s really building our capacity to provide this service,” Huang said.
DCHHS would like to eventually expand the testing program to include private hospitals, he said.
The program was the first to be funded by settlement dollars because it didn’t require a contract process and the equipment needs to be purchased quickly to get the lab up and running, Lewis Jenkins said.
Commissioner Andrew Sommerman said Dallas County has a lot to learn about the crisis in the community and drug testing is an integral first step.
“It’s important that first you identify the people who have the problem,” he said. “Second, how to treat them. And then third, how to keep them off the problem. That’s the frontline issue.”
The long-term plan
Of the $1.6 billion Texas is estimated to receive in settlements, the majority — 85% — will remain in the hands of the state in a trust fund to be allocated by the Opioid Abatement Fund Council.
There is a stipulation in state law that $5 million of those funds be distributed to provide civil legal services to people impacted by opioid-use disorders who cannot afford an attorney as well as children affected by opioid-use disorders.
Another portion of the funds will go to “regions.” Dallas and Kaufman counties are one region, Lewis Jenkins said. Dallas County expects about $100 million of those regional dollars.
State law requires that this tranche be distributed by an appointed council. Lewis Jenkins said the local council will be made up of medical professionals.
“They will be listening to proposals for people who want to access money … score those proposals and recommend contracts in the county,” Lewis Jenkins said.
Lastly, about $239.2 million is expected to directly reach municipalities and counties where officials will determine which opioid-related issues to finance. This portion of the settlements will finance Dallas County’s initiatives.
District Attorney John Creuzot said the county has approved initial plans to create rapid response programs for those who have been arrested and accused of drug possession.
The program — yet to be named — would look to connect those in jail who want treatment to programs quickly.
“One of the best practices and one of the things known to increase your chances of success with this population is to do these evaluations and treatment plans and place and treatment ASAP,” Creuzot said.
Creuzot wants things changed so that a risk and needs assessment as well as mental health and substance abuse screenings would be performed on inmates with drug charges within 24 hours of being jailed. He wants to develop a voluntary treatment program that provides mental health care as needed. This program would not just be for first-time offenders.
“What you want to do is break the cycle of addiction and sometimes it’s the second, the third and the fourth time,” Creuzot said.
Last year, about 2,500 people taken to the county jail could have qualified for such a program, said Marsha Edwards, the DA’s director of special programs.
“The numbers are pretty staggering,” she said.
The county has earmarked $2.7 million for the program.
Sommerman said this court program is a priority for him.
“These are more effective than drug courts, and I want to make sure we get enough money for it,” he said.
Commissioner Elba Garcia said she wants to work with existing treatment and intervention programs for substance abuse to expand services in the county. The county is interested in offering organizations contracts and tracking whether programs are successful.
Lewis Jenkins said the rehabilitation process in Dallas County is costly and there aren’t many services. Beds for those with no insurance are hard to come by.
“You never know, people might need to go through the rehab process multiple times before it ultimately leads to a long period of sobriety,” Lewis Jenkins said. “Those services are lacking for people who are not independently wealthy and frankly, even if you have insurance.”
Edwards said there is no Spanish-speaking residential treatment facility in the county.
Commissioner John Wiley Price said he is willing to wait to get the right programs that the community needs, rather than rush to use the funds and build programs quickly.
“We’re trying to make sure we get it right,” he said.
Dallas County has also found other funding sources to build up better resources to monitor and curb the opioid epidemic. Dallas County Health and Human Services was awarded a federal grant of $11 million over the next five years to create a 24/7 overdose prevention hotline, expand Dallas Fire-Rescue’s overdose response team, add support services at Parkland Health & Hospital System and open an opioid testing and surveillance program targeting wastewater for traces of fentanyl.
“We’re really coordinating in trying to make sure not to have duplication and make sure that all the different efforts and activities complement each other,” Huang said.
Garcia said it will take time to put all the settlement funds to use, but she believes they could mean a different outcome for those struggling.
“We hope that no one has to go through what some of these families have gone through,” she said, “because now we have more resources, prevention, education, and more importantly, intervention and treatment.”
