West Virginia Starts Distributing Funds From The Settlement Of Opioid Lawsuits

West Virginia is issuing the first checks from a fund established by the settlement of opioid lawsuits in the state, which has by far the nation’s highest drug overdose death rate.

West Virginia is issuing the first checks from a fund established by the settlement of opioid lawsuits in the state, which has by far the nation’s highest drug overdose death rate.

The Kanawha County Commission said Thursday it received a $2.9 million check and plans to discuss how it will be spent at its next meeting on Jan. 11. Last week the Mercer County Commission received $1.9 million.

The distribution is part of a memorandum of understanding that was previously adopted by state Attorney General Patrick Morrisey and counsel for West Virginia cities and counties. According to the agreement, the board in charge of around $1 billion in funds will distribute just under three-fourths of the settlement money, and a fourth will go directly to local communities and 3% will remain in trust.

Morrisey told the Kanawha County Commission that his office and the state auditor’s office have formed a partnership to ensure that the settlement funds are used properly. All the money must be used to abate the opioid crisis through efforts such as addiction treatment, recovery and prevention programs, or supporting law enforcement in anti-drug measures.

The state is receiving money from each of its settlement agreements on a staggered schedule, with annual payments coming until at least 2036. The West Virginia First Foundation alone is expected to receive around $367 million over the next five years.

Over the past four years, drug manufacturers, distribution companies, pharmacies and other companies have reached settlements totaling more than $50 billion with governments. While the biggest amounts are national in scope, West Virginia has been aggressive in bringing its own lawsuits and reaching more than a dozen settlements.

A $68 million settlement was announced by the state in May with Kroger, the last remaining defendant in a lawsuit involving Walgreens, Walmart, CVS and Rite Aid. Walgreens settled for $83 million; Walmart for more than $65 million; CVS for $82.5 million; and Rite Aid for up to $30 million.

As part of the state’s 2022 settlement with Teva, the University of Charleston School of Pharmacy starting receiving shipments of the overdose-reversal drug naloxone in September.

Program Helping Babies, Mothers With Opioid Dependence Receives More Funding 

The program also works to connect mothers with addiction recovery programs, education, housing, and job opportunities. The program has expanded the follow-up care babies born with NAS receive after they are discharged from hospital. 

West Virginia has continued to see a rise in babies born dependent on opioids. 

To counter the problem, the West Virginia University Center for Excellence in Disabilities received $1.5 million from the US Department of Health and Human Services to implement services for mothers and babies facing opioid dependence. The money will extend the five-year-old program another three years. 

The center works to reduce the number of babies born with neonatal abstinence syndrome (NAS) as well as aiding in the recovery for babies and mothers by connecting families with already existing resources that help in addiction recovery, health services, and social services using a patient navigator. 

Program Director D. Lesley Cottrell says the patient navigator comes from the community and can relate to the lived experience of mothers and family members and can connect them with providers and resources in the area.

 “They are key to connecting all the different providers across the different settings. If they notice that there’s a need, they can reach out to find a provider that provides that service,” Cottrell said. 

The program introduces patient navigators at birth in the hospital. 

“The patient navigator model works best when that patient navigator is employed within the birthing hospital for a couple of reasons,” Cottrell said. “So, they’re there at the birth of the infant. They can make those pivotal connections while mom and family are there. It happens before if there is a separation of mom and baby, for any reason. And they can be there to work with mom, and even the foster parent who might come into play.”

The program also works to connect mothers with addiction recovery programs, education, housing, and job opportunities. The program has expanded the follow-up care babies born with NAS receive after they are discharged from hospital. 

“We really want to follow up and not just with our child health visits, but in other ways,” Cottrell said. “So, with occupational therapy, if that’s needed- with speech, if that’s needed- With nutrition. This follow-up clinic would bring in an interdisciplinary group of providers to work with the family and continue to connect them to the needs as the baby develops.”

Cottrell also said that the program does not just focus on one baby but stays in contact with mothers in between babies. It also stays in contact with mothers after they have stopped using substances in case of possible relapse. 

Cottrell said that the center helps extend time periods in between giving birth again by aiding in family planning for mothers.

The program works with WVU’s Children’s Hospital, Preston Memorial’s Medication Assisted Treatment Program, Court Appointed Special Advocates Incorporated (CASAINC), WVU behavioral medicine, WVU Pediatrics, and the WVU School of Nursing as well as other national, state, and local programs. 

Marshall Student Selected For National Opioid Affected Youth Advisory Board

Brooklyn Johnson is a member of the Prevention Empowerment Partnership Youth Trainee Program and has been selected to serve on the national Office of Juvenile Justice and Delinquency Prevention Opioid Affected Youth Advisory Board.

Marshall University student Brooklyn Johnson is a member of the Prevention Empowerment Partnership Youth Trainee Program and has been selected to serve on the national Office of Juvenile Justice and Delinquency Prevention Opioid Affected Youth Advisory Board.

Johnson is one of seven students selected for the board nationally. The ages of the students range from 18 to 24.

“Brooklyn’s appointment to the Office of Juvenile Justice and Delinquency Prevention’s Opioid Affected Youth Advisory Board is a significant milestone that reflects her passion, expertise and unwavering dedication to empowering youth and promoting substance use prevention,” Angela Saunders, director of Prevention Empowerment Partnership, said.

“It is truly a dream come true,” Johnson said. “I am so thankful for my community for growing me into the person I am today and am beyond grateful for the Prevention Empowerment Partnership for empowering me with the training and experience which have made me qualified for this national position.”

Brooklyn Johnson. Credit: Marshall University

The board’s mission statement is “The impact of this board will be to enhance youth survival and safety by leveraging the lived experiences of young people and redefining recovery as any positive change. Through advocacy, education, and awareness, we will advance evidence-based prevention and sustainable recovery efforts that are rooted in foundations of cultural humility, holistic approaches, reduction of stigma, and restorative justice.”

The board will address the specific challenges that youth deal with when affected by opioids and substance abuse disorders.

Decoding The Drug Epidemic

When it comes to decoding the language of the drug epidemic, advocates say compassionate language plays a crucial part in discussing the drug epidemic.

When it comes to decoding the language of the drug epidemic, advocates say using compassionate language is vital when speaking with the people behind the numbers.

This language is also medically accurate, as clinicians’ diagnostic manuals have changed.

“In behavioral health disorders there is, for the past several decades, there has been something called the DSM,” said Michael Haney, director of addiction treatment center PROACT, based in Huntington. “It’s the Diagnostic and Statistical Manual of psychiatric disorders, and there used to be a delineation between abuse and dependence which I think is where the whole idea of addiction dependence got confused because abuse is someone that was a problem user, but it hadn’t gotten to the point where they were truly considered as having a disease or sick.”

In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM 5 was released, removing terms like substance abuse for a more simple term.

“It’s simply use disorder,” Haney said. “And it’s like alcohol use disorder, mild alcohol use disorder, moderate or alcohol use disorder severe. And that really just depends on how much of an impact it’s having on you.”

Laura Lander has lived in West Virginia for nearly 20 years and watched the trajectory of the drug epidemic from a social work perspective as an associate professor at West Virginia University’s (WVU) Department of Behavioral Medicine and Psychiatry.

“And now, it’s really a kind of on a continuum,” Lander said. “So people have mild, moderate, or severe substance use disorder. So that’s the diagnosis. So addiction is really an umbrella term, which is not a diagnostic term, is really more of a descriptive colloquial term that we use.”

Lyn O’Connell, associate director for the Division of Addiction Sciences at Marshall University’s Joan C. Edwards School of Medicine, said avoiding derogatory terms and judgemental labels and instead employing person-first language can increase empathy and reinforce the idea that people are experiencing a health issue rather than a moral failing.

“One of the other reasons it matters is because, and we don’t use this term, but if we refer to someone as an addict, we don’t want to use that term, because it’s not person-centered, and it really dehumanizes the individual,” O’Connell said. “So we want to talk about a person with a substance use disorder because they are still a person. And so we want to refer to that person-centered language. The reason for doing that is also to try and reduce stigma to remind people that there is a person in the conversation.”

O’Connell said that with the understanding that language shapes perception and attitudes, adopting an empathetic approach can pave the way for more effective support systems and treatments. 

“And although people might say, ‘well, that’s not going to change how someone enters treatment,’ it absolutely does. How we refer to programs, how we refer to people, how we talk about issues definitely impact our willingness to have treatment,” O’Connell said. “There’s no better example other than probably a needle exchange versus a harm reduction program.”

According to O’Connell, compassionate language not only benefits those directly affected by substance use disorder but also promotes a more inclusive dialogue among policymakers, health care professionals and the general public.

“Unfortunately, we haven’t done enough to combat that first piece of language, but we really want to make sure that, that terminology has impacted our willingness to treat people or provide funding or to legislate this overall,” O’Connell said.

Lander said using compassionate language doesn’t minimize the severity of the drug epidemic but rather acknowledges the humanity and inherent worth of every individual impacted by it. And it has practical applications as well. 

“Previously, we had found there was a stigma around patients receiving Narcan,” Lander said. “Even though there was a state order in place that people did not need a prescription to receive it. It was hard for them to get it from the pharmacies. And now we have distributed so much free Narcan and it’s almost become like a household item, which on the one hand, you can think of as sad. On the other hand, you can think of as what an amazing thing we have done to really de-stigmatize a rescue medication, which allows people to live long enough to hopefully get into treatment and into recovery.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Experts Say Understanding Terminology Of Addiction Helps Treat The Disease

The drug epidemic is an ever-evolving hot-button topic with tons of buzzwords. But what does it all mean?

The drug epidemic is an ever-evolving hot-button topic with tons of buzzwords. But what does it all mean? Appalachia Health News Reporter, Emily Rice sat down with Susan Mullens, West Virginia Collegiate Recovery Network project coordinator to discuss terminology.

This interview has been lightly edited for clarity. 

Rice: What is the difference between addiction and dependence?

Mullens: Well, addiction is more of a common everyday term that really is its everyday language for substance use disorder. So, substance use disorder is the official name in the Diagnostic and Statistical Manual. And you know, so we just we throw around the word or use the word in common conversation, addiction. Dependence can mean different things.

Rice: When it comes to dependence, people who are quite literally prescribed something by their doctor can be dependent on it. When does that transfer over into addiction?

Mullens: Well, again, addiction is not a diagnosis. And so it’s, that’s not really an accurate progression of the disease, or a great way to describe it, because people talk about being addicted to a lot of things. But you know, do they meet clinical criteria for a diagnosis, is really the question?

Rice: When we’re talking about how the brain works, and once a person is diagnosed with substance use disorder, what changes?

Mullens: Part of it depends on the substance, part of it depends on how long the person has been using. A lot of times, individuals experience other traumas, there could also be undiagnosed traumatic brain injuries and other things. So it’s really an individualized situation. What we know is that the longer people are engaged in care, the better their long-term outcomes are.

Rice: We hear a lot of words around the drug epidemic conversation, could you explain in your own words, what harm reduction means?

Mullens: Harm reduction can mean a number of different things. And unfortunately, it’s gotten somewhat of a bad rap. And one size doesn’t fit all with regard to harm reduction either, but we do know that individuals who engage with harm reduction programs, formal type programs are five times more likely to enter treatment, and three times more likely to stop using substances. And really, the goal of harm reduction is to meet people where they are along that process because not everyone who uses substances wants to stop.

Rice: Yeah, it really does sound like each situation requires a different response. Is bringing that human element into care effective?

Mullens: Yeah, it’s definitely it’s not a cookie-cutter situation. Everyone has different needs. Everyone has different strengths. And everyone has different goals and aspirations. And you know, that’s what our programs try to do is to meet people where they are and not force, anything, any particular view or any particular pathway on to somebody because, you know, it’s, it’s, we all come with unique situations and need a customized recovery pathway.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

W.Va. To Receive $1.5 Million In Suboxone Monopoly Settlement

West Virginia will receive close to $1.5 million from a nationwide settlement.

West Virginia will receive close to $1.5 million from a nationwide settlement with the maker of Suboxone, Indivio Inc. 

Suboxone is a prescription medicine used to treat opioid addiction in adults.

West Virginia Attorney General Patrick Morrisey announced that 41 states and Washington, D.C. have settled with Indivior Inc. for a total of $102.5 million nationwide.

The lawsuit began in 2016 when a coalition of states filed a complaint against Indivior Inc., alleging the company used illegal tactics to preserve its drug monopoly.

The coalition argued the alleged unlawful conduct allowed Indivior time to switch the market to its brand name oral film (a film form that dissolves under the patient’s tongue) before generic manufacturers of the pill form were set to enter the market back in 2009.

“Companies should not resort to improper means to control the market, all the while hurting consumers,” Morrisey said. “Competition is the driving force in a free market economy, and those who resort to improper means will be held accountable to the full extent of the law.”

The agreement requires Indivior to pay a total of $102.5 million.

Indivior is also required to comply with negotiated injunctive terms that include disclosures to the states of all citizen petitions to the FDA, the introduction of new products, or if there is a change in corporate control, which will help the states ensure that Indivior refrains from engaging in the same kind of conduct alleged in the complaint.

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