Pima County's $48M cut of 18-year nat'l opioid settlement to help prevent overdose deaths

Pima County is set to receive $48.5 million from a national opioid settlement over the next 18 years, and plans to use the money to prevent more overdose deaths from fentanyl and other drugs, officials announced Wednesday. All of the money that the country gets now and in the future will be put towards fighting the opioid crisis, official said.

The payout to Pima County is their share of two settlements totaling $26 billion. The settlements, reached in July 2021, ended lawsuits brought by state attorneys general from all 50 states against major opioid manufacturer Johnson & Johnson and the three pharmaceutical distributors of opioids — Amerisource Bergen, Cardinal Health and McKesson.

The three distributors will collectively pay about $21 billion through the next 18 years while Johnson & Johnson will pay up to $5 billion over nine years, with $3.7 billion to be paid during the next three years.

Pima County received an electronic transfer of $1.5 million in September that marked their first bit of the settlement money, according a county memo. Officials vowed Wednesday that all of the local share will go towards preventing more overdose deaths via drug education in schools, a public awareness campaign about opioid overdoses and Narcan distribution, among other efforts.

A second portion of the settlement is expected to be transferred soon, Dr. Francisco Garcia, the county’s chief medical officer, said Wednesday. The settlement amount is “modest,” Board of Supervisors Chair Sharon Bronson said, but “it’s a big deal.”

State recreational marijuana tax and licensing fee revenue also goes to county health departments and can be used to fund preventative opioid revenue, according to the county memo. The first year of those allocations, made possible from Prop. 207 passing in 2020, was worth $500,000, according to the memo.

Pima County Attorney Laura Conover listed off a few ways of that the money could be used, from buying more Narcan and fentanyl testing strips, which test for the  powerful opioid in other drugs, to preventive education programs at schools and youth organizations. The county hopes to work with their Tucson metro partners to "identify needs" related to the opioid crisis.

The Pima County Health Department will decide how to use the money through its Board of Health. The health board will panel a subcommittee with representatives from each of the county’s five districts to decide how to use the settlement money.

The Health Department expects to include towns and cities — such as South Tucson, Sahuarita and Tucson, among others — in their plans for using the settlement money, Garcia said.

“This isn’t a Pima County problem,” he said. “This is a problem for all of us and all of us have to be at the table.”

Narcan and the Good Samaritan law

In addition to announcing the settlement, county officials also shared plans to launch a public information campaign, mostly through English and Spanish radio ads but also with TV commercials, about how to inject Narcan, a nasal spray that can reverse an opioid overdose if given quickly.

Narcan, the brand name for the nasal spray form of the drug Naloxone, is free and available at libraries, religious centers and county clinics throughout the Tucson metro area and in certain parts of rural Pima County. The treatment does not have damaging health effects, officials emphasized.

The awareness campaign also aims to tell Pima County residents that they’re protected by the state’s “Good Samaritan Law” from facing criminal charges for possession of drugs if they call 911 to help an overdose victim, Conover said.

“When you don’t hesitate and you call 911, the message from your chief or your sheriff or myself is that you are protected against prosecution,” Conover said. “You are a good samaritan, even when law enforcement comes to the scene and there's evidence of a simple (drug) possession or paraphernalia.”

'A serious crisis'

Fentanyl and opioid deaths are a “serious crisis” locally, Conover said, because of the “ways it’s affecting our streets, our neighborhoods, our businesses.”

“A real escalation” in opioid deaths in Pima County started in 2014, Garcia said. The county has seen 299 deaths from opioids so far in 2022, Garcia said.

Use of opioids — primarily fentanyl but also heroin — has “become the dominant drug abuse currently in this community,” Garcia said.

The racial demographics of Pima County’s opioid overdose victims vary by age group, Garcia said. Elderly victims of opioid overdose tend to be white, but younger victims tend to more often be people of color.

The crisis also “spans the breadth” of socioeconomic demographics, with both the “very poor and much more affluent” dying from the opioids.

“This is all of our problems,” he said. “This is a common problem that we are all having and it will require that kind of coordinated, collaborative and robust approach to solve it.”

Garcia also pointed out the opioid crisis started with the use of prescription opioids, which largely affected older populations.

Fatal overdoses in Pima County from any kind of drug “have been increasing tremendously since 2011,” Bronson said. Most of the deaths have been from fentanyl, meth and cocaine, she said.

Opioids “contribute to the highest number of overdoses treated in our own emergency departments,” Bronson said. “”Fentanyl is the most common substance involved in these visits.”

Since 2017, Pima County has had over 2,015 deaths from opioid overdose, Garcia said. Of those deaths, 60 of them were of people younger than 19 years old, he said, and the oldest person to have died from an opioid overdose in that timeframe was 88 years old.

“This is something that is now impacting everyone from our very youngest, to our very oldest,” he said. “This is affecting every single neighborhood, every single Census tract and every single family in one way or another. Whether we choose to look for it or not, it is the reality of the world that we live in.”

People in their 20s die from these overdoses in Pima County, Bronson said. Instances of neonatal abstinence syndrome, which affects babies in the womb during an opioid addiction, is also on the rise in Pima County, she said, with an increase in such cases over the last three years.

Opioid use is also “generating a lot of illicit activity,” Garcia said. County attorneys are bringing down manslaughter indictments on drug dealers distributing fentanyl and other opioids, Conover said, “to say there will be accountability when you harm our community in this way.

“It’s an illness that’s affecting our youth and at an overdose rate that is unacceptable,” Conover said.