NEW HANOVER COUNTY — Local officials have started to strategize how to best spend roughly $19.5 million the county and city will receive from the $26-billion opioid settlements announced last year.
Attorney General Josh Stein led the charge on prosecuting pharmaceutical companies for their roles in fueling the opioid epidemic and profiting from the addiction of millions of people. He visited New Hanover County on Wednesday to meet with local leaders at Coastal Horizons treatment facility to discuss the settlement.
New Hanover County was the first of North Carolina counties to file suit four years ago alongside Stein. Stein has been visiting counties over the last few weeks to highlight the local work being done to combat the crisis.
“None of us are so naive to think these funds will solve it,” he said. “But because of these funds and the work of public officials … more people will be alive in New Hanover County next year and the year after than otherwise would have been.”
The number of deaths and opioid overdoses shot up in 2020. Stein said it is considered the worst year in history for opioid abuse. There was a 40% increase in overdose deaths in North Carolina from 2019 to 2020, according to the state Department of Health and Human Services.
“We all believe 2021 was deadlier than 2020, but we have not finished compiling the data yet,” Stein said.
In 2020, there were 93 overdose deaths in New Hanover County and 44 in Brunswick County, with 430 emergency department visits between the two.
Along with leaders from New Hanover and Brunswick counties, Stein toured Coastal Horizons to learn more about what programs the facility offers in helping more than 600 individuals with opioid use disorder each day. It tripled its client base from three years ago. Coastal Horizons uses medication-assisted treatment (MAT), something Stein referred to as the “gold standard” of care.
Coastal Horizons vice-president of clinic services Kenny House said using methadone and buprenorphine, to stabilize brain function, is sometimes the only thing that helps addicts live a normal life. Others view it as more controversial, providing drugs to someone who already has a drug dependency.
“Medications alone do not solve the problem, they simply give people a chance to work at solving the problem,” House said.
He also explained the reimbursement rates for MAT drugs are set from 20 years ago and not nearly high enough to adequately cover costs.
The majority of Coastal Horizons patients are on Medicaid or uninsured but are still able to receive treatment and services.
“One of the things we’re most proud of — if someone needs services, they’re going to be served regardless of their ability to pay,” Coastal Horizons president and CEO Margaret Weller-Stargell said.
MAT is considered the type of “evidence-based” treatment the settlement money is supposed to be used toward.
“Winning these funds was an important development to hold companies accountable,” Stein told elected officials, Coastal Horizons staff and media. “But the money has to go to change lives. It has to be effectively invested by our local government to maximize impacts on the number of people whose lives can be turned around.”
During Wednesday’s tour of Coastal Horizons, Weller-Stargell brought up multiple times her disappointment in elected officials for not choosing the 50-plus-year-old Coastal Horizons to run Trillium’s substance use center on Medical Drive.
The county made a deal in 2018 with Trillium to help fund a treatment facility, in an effort to alleviate local jail populations. Originally announcing Coastal Horizons as the organization to run it, Trillium then chose to contract with The Healing Place, based out of Kentucky. The issue lies with the form of services offered. The Healing Place provides abstinence-based detox services, not MAT.
“Everyone in here knows I’m very vocal about this,” Weller-Stargell said. “It’s disheartening to me that Coastal Horizons was put forward to be the treatment facility here and when the decision came to it, they did not go with us … We’ve been doing this for a number of years and without every treatment option available it will not succeed.”
The county is investing more than $25 million in The Healing Place’s five-building substance-use recovery center. The Healing Place cannot utilize opioid settlement funds to offset costs. The money comes with strict guidelines to be used only for prevention, recovery or harm reduction with initiatives that are evidence-based.
“We should have stuck to Coastal Horizons,” county commissioner Jonathan Barfield said on a call Friday. “All the sudden, we switched forces. I’m hoping the investment we’re making will pay off, but only time will tell.”
Barfield added $50 million is set aside from the $1.5-billion sale of the county-owned hospital to Novant and could go toward The Healing Place for the use of mental health resources.
The commissioner has joined forces with a group of 20 local stakeholders to allocate the incoming settlement funds. It met for the second time Friday to continue deploying a plan of action. County spokesperson Jessica Loeper said the goal is for objectives and needs to be outlined by the end of August.
Out of the $750 million in settlement dollars headed to the state, 85% of it will be put in the hands of local government. At the end of May, the first round of payments should be released, with another three coming to the counties and cities before the end of summer.
Stein said 40% of the funds will be distributed in the first five years to help kickstart initiatives, and the remaining will be spread out over the next 18 years to ensure money doesn’t dry up to maintain those programs.
“I’m hoping we have a strategy to help people,” Barfield said, “not build bureaucracy but help people. And that we’re not getting in our own way. That we will partner with the right community partners.”
The committee includes representatives from Coastal Horizons, LINC, Cape Fear Council of Governments, the fire department and more. It will meet twice a month to brainstorm. Barfield said the group plans to invite individuals directly affected by the opioid crisis to join in on the process.
“We talked about a utopia 2032 where there is no opioid problem and what that looks like,” he added. “It’s thinking outside the box and recognizing that no option is off the table, so to speak.”
Entities receiving the financial benefit will have to annually disclose use of the finances and the outcome through an online dashboard.
“Leaders both elected and civic in New Hanover and the City of Wilmington are at the cutting edge of developing the right kind of collaboration to attack the crisis,” Stein said. “They’ve been wrestling with these issues for years and I’m confident they’ll make wise investments.”
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