In March 2019, New York Attorney General Letitia James filed the country’s most extensive lawsuit against the manufacturers and distributors responsible for the opioid epidemic. 

Two years later, several of the companies have settled with the state, generating billions of dollars to help heal the communities in New York hit the hardest by the epidemic. 

On July 20, three major opioid distributors — McKesson, Cardinal Health and AmerisourceBergen — will pay up to $1.1 billion to New York. 

This comes just weeks after James helped shut down Purdue Pharma and secured $4.5 billion from members of the Sackler family for treatment nationwide and less than a month after settling with Johnson & Johnson for $230 million on June 26.

"For more than two decades, the opioid epidemic has wreaked havoc on countless communities throughout New York and across the rest of the nation, killing hundreds of thousands of our friends and family members and poisoning millions more,” James said in a press release. "While no amount of money will ever compensate for the millions of addictions, the hundreds of thousands of deaths, or the countless communities decimated by opioids, this money will be vital in preventing any future devastation."

These settlements will go into the newly formed Opioid Settlement Fund, which Gov. Andrew Cuomo signed into law late June.

Throughout the COVID-19 pandemic, New York and the nation saw an increase in opioid overdoses. Over 93,000 people died from drug overdoses in 2020, a 29.4% increase from 2019, according to newly updated provisional data from the Centers for Disease Control and Prevention.

"It’s largely due to the isolation of the pandemic," New York State Senator Pete Harckham said. "Isolation is the absolute worst thing for people in recovery or people struggling with substance use disorder and behavioral health issues. This was a really hard time for people."

At the height of the mental health crisis brought on by the pandemic, Gov. Cuomo put 10 regional state-wide crisis centers for behavioral health in the state budget. These centers would admit people at all hours without referral including drop-offs by first responders and law enforcement.

"One of the things that I am hoping comes out of this [the opioid settlements] are the 10 crisis centers," Harckham said. 

Harckham, who is the chairman of Committee on Alcoholism and Substance Abuse and co-chair of the Senate Task Force on Opioids Addiction and Overdose Prevention, co-sponsored the legislation, visited Western New York earlier this month.

The region, which covers cities like Rochester and Buffalo and more rural swaths of the state, saw an increase in opioid overdoses throughout the pandemic.

There will be regional apportionment of the opioid funds, Harckham said. 

"The counties, as well as the state, were a part of the litigation, so there will be representation," Harckham said.

The state is not monolithic in its infrastructure. While downstate has more accessible and reliable public transportation, in Western New York and more rural communities throughout the state, transportation presents itself as a major barrier to addiction treatment. 

A major solution to that barrier is mobile syringe exchanges and continuing telehealth services. 

"There are successful models in New York state, we will have to expand on those models allowing new providers to do it or empowering existing ones to expand," Harckham said. "Transportation also applies to the people in treatment."

A potential program could help expand Medicaid-funded transportation to expand beyond treatment appointments to include jobs, school and childcare, Harckham said. 

Other ways the funds will be used include increasing the reimbursement levels to improve salaries of addiction treatment staff, which will help with recruitment and retention and ending prior authorization for Medicaid in regards to opioid use disorders. 

Medicaid is the largest payer of behavioral health services in the nation, and if New York ends prior authorization, it will help decrease delay times for those seeking treatment, saving the state roughly 600 lives per year and millions of dollars in emergency room and hospital care each year.

Other initiatives that could be underway include improving access to Medically Assisted Treatment in correctional facilities, harm reduction programs like needle exchanges and Narcan distributions and keeping telehealth for substance use treatment accessible. Sen. Harckham passed a bill that helps providers bill telehealth services the same as in-person visits, making it more sustainable.

The programs and initiatives from the Opioid Settlement Fund will take time to come to fruition as the state waits to receive the funds from the major distributors and manufacturers, Harckham said. But the state will be getting a $100 million federal block grant to deal with the opioid crisis. 

Camalot Todd is a National Press Foundation 2021 Opioid and Addiction Fellow.