Former Mississippi Attorney General Mike Moore, known for his role in the landmark tobacco settlement in the 1990s, has raised concerns about state and local governments potentially mishandling the $50 billion windfall from opioid settlements. Moore, who represented several states and local governments in lawsuits against drug companies and distributors involved in the addiction epidemic, fears that without strong accountability measures, the funds may be misspent or spread too thinly to effectively address the opioid crisis.

The opioid epidemic has had devastating consequences, with drug overdose deaths increasing fivefold in the last two decades. Initially fueled by prescription opioids, the crisis has since escalated to include heroin and illicit fentanyl.

Moore emphasizes the importance of avoiding the mistakes made with the tobacco settlement, where states used the multibillion-dollar settlements to fill budget gaps, fix infrastructure issues, and even compensate tobacco farmers. He cautions that a lack of real accountability and penalties for misusing the settlement dollars may lead to similar mismanagement in the case of the opioid windfall.

One of the challenges is the sheer number of recipients of opioid settlement dollars, with approximately 4,000 claims filed by state and local governments. This poses a significant obstacle in developing a coordinated and effective response to the opioid crisis. While some states like Ohio have implemented comprehensive plans, others have adopted a more fragmented approach, leaving decisions up to local government officials.

Already, there have been instances of early opioid settlement funds being spent on items such as new police cruisers, phone-hacking equipment, and restraint devices for law enforcement. Moore raises concerns about money being distributed to cities and counties without the necessary infrastructure and regional collaborations in place, potentially limiting the positive impact of the funds.

To address these concerns, 85 percent of the opioid settlement money has been designated for opioid abatement. The settlement agreements also include templates outlining strategies agreed upon by experts to reduce and prevent opioid use. However, Moore stresses that without strong oversight and accountability, the effectiveness of the settlement dollars remains uncertain.

According to Moore, some states are setting up robust organizations to oversee the funds, with Florida and Ohio leading the way by establishing boards overseen by the attorney general. However, he highlights the need for someone to monitor the spending to prevent potential misuse.

Reflecting on his experience with the tobacco settlement, Moore laments the lack of mandated spending on combating the issues at hand. He underscores the importance of having a clear plan on how to use the funds before their receipt to ensure they are used to address the opioid epidemic effectively. He mentions the successes of public education campaigns in curbing tobacco use and suggests a similar approach could be applied to the opioid crisis.

Despite the challenges posed by the pervasiveness of illicit fentanyl and synthetic opioids, Moore believes that focusing on prevention and education programs, ensuring access to naloxone (Narcan), and expanding treatment options are crucial steps in combating the opioid crisis.

However, concerns remain about the level of transparency and accountability in how the settlement dollars are spent. Moore points out that there are no significant penalties for noncompliance and highlights the need for independent task forces or commissions to ensure accountability in the long run.

As the opioid settlement funds begin to flow into state and local governments over the next two decades, the nation awaits to see how effectively the crisis will be tackled and lives saved. With lessons learned from previous settlements, it is essential to prioritize the funding and implement robust plans that address the root causes of the opioid epidemic.