AUSTIN — As Texas officials continue to pursue compensation from opioid manufacturers and distributors, boots-on-the-ground advocacy groups are cautiously optimistic about what settlement money could mean in ending, or at least combatting, the opioid epidemic.

In 2021, Texas reached several settlements with opioid drug makers and distributors including Johnson & Johnson, AmerisourceBergen and most recently Endo Pharmaceuticals for their role in perpetuating the opioid epidemic which in 2018 killed more than 1,400 Texans, according to the National Institute on Drug Abuse.

That same year, Texas providers wrote 47.2 opioid prescriptions for every 100 state residents, data shows.

“Many Texans suffer from addiction and need significant support and treatment to avoid becoming another statistic,” Texas Attorney General Ken Paxton said. “My office will continue to hold the companies that contributed to this crisis accountable and ensure that sufficient funds flow to Texas to provide much needed relief to our citizens.”

With these settlements, the state is expected to bring in an estimated $2 billion in settlement cash, much of which will go to the Texas Opioid Abatement Fund, established in the 87th legislature to manage payments received by the state from opioid manufacturers and distributors. The established fund will ensure settlement money is allocated fairly and spent to remediate the opioid crisis using efficient, cost-effective methods, according to the state’s website.

Records show at least 70% of the awarded money will be sent to the fund.

As of a Jan. 2 deadline, more than 480 Texas counties and cities had signed on to receive some kind of assistance from the fund, as part of the multi-state effort to hold companies accountable. The Texas Opioid Council has been tasked with deciding how and where that money will be spent.

“It’s time for us to come together again as only Texans can, maximize our recovery, and take care of our citizens so that we can serve as an example for the rest of the country,” Paxton said.

Jennifer Sharpe Potter, a professor of psychiatry at UT Health San Antonio, said she hopes the money will help push the state forward in how it perceives and treats opioid addiction.

Potter, who runs Recovery Texas — a website that offers access to immediate, peer-to-peer support services — and Be Well Texas Clinic — which hosts several recovery programs including a 24-hour visual clinic, said she believes the money could be transformative in how the state address substance use disorders by removing some of the many barriers.

One of the biggest barriers, she said, is access to affordable, effective treatment, which her programs look to address.

According to the National Institute of Health, methadone treatment, used to treat narcotic drug addiction, costs about $4,700 per year. This assumes daily visits and includes medication as well as integrated psychosocial and medical support services. Buprenorphine, given to stable patients in certified opioid treatment programs, can cost nearly $6,000 per year, including medication and twice weekly visits, it said. 

“We know how to treat opioid use disorder. What we don't do well is how to get that treatment out into communities,” Potter said.

Harris County, the state’s most populous county, suffered the greatest number of opioid-related deaths in 2019 at 564, according to Texas Department of State Health Services data. This was followed by Dallas, Bexar, Tarrant and Travis counties, respectively.

Suzanne Jarvis, director of Data and Program Analytics at the Houston Recovery Center, said another big obstacle facing opioid use disorder is the stigma attached to drug use.

Jarvis said since there are few health conditions that have negative ripple effects into one’s life like loss of housing or a job equal to opioid use disorder, it can be difficult for society to see it as a treatable disorder and not a moral failing.

“It is a chronic health condition that can be managed over time, [but] it needs to be seen and treated that way,” she said. “We don’t punish diabetics when their sugars are off.”

Jarvis said that she hopes the state funding is used to align policies and programs in political, social and medical structures in a way that produces better health outcomes for people.

This, she said, starts with education as opioid use disorder is a preventable health condition often formed due to genetic and social factors. Then, should someone need treatment, ensure that it is timely and affordable.

“I just think the more open and educated we get, the better the solutions that will come for all of us,” she said.

Jarvis added that with the funding, she hopes the council will appropriate money based on greatest need. In doing this, she said she hopes the council directly works with advocates and communities to evaluate what their needs are and best approaches for their communities, as they vary greatly.

“It's very hard to do, but it does create an opportunity to direct the funds to the biggest bang for the bucks,” Jarvis said.

Texas Comptroller Glenn Hegar will be executive director of the council. His office was not immediately available to confirm when the council will convene or when money will be made available.