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Bottles of prescription painkiller OxyContin made by Purdue Pharma LP sit on a shelf at a local pharmacy in Provo, Utah, U.S. April 25, 2017.George Frey/Reuters

Oklahoma’s legal fight against the opioid industry has racked up settlements and judgments of nearly $1 billion, but as the numbers keep rising, so do concerns over how that money will be spent.

Experts say the $572 million judgment issued Monday against consumer products giant Johnson & Johnson could pay for a year’s worth of statewide drug-treatment efforts. But the company has already announced plans to appeal, which could tie up the money for years. Meanwhile, addiction counsellors worry about when their clients might get more help.

“We get applications every day from people who want help but don’t have the funds to come into our program,” said Lance Lang, who is recovering from an opioid addiction and now helps operate an Oklahoma City non-profit that provides housing for others suffering from addiction.

Cleveland County District Judge Thad Balkman ordered the payment after ruling that Johnson & Johnson and its subsidiaries helped fuel the state’s opioid crisis. The judgment was more than twice the amount Oxycontin-maker Purdue Pharma agreed to pay in a separate settlement.

The allegations against Johnson & Johnson were the first state opioid case to make it to trial, and the outcome could help shape negotiations involving roughly 1,500 similar lawsuits filed by state, local and tribal governments. Those governments are seeking to recover costs ranging from packed jails to overworked coroners and public defenders. Their cases have been consolidated before a federal judge in Ohio.

Lang, who said he became hooked on painkillers after getting his wisdom teeth pulled, said entry into a sober-living home costs about $750 up front and $600 per month.

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“That’s pretty affordable, but I’d say between 50% and 60% don’t have the funds to get in,” Lang said.

Oklahoma’s first settlement — a $270 million deal with Purdue Pharma — was almost entirely earmarked for an addiction research centre at Oklahoma State University. It faced fierce criticism from the families and survivors of the nation’s opioid crisis, who said they wanted a trial to reveal more details about Purdue’s responsibility for the epidemic.

None of the money from Purdue will be spent until a trust has been set up to oversee the funds. A separate $85 million settlement was reached later with Israeli-owned Teva Pharmaceutical Industries Ltd.

“I fear that if the state’s decision on how to spend the Purdue settlement money is any guide, they’re going to fumble the ball and more people are going to die as a result of it,” said Ryan Hampton, who also battled an opioid addiction and wrote a book on the crisis titled “American Fix — Inside the Opioid Addiction Crisis and How to End It.”

“I’m all for research, but spending such a large proportion of money on research at this point when we have people who are literally dying on street corners in Oklahoma because they can’t access services? That is a crime in itself.”

Hampton emphasized treatment options that support not just recovery from opioid addiction, but also other drugs and alcohol.

“The bottom line is that if we’re not setting up an infrastructure that’s all inclusive for behavioural health and addiction services, then we’re setting ourselves up for failure,” he said.

Terri White, commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services since 2007, defended both the state’s settlement with Purdue and the plan for using the judgment from Johnson & Johnson.

The plan “is evidence-based. It’s the gold standard,” White said. “The primary components are prevention and medication-assisted treatment, which is the cutting-edge.”

White acknowledged the state’s 30-year plan called for more than $17 billion and that the money from Johnson & Johnson alone isn’t enough to stop the crisis.

“I think this is going to be a giant first-year step, but I do think it will take more than one year,” she said.

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