Michigan unveils spending on $1.5B opioid settlement, amid secrecy fears

• Michigan will receive about $1.5 billion in opioid settlement money over the next 18 years — funds to address the damage of the deadly opioid epidemic
• The public got its first look at the state health department spending Wednesday, but the head of the advisory commission said it’s missing crucial details
• The funds will be funneled into four areas: prevention, harm reduction, treatment and support for those in recovery

The public got its first look Wednesday at how Michigan plans to spend millions of dollars in opioid settlement money in an effort to address an opioid crisis that claims thousands of lives a year. 

The Michigan Department of Health and Human Services launched a website with details about which companies and organizations will receive funds but some critics — including the head of the Michigan Opioid Advisory Commission — said the state hasn’t provided enough information.

Among spending plans in a 20-page plan called 2023 Opioids Settlement Planning Template:

• $8.5 million in “harm reduction” funds to distribute naloxone, which reverses overdoses, needles and other injection supplies, and test strips for the potentially deadly fentanyl and xylazine, a powerful sedative known as “tranq.”

• $5 million in “treatment” funds to train health providers in working with patients with drug addiction.
• $4.5 million in “recovery funds” to establish “housing recovery grants” to fight homelessness among drug users.
• $2.4 million in “prevention funds” to schools and community groups to expand outreach for youth and to collect data on drug use among them.

Still, precisely who will receive what portion of the funds is unclear on the website. In a five-page document provided to Bridge in response to earlier questions, for example, the state broke down $21.9 million in funds that will be distributed to more than 60 recipients, including health departments, hospitals, treatment centers and advocacy groups. 

Related: 

• Michigan Senate votes to repeal drugmaker immunity shield
• Dana Nessel sues opioid firms under Michigan law intended for drug dealers

The funds are the result of national lawsuits against drugmakers, pharmaceutical companies, and distributors of opioids. The money will be split between local governments, including those tracked by the Michigan Association of Counties.

The other half is sent to the Michigan Opioid Healing and Recovery Fund, and so far has been appropriated to the state health department.

And while some funds have been delayed, others may be forthcoming after being challenged by bankruptcy filings by OxyContin drugmaker Purdue, for example. 

Even before the settlement money, the state had spent about $200 million to address opioid use, said Jared Welehodsky, who manages the implementation of the settlement funds appropriated to the state health department. Among those expenses were the distribution of naloxone kits that help reverse 6,600 overdoses, he said.

It was one of the reasons that, while opioid-linked deaths climbed throughout the first part of the pandemic, the deadly increase wasn’t as steep in Michigan, Dr. Natasha Bagdasarian, the state’s chief medical executive, told lawmakers Wednesday.

According to state data, drug-related deaths fell in 2019 to 2,354, but increased to 2,738 deaths in 2020, the first year of the pandemic, and 3,096 deaths in 2021.

“We were able to weather the storm and weather COVID-19 just a little bit better than many other parts of the country,” Bagdasarian said.

But Bagdasarian also acknowledged the continued increases in deaths, especially among Black Michiganders. 

“We can do better, and we must do better, and we finally have money that we can target towards this problem,” she said.

On the same day as the website launch, lawmakers heard concerns that the state isn’t being as transparent as it should.

“It has felt at times that there has not been meaningful collaboration or bidirectional flow of information,” Dr. Cara Anne Poland, who chairs the Michigan Opioid Advisory Commission, told the Michigan House budget subcommittee for health and human services. Created by the Legislature, the commission is charged with advising the lawmakers on how the funds should be spent.

“We've struggled at times receiving information. We've only been able to access that which is publicly available, which has been a limiting factor for our ability to meaningfully work together,” Poland said, referring to the state health department.

Welehodsky, who at times has been the state representative on the Opioid Advisory Commission, told Bridge in an interview after the hearing the state has, in fact, shared details of the funding, including the state’s plans and how the funds will be distributed, with the commission.

“I’m not sure what other information we can be providing,” he said.

“Our goal is to be able to use this money to save lives, and we're really focused on having it be implemented in a manner (that will) demonstrate the impact of it to the public,” he said.

Michigan is one of just 16 states that has not committed to publicly reporting how it will spend much of the more than $1.6 billion in funding to the state in the next 18 years, according to a settlement tracker, which analyzes state’s spending, and reporting by KFF Health News.

Beyond the need for transparency for any government spending, these funds are being prioritized through citizen input for a crisis that is ongoing, Poland, of the advisory commission, said.