Maximizing Texas’s Opioid Settlement: Investing in Treatment & Rehabilitation

The US has been experiencing an opioid crisis since the mid-90s. This was around the time when there was a shift in how doctors prescribed pain medication. Pharmaceutical companies downplayed the addictive potential of opioids, and doctors were encouraged to prescribe them more liberally for chronic pain. Sadly, this led to a significant increase in the number of people taking prescription opioids like Percocet and OxyContin.

As more people were exposed to opioids, rates of addiction and misuse skyrocketed. Many who became addicted to prescription drugs eventually turned to cheaper, more dangerous alternatives like heroin, further inflating overdose deaths. The rise in opioid overdose deaths paralleled the increase in opioid prescriptions, highlighting a clear link between the two. 

After the CDC survey that found over 10 million patients misused prescription opioids in 2018, it, along with states like Texas, declared an opioid epidemic and changed prescription standards. Texas and 13 other states took the drug companies to court, with both Democrat and Republican attorneys general teaming up to sue. 

In July 2021, a significant agreement was made: Johnson & Johnson and three drug distributors agreed to cough up $26 billion to settle the case. But other settlements, including with OcyContin manufacturer Purdue Pharma, are still pending. Texas is expected to get about $1.6 billion from six companies over 18 years as part of these settlement agreements.

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The Current State of Opioid Addiction in Texas

Texas is experiencing a drug poisoning epidemic. According to surveys, deaths from poisoning in the state increased by more than 75% in just five years. In 2017, the rate was 9.4 deaths per 100,000, and that nearly doubled to 15.8 deaths per 100,000 residents in 2021.

Although the prescription of opioids by doctors in Texas has reduced over the last few years, overdose deaths from illegally manufactured fentanyl continue to rise. A CDC report estimates 5,566 drug-related deaths occurred in Texas between August 2022 and August 2023. 45% of these deaths involved fentanyl.

The human cost of opioid addiction is immense. For every statistic, there’s a person and a story—a family member, a friend, or a neighbor whose life has been affected. Beyond that, the opioid epidemic is putting a strain on all levels of care. Hospitals and emergency services are overwhelmed by the number of overdose cases they handle daily.

This strain makes it harder for everyone to get the care they need. Local resources such as law enforcement and social services are also stretched thin trying to manage the wide-ranging consequences of the opioid crisis. 

The Potential Impact of Strategic Investments 

The $1.6 billion settlement presents a significant opportunity for Texas to combat the opioid crisis effectively through strategic investments. Proper allocation of these funds can profoundly impact the state's ability to support the people who are struggling with addiction, improve public health, and reduce the overall burden of the crisis.

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Let’s explore some key areas where strategic investments can make a difference:

Expansion of Treatment Facilities

There’s a need for more treatment facilities so more people can get the help they desperately need. With more money, we can build new treatment centers and improve upon the ones we already have. This means people won’t have to wait so long to get care. These centers can offer a variety of services like detox, inpatient and intensive outpatient treatments, and special treatments for mental health conditions. More facilities means increasing the number of beds, doctors, and nurses, which ultimately leads to saving more lives.

Enhancement of Recovery Support Services

The money can also go to recovery support to give people the tools they need to rebuild their lives. This includes access to counseling and therapy, which are crucial for long-term recovery. Programs that offer stable housing and job training can help people recover and stay sober.

We can also create peer support groups and mentorship programs where people who have been through recovery can offer support and advice. These services build a strong support network that can make a huge difference.

Implementation of Prevention Programs

Preventing addiction before it starts is key to tackling the opioid crisis. When we invest in prevention programs, we can educate communities about the dangers of opioid misuse and teach healthy coping strategies.

Schools, workplaces, and community centers can run educational programs to raise awareness. Early intervention programs can identify at-risk people and help them before things worsen. Strengthening prescription monitoring systems can also prevent misuse and diversion of opioids. Prevention efforts can stop the cycle of addiction before it starts, saving lives and reducing the impact of the crisis. 

Misallocation of Opioid Settlement Funds Raises Concerns

In the wake of the opioid crisis, states across the country have received significant settlement funds intended to combat addiction and support affected communities. However, there are growing concerns about how these funds are being used. Instead of directing the money towards prevention and treatment options, some states are spending it on things like new police cars and slush funds that don't directly help those struggling with substance use disorders.

Police Cars and Equipment

In several states, portions of the opioid settlement funds have been used to buy new police cars and other law enforcement equipment. While law enforcement is crucial in addressing the crisis, these expenditures don’t provide the necessary treatment or support for individuals battling addiction.

Filling Budget Gaps

Some states use the funds to cover general budget shortfalls or unrelated projects. This means the money isn’t going to addiction treatment or prevention programs, which undermines efforts to combat the opioid epidemic.

Lack of Transparency

In some instances, funds have been placed into slush funds with little oversight or accountability. Without explicit tracking, it’s hard to ensure the money is being used to help those who need it most.

The Need for Transparency and Accountability

Unless the state and local governments put the funds to good use, they won’t help those affected. The state can ensure this happens by:

  1. Establishing robust oversight mechanisms. This includes transparent reporting, regular audits, and involving community stakeholders in decision-making processes.
  2. Learning from the missteps of other states, where funds have been diverted to unrelated expenses like new police cars and slush funds, Texas must commit to using the settlement money exclusively for addressing the opioid crisis.
  3. Strategically allocating funds to areas with the highest need and potential impact. This way, Texas can maximize the benefits of the settlement, supporting recovery, reducing overdose deaths, and ultimately diminishing the overall opioid crisis in the state.
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How to Track Fund Usage in Your Community

There are several resources available to help track the allocation and use of opioid settlement funds:

News Sites

While the information might not be readily available, some platforms, like KFF Health News, have made it public after negotiations.

Government Websites

Check state and local government websites for information on fund allocation and spending. Look for sections on budget reports, public health initiatives, or opioid response plans. BrownGeer, a court-appointed firm administering the settlements, also shares the information on a public website.

Public Records Requests

You can file public records requests to obtain detailed information about funds' use. Do this through state or local government offices handling public information requests.

Community Advocacy Groups

Local advocacy groups focused on addiction and public health, such as the Texas Harm Reduction Alliance and the Texas Overdose Naloxone Initiative (TONI), can be valuable resources for information and action.

Opioid Addiction Treatment at More Than Rehab

At More Than Rehab, we’re committed to making a real impact. We offer comprehensive care, from detox and therapy to long-term support and education. Our mission is to provide a safe, supportive environment where people can recover and thrive.

With the right investments and a commitment to transparency and effectiveness, we can make a significant difference in the fight against the opioid crisis in Texas. Let’s work together to ensure these funds are used to their fullest potential, helping those in need and building healthier communities across our state.

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The Price of Pills: The Hidden Costs of Drug Use

Pills have become integral to modern medicine, helping individuals manage pain, treat illnesses, and improve overall health. They are a vital component of health care – with over 131 million people (66%) of all adults in the US using prescription pills. However, the use of prescription drugs can also come at a high cost. This is the real price of pills.

Statistics show Americans spend more on prescription drugs, averaging about $1,300 per person yearly. And with almost half of the prescription medicines being paid out-of-pocket, the financial burden can be overwhelming.

But the true cost of prescription drug abuse extends beyond the price tag. The financial cost of prescription drugs can negatively impact physical and mental health, social relationships, career prospects, and personal safety.

This article will explore how drug use can impact an individual's life and why it's essential to be aware of the hidden costs. We'll also discuss the difference between drug misuse and drug abuse, the risk factors, and how to uncover the signs of prescription drug abuse.

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Prescription Pills and Addiction

Prescription pills are highly effective in treating various medical conditions. When taken as directed by a healthcare provider, they can provide significant relief. However, the misuse and abuse of prescription medications can lead to addiction and other negative consequences. Sadly, the Substance Abuse and Mental Health Services Administration reveals that prescription drug use is the fastest-growing drug problem in the United States, especially among young people.

Prescription pill addiction happens when individuals take medications beyond the prescribed dose or for reasons other than their intended use. This behavior can lead to physical dependence, where the body relies on the substance to function normally. Those addicted to prescription pills may experience withdrawal symptoms when they try to stop taking the drug.

The difference between prescription pill misuse and abuse lies in the severity and frequency of the behavior.

Misuse refers to using the drug in a manner other than prescribed, such as:

Misuse can be dangerous and potentially lead to addiction. But it does not necessarily indicate a substance use disorder.

On the other hand, prescription pill abuse refers to using the drug in a manner that is harmful, dangerous, or compulsive. Abuse can lead to physical and psychological dependence and negative consequences like health problems, self-harm, legal issues, and strained relationships. Abuse of prescription pills is a serious concern and requires professional help to overcome.

Some risk factors that increase the likelihood of prescription drug abuse are:

With that in mind, let's look at some hidden costs of drug use.

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The Cost of Prescription Drug Abuse on Relationships

Prescription drug abuse can have a profound impact on all types of relationships. But the biggest casualty of addiction is intimacy between partners. Substance use disorders can create a rift between partners as the person using drugs shifts their attention to obtaining and using drugs than to maintaining the relationship. The trust that was once there can be lost, and the relationship can become strained or even completely shattered.

Beyond that, the financial impact of prescription drug abuse can cause a significant strain on relationships. The cost of addiction can quickly become overwhelming, leading to financial instability and debt.

The partner abusing pills may spend considerable money on obtaining drugs. This may translate to missed bill payments, unpaid debts, and bankruptcy. Such financial stress can further strain the relationship and lead to resentment and mistrust.

In extreme cases, partners abusing pills may turn to illegal activities, like theft or fraud, to support their addiction. This behavior can have legal consequences and can further damage the relationship, leading to feelings of betrayal and anger. There are also legal costs that may come to play.

The Cost of Prescription Drug Abuse on Career

Prescription drug abuse can also significantly impact an individual's career. Those who abuse prescription drugs may struggle to maintain a job or perform their duties at work. They may be absent or late for work due to drug use or perform poorly due to the effects of the drugs. This can lead to job loss, difficulty finding new employment, and financial instability.

Drug abuse can also lead to legal and disciplinary actions at work. For example, if an employee is found to be using prescription drugs without a valid prescription or is caught using drugs while on the job, they may face legal consequences or disciplinary actions from their employer. This can result in a tarnished reputation and limited career prospects in the future.

There's also the comorbidity issue, where mental and addiction problems co-occur. According to studies, those struggling with addiction are likely to struggle with mental problems, as one issue often leads to another. Comorbidity can further impact career – as depression and anxiety may affect one's ability to work.

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The Cost of Prescription Drug Abuse on Health

Prescription drug abuse can have severe health consequences, ranging from short-term side effects like dizziness, nausea, high blood pressure, and confusion to long-term impacts such as heart and liver damage, respiratory problems, and increased risk of overdose. Some prescription drugs, such as opioids and benzodiazepines, can lead to physical dependence and addiction, further worsening health outcomes and severe withdrawal symptoms.

Beyond the direct health impacts, prescription drug abuse can increase the risk of accidents and injuries, including falls, car accidents, and other types of trauma. They can also exacerbate existing health problems, like mental health conditions, and interfere with medical treatments for other illnesses.

Most notable is the cost of addiction treatment. Treatment options such as detoxification, inpatient rehabilitation, outpatient therapy, and medication-assisted treatment can be expensive and may not be covered by insurance. The cost of addiction treatment can further exacerbate financial instability and debt, leading to additional stress on relationships and careers.

Cost of Prescription Drug Abuse on Education

Prescription drug abuse can hurt academic performance and educational outcomes, particularly for young people. Substance use can interfere with learning and memory, making it difficult for students to retain information and perform well on exams. Drug use can also lead to absenteeism, tardiness, and difficulty concentrating in class, leading to lower grades and an increased risk of dropping out.

As with other mind-altering drugs, prescription pill abuse can impair judgment and inhibition, putting young adults at heightened risk for HIV and other STIs, misusing different types of drugs, and engaging in other risky behaviors. According to SAMHSA, most adolescents who misuse pain pills get them from friends and family, including their home's medicine cabinet.

Prescription drug abuse is a serious issue that requires prompt attention and intervention. If you or someone you know is struggling with prescription drug abuse, you must seek help from an addiction specialist. With the proper treatment and support, it is possible to overcome prescription drug abuse and lead a healthy, fulfilling life.

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How Prescription Drugs Helped Fuel the Drug Overdose Epidemic

The opioid epidemic is a serious public health crisis that has been ravaging communities in the United States for years. While many of us may associate illicit drugs such as heroin with causing drug overdoses, prescription drugs have also played a significant role in this devastating trend. The widespread availability and ease of obtaining these medications, combined with their powerful strength and addictive properties, have resulted in an alarming rise in overdose deaths due to prescription drug misuse.

Data from the Centers for Disease Control and Prevention's statistics indicate about 107,622 drug overdose deaths in the US during 2021. Synthetic opioids like fentanyl were responsible for a large portion of the deaths, accounting for 71,238 deaths. But prescription opioids (such as oxycodone and hydrocodone) were also major contributors to the crisis. According to the CDC, natural or semi-synthetic drugs accounted for 13,722 overdose deaths in 2020 and 13,503 in 2021.

These deaths were attributed mainly to over-prescribing opioid painkillers like OxyContin, which has led to numerous cases of physical dependence and addiction. In 2016, the CDC issued a national guideline on pain management to help improve appropriate opioid prescribing and minimize opioid-related risks. The guideline got a lot of support from Americans, especially in two key elements: advising physicians to issue less than a three-day supply of opioid painkillers for acute pain and trying other treatment options before considering opioids for chronic pain.

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Understanding Prescription Drugs Misuse

Prescription drugs are obtained with a doctor's prescription. They treat medical conditions, including pain, anxiety, and depression. However, they can also be abused due to their powerful effects.

Prescription drugs, like any other drug, can lead to substance use disorders as an unintended consequence. It is well-documented that these medications can be highly addictive and are major risk factors for people developing opioid use disorder.

The false sense of safety that comes with obtaining these medications from a doctor or pharmacy can lead some people to take them in ways they weren't prescribed. For example, they will:

Besides, since many people store these drugs in the medicine cabinet, they can be easily accessible to others, including young people. This increases the risk of them being taken and abused without the supervision of a healthcare professional. Taking someone else's medication can lead to dangerous side effects and death.

How Prescription Drug Abuse Contributes to the Overdose Crisis

Prescription painkiller abuse has become a major contributor to the overdose crisis in the United States. These drugs are often prescribed for legitimate medical conditions, such as pain management or attention deficit hyperactivity disorder (ADHD). However, when used improperly or for non-medical reasons, they can lead to substance use disorders, addiction, and even overdose deaths.

There are several ways in which prescription drugs like Oxycontin, Adderall, etc., contribute to the overdose crisis:

One of the ways is through the development of opioid dependence. People prescribed opioids for an injury or chronic pain may start to rely on them for relief, leading to a physical dependence on the drug. As their tolerance builds, they may need to take higher doses to achieve the same level of pain relief, increasing their risk of overdose.

Another way is through the use of street drugs. When people become dependent on prescription opioids and cannot obtain them, they may turn to street drugs like heroin to manage their withdrawal symptoms. Heroin is often cheaper and more readily available than prescription opioids, making it an attractive option for those struggling with addiction. However, street drugs are often more potent and can lead to a higher risk of overdose.

Polydrug use is also an issue, particularly when people combine opioids with alcohol or other sedatives. This practice often increases the risk of overdose and can be deadly.

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Who is to Blame for the Opioid Crisis?

It's important to note that the misuse of prescription drugs is not solely the patient's fault. Physicians have been criticized for overprescribing opioids, with some labeled as "pill mill doctors." They were seen as contributors to the crisis due to their over-reliance on opioid prescriptions to manage pain rather than exploring alternative treatments.

Pharmaceutical companies such as Purdue Pharmaceuticals have also been blamed for the crisis. Purdue, the real co-conspirator, was accused of downplaying the risks of addiction and exaggerating the benefits of OxyContin. It was also blamed for aggressively marketing the drug to physicians and misleading the public about the safety of its products.

The third guilty party is the American Pain Society, with its "pain as the 5th vital sign" campaign. This campaign promoted the idea that pain should be treated as a vital sign, like temperature, pulse, etc. However, it didn't come with any device to objectively measure pain as the previous vital signs, pulse temperature, respiratory rate, and blood pressure.

The 5th vital sign campaign was the first and only subjective vital sign. It led to a significant increase in opioid prescriptions, as doctors were pressured to treat patients' pain more aggressively.

Fourth on the list of blame is the Joint Commission. In 2001, it issued a mandate that required hospitals to use pain scales to evaluate patients' pain.

The commission also published a pain management guide that downplayed doctors' concerns about opioid addiction, tolerance, and risk of death. Additionally, it framed pain management as a patient's rights issue, increasing the pressure to prescribe opioids. Purdue Pharma sponsored this guide. 

Press Ganey is the fifth guilty party on the list. This company helped develop patient satisfaction surveys. The results of these surveys were then used to rank hospitals.

Then enters, the Centers for Medicare and Medicaid Services (CMS) issued a mandate to hospitals in 2002. The mandate threatened their Medicare reimbursement if patient satisfaction scores didn't meet specific standards. Patient satisfaction was based on surveys that included them scoring their satisfaction with pain control.

Inevitably, hospital administrators made it to the blame list. With CMS' mandate, hospital administrators felt pressure to increase patient satisfaction scores by any means necessary. So they started to pressure doctors to prescribe more opioids for pain management and patient satisfaction. This eventually led to overprescribing and misuse of opioids.

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Prescription Drugs Lawsuits

Numerous lawsuits have been filed against major pharmaceutical companies and high-profile figures concerning the opioid epidemic. One notable example is the lawsuit against Purdue Pharma, the maker of OxyContin. The company and members of the Sackler family, who owned Purdue, have been accused of aggressively marketing OxyContin while downplaying the risks of addiction, leading to the widespread abuse of the drug and the opioid epidemic.

In 2019, Purdue Pharma pleaded guilty to federal criminal charges and settled with the Department of Justice. The company and the Sackler family agreed to pay $8 billion in fines and penalties.

States and municipalities have also sued Johnson & Johnson, Teva, and Endo International over their role in the opioid epidemic. In 2021, Johnson & Johnson was ordered to pay $572 million in a landmark opioid trial in Oklahoma and is currently facing lawsuits in several other states.

Teva has settled with New York for $523 million and is working to finalize a nationwide settlement valued at more than $4.2 billion. And Endo which has now filed for bankruptcy has agreed to pay $450 million to support the treatment and prevention of opioid abuse. 

Opioid Abuse Treatment

More Than Rehab offers a range of treatment options to help those struggling with opioid addiction and substance abuse break the cycle and achieve long-term sobriety. The treatment center provides an array of evidence-based therapies, including individual and group counseling, medication-assisted treatment (MAT), relapse prevention training, and more.

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Why Are Older Adults Abusing Drugs More Than Ever?

Substance abuse among older adults is a significant issue that can have severe consequences for the health and well-being of older adults and those around them. Despite this, drug abuse rates among older adults are increasing faster than any other age group. A 2018 Substance Abuse and Mental Health Administration survey found that approximately one million seniors above 65 (or 2% of the senior population) had a substance use disorder in the past year. Some 3% use marijuana, and 1 in 10 engage in binge drinking.

The pandemic didn't help either, as lockdowns disrupted routines, isolation, and fear spread. 2020 reports from the National Center for Health Statistics showed a shocking 53% increase in opioid-related deaths among the baby boomers over the previous year. Alcohol-related deaths, which had already been rising for a decade in this age group, rose by 18%.

All these numbers lead us to the question, why are more older adults in the United States abusing drugs than ever before? This article will explore potential causes of this trend, including loneliness, boredom, mental health problems, and lack of access to appropriate healthcare.

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Prescription Medication

One of the key factors behind increasing substance abuse among older adults is the use of prescription medications. Older adults may face an increased risk of chronic pain, heart disease, and other health conditions as they age.

As part of quality health care, prescription medications can help relieve symptoms and improve the quality of life. However, if the medication is misused, it could lead to abuse. Sadly, many senior citizens abuse prescription medications for reasons like:

Social Isolation

Social isolation, or the lack of social connections and relationships, can be a risk factor for substance abuse in adults of all ages. That's because it can lead to negative emotions such as loneliness, boredom, and stress.

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Older adults may be more vulnerable to social isolation due to retirement, losing a spouse or other loved ones, or limited mobility. They may turn to drugs or alcohol to cope with these negative emotions. Social isolation can also increase the risk of mental health problems such as depression and anxiety, which can increase the risk of substance abuse.

Mental Health Issues

Mental health issues such as depression, anxiety, and cognitive impairments can increase the risk of substance abuse in older adults. These mental health issues may be due to various factors, including the natural aging process, physical health problems, social isolation, or other stressors.

Older adults with mental health issues may turn to drugs or alcohol to cope with their emotions or self-medicate for their mental health problems. Substance abuse can temporarily relieve negative emotions but can also lead to addiction and other negative consequences. Substance abuse can also exacerbate mental health problems and create a cycle of substance abuse and mental health issues.

Other Common Causes of Drug Abuse Among the Elderly

Impacts of Drug Abuse Among Older Adults

Substance abuse among older adults can seriously impact physical and mental health and the overall quality of life. Some of the potential impacts of drug abuse among older adults include:

Challenges in Identifying Addiction in the Elderly

Age-related changes can make it difficult for caregivers and healthcare providers to recognize and diagnose substance abuse in older adults. These age-related changes include changes in metabolism, which can affect how quickly and effectively a person's body processes drugs. In addition, older adults may be less likely to report symptoms of substance abuse, as they may feel embarrassed or ashamed to admit that they are having a problem with drugs or alcohol.

These age-related changes can make it difficult for healthcare providers to identify addiction in an older adult accurately. For this reason, it is essential for caregivers and healthcare providers to be aware of the risk factors and warning signs of substance abuse among older adults.

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Some Warning Signs of Drug Abuse in Older Adults

Some common signs that may indicate an older adult is abusing drugs or alcohol include:

Treating Substance Abuse in Older Adults

Addiction treatment in older adults should be tailored to the individual's age and health status. Treatment options include medication-assisted treatment, behavioral health therapies, counseling, and support groups. In some cases, long-term residential care may be necessary to ensure the individual gets the treatment they need to successfully manage addiction and live a healthy life.

It is also important to remember that addiction in older adults can be caused by underlying medical or mental health conditions. Therefore, it is essential to address any underlying issues to ensure that the individual receives comprehensive care and support.

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