For years, pharmaceutical companies sold doctors and patients on the promise of new pain medications with a dishonest but very lucrative campaign. Now, they are finally paying up, in some small way, for the death and destruction they caused in every corner of America.

Over the next 18 years, states will receive a total of some $50 billion as part of a landmark settlement with the companies that helped kicked off the addiction crisis that has killed more than 1 million Americans since 1999, and about 105,000 last year alone.

Here in Maine, where opioid addiction has been particularly destructive, we’ll receive roughly $235 million over the next two decades. Every cent should go to repairing the terrible damage that drug addiction has wrought in our state, and helping people move past the horror the disease has brought to their lives.

As many advocates are doing right now, it’s worth looking back on the experience surrounding another settlement – the 1998 agreement with tobacco companies that sends about $54 million per year to Maine.

That money was meant to make amends for the billions of dollars in health care-related costs incurred by states treating illness and disease caused by smoking. It was supposed to act as a counterweight to all the money and effort tobacco companies used to hook millions of smokers and plant smoking firmly in our culture.

States, however, have mostly failed to use the settlement funds for their stated purpose, instead diverting them to pay for unrelated programs or fill budget holes. The 20-year report on the settlement by Campaign for Tobacco-Free Kids found that just 2.4% of funds in 2019 were used for tobacco prevention and cessation programs.


Maine has done better than most. For the first decade of the settlement, the state put settlement funds toward prevention programs and it helped drive down smoking rates.

Gov. Paul LePage, however, used the money to shore up Maine’s Medicaid program and eventually disbanded the local organizations tasked with working on tobacco prevention, among other public health goals.

It would be very easy for the same thing to happen to the funds from the opioid settlement. The bodies distributing the funds, which includes the Maine Recovery Council in the Office of the Attorney General, as well as counties, cities and towns, should be clear that the money should be spent, as long as it lasts, on matters directly related to the damage caused by opioids and addiction. Legislators should set an example for their future counterparts by doing the same.

The fund must also be used to expand the programs and services we don’t have enough of, and to support new ideas for engaging with folks whose lives have been upended by the drug crisis – and everything that comes along with it.

As has been the case since the beginning of the crisis, Maine continues to have a shortage of medication-assisted treatment and detox options. People in crisis should not have to wait to access the most successful forms of health care.

Harm reduction must also continue its journey to the forefront of our response. Access to naloxone, clean syringes and drug testing kits saves lives, as do the people and groups who help people get those items – and try to steer them toward care.

And as anyone who has seen tent encampments pop up in communities across the state this summer knows, the addiction crisis is intertwined with the crisis of homelessness. To get people off the streets, and into situations that are healthier for them and our society as a whole, Maine needs more housing support, both for those in recovery and those actively using drugs, who often don’t have anywhere to go.

Faced with a deadly and overwhelming addiction crisis, the way forward for Maine is clear. The state’s goal should be to save as many lives as it can, where it can, while giving people a path to a healthier life. That’s how our money should be spent.

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