Opioid settlement funds flowing into counties present opportunities

NORTHEAST WIS. – With over $746 million expected to flow into Wisconsin counties over the next 13 years from various opioid settlements, county leaders face the task of spending it wisely.

“The question is, Where do we spend the money to get the biggest bang for the buck?” Marinette County Administrator John Lefebvre said.

Those in the field of substance-abuse treatment say the problem of addiction is a stubborn one, and the funds can be put to good use.

“There is not a county that is even aware of the magnitude of the problem they have,” said Todd Vander Galien, co-executive director at Unity Recovery Services, which receives funding from Oconto County and two other counties.

Substance abusers often try to conceal their addictions, but this doesn’t mean they don’t exist. Without treatment and ongoing support, they often recur, Vander Galien said. He should know. He’s a recovered addict.

Growing awareness of Narcan, which can block opioids to prevent fatal overdoses, means some overdoses aren’t reported when Narcan is administered outside of a hospital or health clinic. This could be affecting statistics based on reported overdoses, making it more challenging for county leaders to confidently spend opioid settlement funds wisely because, to many, the issue goes largely unnoticed.

As of Dec. 31, 2024, Marinette County received $643,278 in settlement funds, Lefebvre said. More funds are expected to follow for the next 13 to 15 years.

The Wisconsin Counties Association is serving as a resource for the counties and encouraging them to spend the funds, Lefebvre said.
“The money is going to come for a good number of years. This isn’t the only money we’re going to receive,” he said. “We’ll find uses. It can be used for a lot of different things.”

Funds from various opioid settlements through 2038 are starting to pour in, including approximately: $10.4 million from the McKinsey settlement; $5.9 million from Mallinckrodt; $400 million from Distributors; $277 million from Walgreens; $47.3 million from Walmart; and $6 million from Publicis.

Opioid settlements have been announced on a yearly basis. Most companies settled without admitting liability or wrongdoing.

Companies such as Johnson & Johnson’s Janssen Pharmaceuticals Inc. said it would no longer sell opioid prescription medication because of the epidemic.

While Wisconsin will receive 30% of the total distribution, about 70% is available to counties and local municipalities to distribute to health clinics, law enforcement and community programs, according to the Wisconsin Department of Health Services.

The funds could multiply, thanks to matching grant programs, such as one for rural areas from Vital Strategies with an application deadline of June 30. The grant is focused on projects providing evidence-based harm reduction and overdose prevention interventions to end opioid substance abuse through treatment, education and awareness.

However, getting the funds to the people who need them the most is the challenge.

“There are a lot of counties that haven’t touched this. They are sitting on the money and letting it collect interest, or they need to justify how they spend it,” Vander Galien said.

Organizations on the front lines of battling substance abuse and the stigmas attached to it could use more resources, but some don’t know how to apply for the settlement funds. They also may have to work internally to launch new programs.

Marinette County has focused internally on ways to use the money. It has budgeted $125,000 for Alcohol and Other Drug Abuse (AODA) programs, though it hasn’t utilized all of these funds yet, Lefebvre said. It discussed partially funding an education position at the jail for inmate education and allocated some money for the purpose, he added. But, the number of jail inmates with opioid addiction issues might not justify a full-timer.

“We decided to put the position on hold. The funds never got utilized. They got put back,” he said. About $30,868 was disbursed to an Alcohol and Other Drug Abuse treatment service in 2024, but only a portion of the available funds has been used so far, he explained.

When Marinette County decides to fund a program, it generally starts with a relatively modest amount, such as $25,000 for a residential treatment program when private insurance or Medicare won’t cover it, Lefebvre said.

“The reason we haven’t progressed quicker is [because] we didn’t want to be the pioneer in this whole opioid response. We wanted to sit back and see how other counties and cities were going to use their money to see what kind of bang for the buck they got before we use it in greater amounts,” he said.

At the same time, Beka Bussineau, a peer counselor for Biehl Bridges to Recovery’s Recovery Friendly Workplace program, would like to see the program she was hired for continue, but the grant funding is scheduled to run out in a matter of months, she said.

The program aims to enroll at least 20 businesses in the Recovery Friendly Workplace program, which works to reduce the stigma associated with substance abuse to help companies retain workers and to support employees with substance abuse in their backgrounds. Employment helps to fight substance abuse by preventing relapses, yet many employers are reluctant to hire people who have had a substance abuse problem or conviction, Bussineau said.

Bridges to Recovery hasn’t received any of the opioid settlement funds yet, said Meghan Rutherford, a clinical social worker and project director at Bridges to Recovery. Bridges to Recovery serves about 200 people annually, providing treatment programs and educational programs for families and community members.

The organization received a three-year grant for the Recovery Friendly Workplace program by partnering with the University of Wisconsin Extension and the Wisconsin Partnership Program at the University of Wisconsin-Madison.

Lefebvre said the county hasn’t funded outside programs with the opioid settlement funds. “We haven’t partnered yet with any other agencies,” he said.

Documents from the state indicate Bridges to Recovery has received 1,200 Narcan kits, but the kits don’t come with funds for employees.

As awareness of Narcan has grown, reported Wisconsin opioid overdoses have dropped, according to state data.

In March, the most recent month with available data, northeast Wisconsin had 63 opioid overdose ambulance runs, including three in Marinette County, down from about 100 in March 2023, according to the Wisconsin Department of Health Services.

Oconto County had no reported opioid overdose ambulance runs in March, the Department of Health Services said.

From Jan. 1 to March 31, 175 reported naloxone doses were administered in northeast Wisconsin, including eight each in Marinette and Oconto counties.

Naloxone is an opioid antagonist that blocks opioid’s effects. It’s readily available at many convenience stories, community centers and college campuses in Narcan boxes. Those who administer naloxone are required to call 911 when they do, but some cases go unreported.

Narcan’s effectiveness may be reducing the number of emergency room visits and concealing some opioid substance abuse cases.