The opioid crisis has been a tragic period for communities across the nation, including in Pima County, which over the past three years has averaged about 500 overdose deaths per year.
Now Pima County and Tucson are in the midst of discussions about how to best spend their share of a $50 billion national lawsuit settlement that required drug and pharmaceutical companies to pay for the harms of the opioid crisis.
How to get involved
- Attend Tucson city council meetings to hear updates from the committee. Monthly updates on unsheltered communities may include information about the opioid response. Find meeting dates and agendas here.
- Pima County offers a list of places that people can pick up Narcan or another overdose treatment. See the map here. Pima County also runs a needle exchange program.
- A community-led mutual aid group called the Church of Safe Injection offers fentanyl test strips, Narcan and other supports to people who may need them. Learn more here.
At a Dec. 10 Tucson City Council study session, Pima County’s Francisco García presented an update on the regional planning for how to spend the opioid settlement funds. García is the deputy administrator and chief medical officer for the county.
Regionally, the Pima County Health Department is the lead agency that administers funds and facilitates payments from the settlement fund to municipalities. The county also has a five-year agreement with the city of Tucson to pool their respective funds — which could approach $100 million collectively — and work collaboratively on the issue.
The settlement will build on more than a decade of work in substance misuse, García said in his presentation to the city council.
“There has been a lot of homework that has gotten us to where we’re at,” he said.
Here’s what southern Arizona residents need to know about where the opioid settlement stands now:
1. The total settlement dollars received by Pima County to date is $24 million
Pima County will receive a portion of the total master settlement. About $1.14 billion will be paid out to the state of Arizona, with 44% of the total (approximately $502 million) going to state-level funds and 56%, or $639 million, to local jurisdictions.
These details are laid out in a 2021 agreement between the state of Arizona and other localities to disburse funds based on population size and severity of harm.
In total, Pima County is expected to eventually receive around $100 million, disbursed over 18 years; the county is also responsible for distributing funds to towns and cities like Marana and South Tucson.
While that funding continues to be disbursed to Arizona, the timeline of when the county will receive the money is unclear, making it challenging to plan ahead for use of the funds, said García.
“I know that you well understand, having to manage the city budget, it’s very difficult to program dollars out when you don’t have a schedule of how they are coming in,” he told the city council Tuesday. “You run the risk of either spending too much or spending too little.”
The long-term amount of money the region gets through the settlement may also change, García noted, because some of the companies responsible for paying out funds have gone bankrupt.
Drug distributor Mallinckrodt filed for bankruptcy in 2020, and opioid manufacturer Endo International filed for bankruptcy in 2022.
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2. Medication is a big part of the settlement funding approach
So far, the settlement money has been used in part to fund a harm-reduction approach, which means using public health interventions to engage directly with people using substances.
The county has spent more than $150,000 to purchase Narcan, a medicine that can rapidly reverse the effects of an overdose of opioids and is often administered as a nasal spray.
The other harm reduction focus is called medication assisted treatment, or MAT, a type of opioid addiction treatment that gives people drugs to lessen symptoms of withdrawal.
Settlement funds have helped pay for treatment in the Pima County jail, and in particular to hire “release planners” whose help “support successful reentry into society” of people with opioid addiction.
In the future, the county plans to expand medication assisted treatment to target people who are pregnant and parenting, as well as for a mobile unit to reach people in more rural parts of the county.
3. Even though opioid deaths are dropping, need continues to outstrip resources
The Pima County death dashboard shows overdose deaths have begun to trend downward since last year.
That does not mean that the settlement money, as large as it is, will entirely meet the needs to address the issue, García said.
“People see $80 million and their eyes get really big,” said García. “That’s a drop in the bucket in terms of the need.”
“The toll of substance misuse is going to require an all-community effort,” he said.
4. “Our biggest real challenge is stigma, and nobody is going to start therapy until we can bridge that”
During the meeting, Ward 1 councilmember Lane Santa Cruz spoke about the need for a treatment approach that didn’t blame people for their reliance on opioids, and making sure that resources were available in Spanish.
“I believe that people are self-medicating from past traumatic events,” Santa Cruz said, noting they had a family member die from an overdose. “I think we could use a lot of assistance from the health department on public education and messaging.”
García confirmed that a portion of the settlement funds would be used for a public information campaign that addresses the links between mental health and addiction.
“Every one of us is touched by substance misuse,” said García, who also noted how trauma, homelessness and other social difficulties overlapped with substance use. “The communication strategies that we are undertaking is trying to figure out how to destigmatize what is a very stigmatizing kind of condition.”
5. An advisory committee will move to finalize recommendations in February 2025
As part of an effort to decide how to spend the money, Pima County put together a Regional Opioid Settlement Committee that included representatives from the city of Tucson, South Tucson and Marana, along with community representatives.
That group has been meeting monthly since July. Those meetings have not been public to allow committee members to speak frankly, said García, but he has felt positive about their progress on tackling a broad topic so far.
“You can’t do everything, and you have to start somewhere, and so they’ve done a really good job,” he said.
The five priorities identified by the group so far include:
- Streamline recovery services between health services and community-based services like housing support
- Support schools to prevent substance misuse among young people
- Support people with opioid use disorder when they leave jail
- Support people in managing their addiction before and after an arrest
- Convene community stakeholders to create a regional plan
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