The opioid epidemic has blown into this picturesque Oregon town like a poisonous wind, followed by drug overdose, addiction, homelessness and family breakdown.

In a simple single-story brick building three blocks from the tasting room and cafe in downtown McMinnville, the staff and volunteers of the rehabilitation center named Provoking Hope are helping the wounded. Workers who are recovering from drug addiction provide consultation, coffee and some clean syringes.

In the second largest legal settlement in American history, McMinnville and thousands of other American towns are about to receive billions of dollars in compensation. US$26 billion from three drug distributors and one drug manufacturer will be used to address the damage caused by opioids, which the federal government declared as a public health emergency in 2017.

States, counties, and cities face deadlines for signing the agreement within three weeks, and most states have agreed to do so. But there are still some opponents, including Oregon, and there are disagreements between state and local government officials.

Money is needed. County Commissioner Casey Kulla said that in Yamhill County, where McMinnville is the county seat, it will expand counseling and treatment, including in prisons, expand residential treatment and rehabilitation facilities, and fund other projects.

As the office manager of Provoking Hope, Anne Muilenburg witnessed and experienced the devastating effects of drug addiction. She said that after her doctor prescribed opioids, her drug addiction began with what many people in the United States did. They are for painful spinal spurs. Ten years later, using her prescription, I bought the prescriptions of two other people. She took 35 capsules a day, far exceeding the maximum dose.

“It’s not even enough to excite me. It’s enough to keep me from getting sick,” Muhlenberg said. She described opioid withdrawal as “the worst feeling ever.”

“It makes you feel like someone is skinning you,” she recalled in her small office, decorated with posters with words such as “kindness” and “being humble”.

Muilenburg finally received treatment, but then “drugged” alcohol and methamphetamine. She eventually lost her job in a car dealership and parted ways with her husband, even though they were reunited. She went in and out of the prison and found herself living on the street.

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“Homelessness is one of the reasons why I want to change my life,” Muhlenberg said.

She has been abstaining from drugs for 4 1/2 years. Muilenburg said that resolving the community’s drug dependence problem requires settlement funds.

“We need more treatment centers. Every place needs more treatment centers,” she said. “It’s ridiculous that someone wants to be treated but has to wait 8 to 10 weeks to find a bed.”

In the United States, more than 500,000 deaths have been related to opioids in the past two decades, including prescription drugs and illegal drugs.

The time for the settlement is passing by, and its expenditure is second only to the tobacco settlement agreement of more than US$200 billion reached with the four major US tobacco companies in 1998.

Three drug distributors—AmerisourceBergen, Cardinal Health, and McKesson—and the drugmaker Johnson & Johnson agreed in July to pay a total of $26 billion to resolve thousands of state and local government lawsuits. However, if the defendant believes that the state and local jurisdictions lack participation, it may cause them to withdraw from the landmark agreement or ultimately reduce the settlement amount.

The plaintiff’s lawyer Joe Rice said: “The defendant bit the apple and said,’Do we have enough numbers to justify going forward?’”

In exchange for compensation, the participating states, counties, and cities will have to abandon any lawsuits against the defendants and agree not to sue them for opioid epidemics in the future.

“There are complex trade-offs,” said Caleb Alexander, a drug safety expert at the Bloomberg School of Public Health at Johns Hopkins University. “On the one hand, the settlement agreement will provide much-needed funds to expand the scale of treatment and solve the opioid epidemic in other ways. On the other hand, many political parties believe that settlement is not enough.”

The plaintiff’s lawyer said on Friday that at least 45 states have signed or expressed their intention to do so, and at least 4,012 counties and cities have confirmed their participation.

Washington State has ruled out the possibility of participation, and Attorney General Bob Ferguson called the settlement “seriously insufficient.” In a trial that began in November, he sued the three largest drug distributors in the United States for $38 billion—and the same is true in the national settlement.

In Pennsylvania, the district attorneys of Philadelphia and Allegheny counties (including Pittsburgh) have sued the state attorney general to ensure that their lawsuits against the pharmaceutical industry can continue, and stated that their communities’ share of the settlement will only be Cover a small part of the pandemic’s finances. toll.

“We will not accept the settlement of the betrayal,” said Philadelphia District Attorney Larry Krasner (Larry Krasner).

Pennsylvania Attorney General Josh Shapiro said that unlike continuing to file lawsuits against these companies, it is certain to receive compensation from the settlement. He said that local governments can choose to withdraw and continue to prosecute, but the more they do, the less the country receives.

New Mexico is still working on the details, “We expect county and local governments to respond soon,” said Jerry Mares of the state attorney general’s office.

According to the health care news website The Lund Report, in Oregon, local and state lawyers have recently resolved a deadlock over how to pay the settlement.

Oregon had hoped that local governments would apply for funding. On the contrary, local governments hope to obtain a larger share of funds in direct payments. There are now disagreements over the amount of settlement that lawyers representing several counties in Oregon should receive.

Yamhill County Commissioner Kulla supports the opioid solution, but does not want the state to over-control it.

“The people in our county are those who are addicted and their families, and we bear the social costs of these addictions,” he said.

According to the settlement agreement, payment will be made within 18 years. Tobacco settlement is controlled by the state government, and most of the money is not used to pay for tobacco. In contrast, opioid solutions are well-structured, so most of the funds are used to deal with the crisis.

Kulla realized that there would be no quick solution.

“This will be long-term,” Kula said. “Really, we need several generations to get out of this predicament.”