Support for Arkansas Week provided by the Arkansas Democrat-Gazette, the Arkansas Times and Little Rock Public Radio.

Welcome to Arkansas Week.

I'm Christina munoz.

Opioid addiction continues taking a toll, especially the powerful synthetic fentanyl.

Efforts to combat the problem on the state and federal level are ongoing.

Prosecutors are targeting more low level dealers who are directly implicated in overdose deaths.

And a year after the state began distributing funds from a national opioid settlement with pharmaceutical companies, officials are evaluating the effectiveness of programs that money was used for.

We'll have more on that angle later in the program.

But first, Arkansas is suing to pharmacy benefit managers and their subsidiaries, accusing them of helping cause the opioid epidemic in Arkansas.

Attorney General Tim Griffin filed a lawsuit earlier this summer and joins me now.

Thank you so much for being with us today.

Thank you for having me.

Absolutely.

We appreciate you.

Now, one of the defendants.

Explain a little bit First about how the actions of these defendants in the defendants name are Express Scripts Inc. and Optum Inc. and their subsidiaries.

So talk to us a little bit about how you and how the state believes that they really helped fuel this opioid epidemic that we have.

Yeah, well, a lot of people may not be familiar with the structure, but the PBMs, the pharmacy benefit managers, they play a role in they in the supply chains here, the manufacturers, the PBMs and the drug.

They're sort of the gatekeepers for the drugs and where they go, which pharmacies are getting what.

And the pharmacies are down below.

And I'll say, first of all, this is a multifaceted effort.

We're here talking about litigation, but there's a lot else.

There's a lot of other stuff going on to deal with this.

I'm happy to talk about like the 50 million oh, we're starting the National Center for Opioid Research at Children's Hospital.

And, you know, there's the preventative side.

There's the criminal prosecution side, which we've toughened legislation the last two sessions ago.

But on this litigation, I looked at who we had sought to hold accountable as a state, and I said, wait a minute, why weren't the PBMs a part of that?

They were not included in the original litigation.

And that struck me as strange because they played a critical role.

They were in the middle of it.

They weren't they weren't on the periphery sort of watching.

They have access to critical data because they are the ones that distribute.

They know where the drugs are going when the demand is up, when the demand is down.

And I can't get into all the details because of some confidentiality agreements that relate to the investigation.

But let me just say this.

They knew exactly what was going on.

And there's no question about it.

And so they should have been sued a long time ago as part of the original push.

And I think what you're going to see is a number of other states doing exactly what we've done, which is sort of going back and saying, wait a minute, we miss these folks.

And so this needed to be done.

And I think that in the end, once all the facts come out, I think that Arkansans will say, oh, well, of course, we should have sued them.

Of course we needed to sue them.

And that was the right thing to do.

So they were not bit players on the sidelines.

They were in the middle of this.

And we're going to hold them accountable through this litigation.

And you mentioned all these different facets going on, but just sticking to this litigation, how do you think this particular lawsuit will actually help the situation in Arkansas?

Well, it will ultimately.

I think, first of all, we're going to expose more facts of what actually happened in the Army.

We talk about doing after action report.

Right.

So something happens and then you look back and say, okay, let's account for what happened.

Let's figure out what the facts were.

We've got a lot of facts, but there are still more facts to be known that that are going to become available to the public as a result of this litigation.

So we're going to know more.

If you're going to prevent things from happening in the future, you need to know as much as possible about what happened in the past.

So that's number one.

Number two, depending on the outcome of this, at least I hope to have commitments from the PBMs as to future behavior.

Right.

Often we call that injunctive relief or maybe it'll be part of a settlement.

We'll see.

The other thing is damages.

We will be able to get money that can be used for the sort of things that we referred to at the beginning that are not directly related to the litigation.

That money to be spent now during this ongoing crisis, but obtained from these parties to help us prevent people from taking it.

Prevent the drugs, the illicit drugs in particular from coming in to the country or coming into our communities, etc.. And then there's the third part, which is once they've come into our communities, once people have taken them and harm themselves, we have to deal with the addiction and trying to get these people the treatment they need.

Right.

So there's prevention which says don't ever use it.

One pill can kill.

Education awareness.

Then there's the the dealing with the law enforcement side of it, stopping it ever coming in.

That's a separate fight.

Right.

And it's all related.

And then there's the third part, which is when it's already happened, the drugs have made it in.

People have abused them.

They've been impacted.

Well, there's this third part, which is treatment.

You've got to help people get back on their feet if they survive because these drugs can kill.

We've got to help them get their lives back together and help them deal with the the the the effects of that.

So there's really multiple aspects to this.

And the key is not one or the other.

It's push all three at once.

It's sort of like, to use another military analogy, land, sea, air.

You do them all at once.

To be effective, you can't just do one without the others.

It has to be a coordinated effort.

And that's what I that's the way I like to think of it.

And all those aspects, of course, take funding, which we'll talk more about that.

Sure.

But one of the defendants, Optum, Inc., did release a statement after the lawsuit was filed, and it says, quote, Optum did not cause the opioid crisis or make it worse.

And we will defend ourselves in this litigation.

Optum takes the opioid epidemic seriously and has taken a comprehensive approach to fight this issue, including the opioid risk management program available to all Optum RCS clients to address opioid abuse and promote patient health.

What is your response to that statement?

Well, I doubt that statement surprises you.

What do you expect them to say?

That's exactly what you would expect them to say.

And I think at the end of the day, I deal in facts and where this is now ongoing litigation.

So I would just say stay tuned.

This is the beginning, not the end.

And at the end of the day, the facts will demonstrate that we're correct.

And as you mentioned, there are a lot of lawsuits regarding this topic on different levels from different entities.

So are you concerned or do you believe that a settlement, like many of those have ended is in the future for this case?

We will see.

All I know is we're on the right side of the facts.

We're on the right side of the law.

And I feel confident that in the end, this litigation is in the interest of the state of Arkansas.

And and we're going to hold them accountable.

So data released in May did show that the number of drug overdose deaths last year in Arkansas had to decline by 13.7% in 2023.

The state reported 510 deaths compared to 591 in 2022.

And in a minute, I'm going to talk with Kirk Lane, the director of the Arkansas Opioid Recovery Partnership, which has been distributing the state's portion from a national opioid settlement.

But I wanted to get your reaction to those latest numbers first.

Look, that's encouraging.

We need to keep doing what we're doing.

I think that one of the things that has happened is we went from a lot of misuse and abuse of prescription drugs to getting our arms around that.

And now a lot of what we're saying is the the illicit drugs, illegal drugs coming in from overseas.

A lot of the components are from China.

And a lot of that is routed through Mexico.

Some are produced in Mexico using elements from China and pushed into the U.S..

So now we have you still always have prescription drug abuse.

But what you've seen now is is predominantly illicit drugs.

And the problem with these illicit drugs, you don't know what you're taking.

You have no idea.

And the people pushing them into this country, they don't care.

One thing about you.

And that's why we talk about one pill can kill you literally can get a pill.

Think you know what it is and you could be dead upon taking it.

I think that the education efforts are helping.

People are becoming more aware.

Also, we have strengthened our laws in this regard.

The legislature, not this fiscal session, but the session and 23 dealt with that.

Senator Ben Gilmore, Representative Jimmy Gasaway.

We're big leaders on that.

The governor led on that.

We worked together to stiffen penalties on that.

And then on the treatment part, a lot of the funds that we got from the earlier settlement have been helping there.

I've worked with Kirk Line and they're doing a good job there.

So Kirk's partnership, the opioid partnership, they're distributing the money that went to the counties in the cities and my office distributes the money that went to the state.

Well, and I have to wonder that with the legal side of this, if you are encouraged by the fact that more prosecutors, local prosecutors filing murder charges against people that are directly implicated in providing fentanyl to those who die from it.

Look, there they are equipped with these laws now that have stiffer penalties for this death by delivery.

And my office is putting on training for prosecutors on this specific area because these laws are relatively new.

And so this is a team effort.

It's again, it's not one or the other.

It's all of the above.

At the same time.

Lot of important players from the legislature to the prosecutors to medical professionals.

Kirk and what he's doing, just everybody working together is having an impact.

And while number is trending down is, of course, good news.

510 is still 500.

We've got a lot of work to do.

So but but look, there are a lot of people doing a lot of good work on this and we're going to lean into it.

And I believe one of the things I want to do with the state money with regard to Children's Hospital.

Well, I wanted to take some of the state money and not just spend it on things that are that are ephemeral, that will be gone in a year or two.

Those are often good causes.

But I wanted with this massive money to create something lasting that infrastructure wise.

Right.

That could that could be around long after I'm done and still contribute.

And and we've got a great partner in Children's Hospital.

We are, as you know, putting a flag in the ground and declaring Little Rock's own Arkansas's own National Center for Opioid Research.

It's going to be brick and mortar building.

The best experts from around the country, it's going to be right there at Children's Hospital.

And I have committed 50 million to that.

They've given ten going to give another chunk of that soon, and they're putting some money in from their foundation.

This can be a game changer for research, not just in Arkansas, but this will be the national, dare I say, International Center for Opioid Research.

And it's going to be called Oncor.

Just really excited about what they're doing.

So all hands on deck and we're making an impact.

Attorney General Tim Griffin, thank you so much for being with us today.

We appreciate your time.

Thank you.

Stay with us.

We'll be right back after this.

Welcome back.

One year after the Arkansas Opioid Recovery Partnership began distributing funds from a national settlement with pharmaceutical companies, evaluations are now looking at the effectiveness of programs that were supported.

$216 million was split evenly between the Arkansas Attorney general's office, the Arkansas Municipal League and the Arkansas Association of Counties.

Leading the partnership is its director, Kirk Lane, and he now joins us live.

Thank you so much for being with us.

Thank you.

We do appreciate your time.

So first, for anyone that is not familiar with the settlement or how it came about, can you just fill us in and give us some background?

Sure.

So to the best of my knowledge, attorneys representing the cities through the Municipal League and the counties through the Association of Arkansas Counties and the state through the attorney General's office, filed litigation against big pharma companies, and there was a national settlement that came forward from that.

Okay.

And so when we talk about funding in that settlement, what kind of programs and what programs was funding directed to?

Within the settlement, it gave the court gave a mandate called Exhibit E, which is allotments for concepts and prevention, treatment, recovery and some law enforcement programs.

Okay.

So more specifically, can you kind of tell us a little bit about those programs and then how that money is distributed through those programs?

Sure.

So our process is we know different.

And because the settlement agreement did not really give you the mechanics of how you should set up those disbursement channels.

So each state or region was forced to come up with their own mechanisms to get them out the door.

So in our process, we built a website, we built a proposal template site where entities could provide proposals to us and we would review those proposals.

And we developed the advisory board and we would go through those proposals to try to vet them, to see to make sure that we weren't duplicating what the state was already doing or there was other programs in place that were already doing those things so we could make sure that we're using money wisely and then go through our process of approvals through the executive directors of the Municipal League and the Association of Counties in a qualified settlement funding attorneys that would work with you to make sure that the criteria of the national settlement under Exhibit A and then they would issue a check.

Wow.

Quite the process, no doubt.

So your partnership most recently allocated money to the Pulaski County Sheriff's Office.

It's establishing an overdose response team with $360,000 going toward training on how to respond to 911 calls and provide education and support communities.

So is this an example of the kind of programs that you would like to see and how you'd like to see that money used?

Yeah, we value in those overdose response teams because for many years law enforcement did not investigate an overdose and try to find and hold responsible somebody for poisoning another person for profit.

So you developed a concept of a team to ensure on the law enforcement side to make sure that they would investigate those that overdoses and hold people responsible for it those drugs were coming from.

And then secondly, that the team would also consist of a peer recovery specialist hired by the law enforcement agency to deal with that person if they survived the overdose or the people around that person and the family that sometimes may have an overdose or excuse me, risk of an overdose or what we call an over a opioid use disorder or a separate use disorder and lead them pathways to recovery.

So it definitely sounds like a multifaceted program when you talk about all these different angles and different things that do need to be funded.

So as we mentioned in our first segment with Attorney General Tim Griffin, data released just in May shows that drug overdoses in the state of Arkansas did decline in 2023 by 13%.

So what are your thoughts and your reaction to that?

I you know, I'm I'm not surprised.

Before COVID, we started seeing double digit reductions in Arkansas based on the fact that communities and and entities were starting to work together to resolve this problem.

And then COVID stopped everything.

So coming out of COVID and going back in stronger now with some funding to help those efforts, I would expect to see us reduce even more in the years to come.

And do you believe it's these programs and the funding of these programs that has directly led to that decrease?

I think that's a piece of it.

I think the real jewel of this is people working together to overcome it.

So let's talk about Narcan, which reverses the effects of opioid overdoses.

It is now much more widely available.

So how much of a contributing factor do you think that is?

I think it's a huge piece of the puzzle because without naloxone, allowing somebody to breathe during opioid overdose, if if they're if they don't survive it, then they can't recover.

So having naloxone in every available in every nook and cranny in Arkansas is critical.

And just like anything that takes money and funding to be sure that that happens.

Tell me about how that is working to get Narcan into all of those nooks and crannies throughout the state.

So our entity, or as we call it, Arkansas, help your recovery partnership develop what we call it naloxone, that we installed about $2.6 million into it since 2000.

And we have disbursed over about a thousand doses to communities that want to be able to do that at the time when they need to be.

And has there been assessments or evaluations on how much those have worked or helped or been used?

So I think it's hard to distinguish between the different projects and the state's projects and all that.

But people that were willing to move forward.

We're seeing about 3000 doses, units that were used over the last two or three years.

So no opioid overdose.

Wow.

And saving one life.

What makes it worth every penny?

So I want to talk about there's so many different issues we've talked about with litigation settlement funding programs.

But we talk a lot about education and awareness with regard to this subject.

So after all you've learned and as long as you've been involved, what do you really want people to learn and be educated about this opioid crisis?

You know, I think the main message is we created it and we can solve it.

We just kind to want to.

Wow.

Very well said and to kind of humanize it.

I know you've heard stories.

I know you have talked to parents.

I know you have seen those who have gone through loss.

Talk about this addiction and this issue and this sudden loss and how it can really affect these families and loved ones.

So, you know, I think a lot of people don't realize that having that, oh, your day or an issue and opioid use disorder or substance use disorder, which is a better word they are trying to break the stigma is a lifetime.

It's a it's a life sentence.

So even if you recover, you still spend the rest of your life trying to figure out how not to slip.

And so a lot of education doesn't really focus on that.

And also, in today's day and time, with all the synthetic drugs coming out, there are no safe use of drugs.

And we need to realize that because that whole and other it illicit substances are being placed in the drugs now.

You don't know what you're doing.

So I think we live in that society and that's the direction we're going and we have to educate for that.

Very well said.

So how much longer will funding continue and and what are your future goals overall?

So we are looking at funding for the next 12 to 16 years as these opioids settlement dollars come in.

And then we're also keeping our eye on the future or maybe developing some other pathways to own funding or apply for grants and things of that nature in the future.

And so hindsight is always 2020.

What have you learned at this point that you may change moving forward?

I think what we're learning is we're seeing a lot of applications that have heart.

We are funding with that plan of them attaining some type of sustainability.

Some of these programs will go on and look at.

We're just now seeing those one year evaluations and we like what we see.

And that is definitely good news on a subject that it can be very tough to talk about.

Director Kirk Layne, thank you so much for joining us today and spending your time with us.

We appreciate you.

Thank you for having me.

And we thank you for watching.

Support for Arkansas Week provided by the Arkansas Democrat-Gazette, The Arkansas Times and Little Rock Public Radio.