Opioid settlement remains unsettled for Iowans

Deborah Thompson spent days looking for her husband who she knew in her heart to be dead. She tried treatment centers, hospitals, even the phone company. She was dismissed at every turn. “I'm so sorry. I know your husband is missing and you can't find him, but it's against our policy to help you.”

Years later, she is running up against the same issue of policy preventing people from helping her. Navigating the opioid settlement process is complex, even for a policy expert like Thompson, a respected health and human service consultant. It is a frustrating, time-consuming, and painful process. She has been laughed at, gaslit, and flatly told no to her requests for help.

And she deserves better.

As do the other victims of the opioid epidemic.

In the United States, health is often seen as a matter of individual choice and personal responsibility. Too often, people are being asked “why do you deserve my help?” as opposed to how can we heal you or what happened to you? Whether they are family members or current or former users, so many are struggling to receive help due to shame and stigma.

If we want to talk about responsibility, we need to focus attention on the opioid manufacturers that deceived Americans about how safe and addictive opioids are, oversaturated the market, and failed to implement controls to protect the public. This was a prolonged and calculated choice that has affected hundreds of thousands in the United States.

“While the settlement is much needed to battle the opioid epidemic, it also highlights the disparate treatment between the 1% and the rest of America. It shows with enough money you can elude criminal charges. It says $4.2 billion in personal assets justifies more than 560,000 American deaths. No one should be immune from criminal prosecution, especially someone linked to 560,000-plus deaths in America,” Larry McBurney, Candidate for Iowa House of Representatives explains.

Nationwide settlements were reached in 2021 to resolve the large amount of litigation that was brought against major opioid manufacturers and distributors. In addition to victim compensation, the settlement funds are intended to be spent on “ opioid remediation efforts” and supporting structures to ensure treatment and rehabilitation.

Meanwhile, those struggling with addiction or the loss of the loved one are hamstrung with getting help to fight their illness or being compensated for their loss. Specifically in Iowa, insurance companies, health care providers, and boards are interpreting laws too narrowly, according to Thompson, and this is making it difficult for her to make headway in her claim. It is a frustrating and isolating experience. “That's why I'm like, am I the only one doing this each time I've called? It's as if I'm the first person that has made this request.”

The recent Supreme Court ruling along nonideological lines has caused further confusion and concern about claim money for victims of Purdue Pharma.

Meanwhile, Thompson’s son Lincoln is one of 320,000 American children who lost their parent to a drug overdose in a span of 10 years. This bright and kind child whose smile lights up a room will forever be affected by those who choices robbed him of his father. A father whose disease many won’t bother take the time to understand.

Many Americans are prescribed opioids for pain relief. The euphoric feelings produced by opioids often overcomes the ability to assess negative consequences of continued use. Further complicating the problem, only a quarter receive appropriate treatment for opioid use disorder.

Almost half of heroin users start with an addiction to opioids. When a drug is prescribed by a trusted medical provider, it is easy to see how so many can succumb to this dangerous trajectory. The pleasure circuits in the brain become overwhelmed, sometimes permanently. This is why it is not a matter of abstinence — most effective treatments are medication based.

Which requires judgement-free pathways and readily available resources. That’s hard when an issue has been forgotten in the midst of other issues. The opioid crisis has not gone away, and neither has the stigma of substance use in general. Thompson explains that for an issue “that as one of the biggest drivers of negative health consequences in this state, it is somehow the least acknowledged, least supported, and least advocated for.”

Thompson has so much going for her. She has interpreted policy, and she serves as an advocate for public health issues, and for those experiencing grief through her work as an Amanda the Panda volunteer. She is highly intelligent, personable, and has a lot of connections with her previous work with the state. She worries about how others are navigating the process.

“I can't even imagine how they are able to read the document like the form to submit a claim. For example, I had to look up a probate code section. So I knew I could go to the General Assembly's website, click on the Iowa acts tab, click under archive search. I know this because of specialized training and knowledge of the language and knowledge of the legal process,” Thompson explains. “If I had worked in any other part of state government, I wouldn't know about the prescription drug monitoring program” which is how families can track the prescription drugs that members used that might be able to be related to the settlement programs.

She continues, “Policy is reflective of culture and just like culture evolves, so should policy.”

The crisis is far from over, it will take a variety of resources to prevent addiction and deaths, and to relieve the suffering of Iowans and their families.

McBurney, and Rep. Megan Srinivas are trying to pass legislation to legalize fentanyl test strips in Iowa. “We know through the opioid settlement many people who relied on opioids have turned to alternative relief measures which have been laced with fentanyl leading to overdoses in high numbers. Hopefully with testing strips available for public use, we can actively reduce the number of deaths related to fentanyl overdoses and refocus our local resources toward treating the root cause” McBurney told me.

Policy that accounts for the complexity of a situation and training that ensure appropriate interpretation to current and future policies. Accountability has been lacking and drawn-out for far too long, further complicating recourse for victims. This is pain that has been unnecessary prolonged for Thompson and her family over the span of a decade.

In the meantime, every one of us can practice a little more kindness and learn more about the disease. We never know when it will impact someone you love.

Chris Espersen is a Gazette editorial fellow. chris.espersen@thegazette.com