Alaska Native and American Indian tribes have reached a settlement with a drug manufacturer and the country’s three largest distributors over the toll that opioids have taken on communities across the nation.
The Kenaitze Indian Tribe is one of more than 400 tribes and tribal organizations to have sued over opioids. The Tribe joined more than 60 tribal communities nationwide in filing a suit in November 2018.
The $590 million settlement involves drugmaker Johnson & Johnson, and distributors AmerisourceBergen, McKesson, and Cardinal. Johnson & Johnson would pay $150 million over two years, while the distributors would pay $440 million over 6 1/2 years.
All 574 federally recognized tribes will be eligible to participate in the settlement. The agreement will go into effect when 95 percent of the tribes that have filed lawsuits against the companies agree to it.
The court filing was made public on Feb. 1. The filing lays out the agreement in broad terms, with some details still being worked out.
In Alaska, funds would be distributed using the same formula by which tribal compact funds are shared. The Kenaitze Indian Tribe is ranked sixth among tribes and tribal health organizations in Alaska, and 117th across all tribes with regard to percentage of the distribution.
Diana L. Zirul, Tribal Council Treasurer and Chair of the Kahtnuht’ana Dena’ina Health Board, said that when the Tribe joined the lawsuit in 2018, the Kenai Peninsula had the highest rate of opioid addiction in Alaska.
In its Statement of Interest filed with the lawsuit, the Tribe wrote that the opioid crisis was straining its ability to provide adequate services. Funds were diverted from Tribal priorities to provide new positions needed to address the crisis, such as substance abuse counselors and nurses and physicians specializing in addiction.
The Statement of Interest describes some of the impacts of the opioid crisis on the community:
“The Tribe has lost sons and daughters, mothers and fathers, brothers and sisters to addiction, homelessness, incarceration and death. This crisis has caused financial stress on families and our community, and our children are encountering drugs at a much earlier age. Our children are being raised by single parents, fragmented families, grandparents and great-grandparents or being taken into Tribal and State custody. The crisis is straining nearly every governmental and cultural service we provide to the breaking point.”
Alaska Native and American Indian people are three times more likely to die of a drug overdose than the general population, according to the Substance Abuse and Mental Health Services Administration. According to the Centers for Disease Control and Prevention, in 2017, American Indian and Alaska Native people had the second-highest rate of opioid overdose out of all U.S. racial and ethnic groups, and the second and third highest overdose death rates from heroin and synthetic opioids, respectively.
The Tribal Council will be discussing how to move forward. While the amount of funding that would come to the Tribe has yet to be determined, it will be required to be used to address the opioid crisis. The Tribal Council will evaluate how best to strategically use settlement funds to sustain the services and facilities necessary for treatment.
The Tribal Council, the Kahtnuht’ana Dena’ina Health Board, and the Behavioral Health Committee also have concerns about the stigma associated with dependence and addiction, and will work to encourage those facing substance use issues to seek help.
The settlement with the tribes is separate from settlements being worked out with state and local governments. Settlements between tribes and other companies involved in the opioid industry also are being negotiated.
However, Zirul, who also serves on the Governor’s Advisory Council on Opioid Remediation, stressed the need for the state to work collaboratively with tribes, especially in rural areas where tribal clinics are the only places that provide substance use services.