On a dry Boise morning in early May, when the foothills appear bleached and the press releases pile up more quickly than anyone can read them, the settlement announcement was made. Raúl Labrador, the Attorney General, called it justice as he stood in front of the cameras. Perhaps it is. However, the families who lost a loved one to heroin in 2012, OxyContin in 2004, or a fake blue pill last winter were not standing beside him. Seldom are they during these times.
In an odd week, Idaho’s share of the $7.4 billion deal with Purdue Pharma and the Sacklers was finalized. According to data recently released by the state’s public health office, fentanyl-related deaths are on the rise once more and are at their highest point in almost ten years. Speaking with those who work in rural emergency rooms gives me the impression that money is coming in for a battle that has already undergone three transformations. Initially, a doctor prescribed pills. Then it was heroin from a Spokane dealer. These days, it’s powder that has been compressed into tablets that resemble what a pharmacist would give you.
For years, the Centers for Disease Control has described the crisis in waves; in 2022, researchers added a fourth. Depending on the county, Idaho appears to be living all four at once. Paramedics in the Panhandle refer to Narcan in the same way that mechanics refer to a wrench. School counselors in the Magic Valley are constantly discovering small baggies in lockers. Despite the size of the settlement, it is difficult to ignore the fact that it is based on a medication that Purdue stopped actively promoting years ago.
That’s the awkward math involved in it all. Economists like Abby Alpert and her colleagues, whose 2021 study examined the differences between states with triplicate prescription programs and those without, claim that OxyContin ignited the fire. States that lacked those barriers were inundated. Among them was Idaho. Twenty years later, those who grew up witnessing a parent vanish into a pill bottle are now being buried; however, the cause of death listed on the report is fentanyl from Mexico rather than oxycodone from Connecticut.
According to Labrador’s office, the money will go toward law enforcement, treatment, prevention, and recovery. By now, you are familiar with the phrase. All of the signatory states essentially say the same thing. KFF Health News has been monitoring the actual flow of funds, and the results show a mixed picture: some counties build clinics, others spend on patrol cars, and some don’t seem to know what to do with their allotments at all. The same fork in the road will be faced by Idaho. Whether the money ends up where the politics are easiest or where the dying are occurring is still up for debate.
Last winter, a Coeur d’Alene grandmother who is currently raising two of her daughter’s children told a local reporter that no amount of money could bring her daughter back. Of course, she is correct. However, money is important because there aren’t enough treatment beds, counselors in rural areas are overworked, and some pharmacies still charge too much for naloxone. As this develops, one wonders if the settlement is a conclusion or merely an accounting note in a much longer ledger. Most likely the latter. The medications were altered. It didn’t hurt.
