Lessons From Virginia's Opioid Settlement: Invest in Youth-Oriented Primary Prevention

In May 2007, Purdue Pharma and three executives of the company pleaded guilty in federal court in Abingdon, Virginia, to criminal charges that they misled regulators, prescribers, and patients about the risk of addiction and potential of misuse related to OxyContin®. To resolve criminal and civil charges related to the drug’s “misbranding,” Purdue Pharma agreed to pay some $600 million in fines and other payments, one of the largest amounts ever paid by a drug company in such a case. The fines were distributed to state and federal law enforcement agencies, the federal government, federal and state Medicaid programs, a Virginia prescription monitoring program, and individuals who had sued the company.

Fast forward to July 2021 when a $26 billion settlement offer was made by opioid manufacturer Johnson & Johnson ($5 billion) and three distributors including McKesson, AmerisourceBergen, and Cardinal Health ($21 billion) to resolve their liabilities in more than 3,000 opioid crisis-related suits across the United States. As these opioid settlements are reached, we must learn from missed opportunities with the original $600 million settlement and settlements that came from suits resulting from suits against “Big Tobacco.” Of priority is dedication of funds from settlements to solidify the U.S. public health system to respond to the opioid crisis and prevent development of substance use disorders and related morbidity and mortality.

This session will examine how monies can and should be allocated to youth-related primary prevention. Primary prevention aims to prevent disease or injury before it occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviors that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur. Presenters also address needed infrastructure to engage individuals at-risk for substance use disorders and how to combat stigma that may impede primary prevention activities.