Thread by @HesslerHD

I’m back for day 31 of the #opioidtrial in Charleston, W.Va. Yesterday an expert discussed a plan he said would improve the crisis by halving the number of overdoses, deaths and number of people with substance use disorder over 15 years herald-dispatch.com/news/proper-fu…

Caleb Alexander, a pharmacoepidemiologist at the Johns Hopkins University School of Medicine, will resume the stand today to discuss the abatement plan.

In case you’re wondering, Farrell won today. He says he’s won three days in a row now. One security guard said the coin is rigged.

https://twitter.com/hesslerhd/status/1403335798959788037

Anyways. Alexander says that you can’t just take the currently ~8k people living in Cabell County with opioid use disorder, get them in recovery and expect the problem to disappear.
You have to account for their kids and others who might develop OUD as a result of the environment

Yesterday the defense said Alexander had used one peer reviewed source funded by the plaintiffs to reach his opinion. However, plaintiffs went over a handful of other sources this morning he used which were government funded.

Alexander has finished his testimony. The defense wants his testimony to be tossed out because they said it lacks relevance for the case at hand.

The judge is going to make a ruling on it later. Just called to the stand is George Barrett, Forensic Economist. He is going to discus the cost the crisis has had on the Huntington, Cabell community and what they need to abate it.

Barrett says he was asked to calculate the value of Alexander’s abatement plan. He used calculations similar to that of a life care plan in personal injury cases. He looked at the items being recommended, cost of those items and frequency those items would be needed.

The cost of items broke down into three things: medical, social and wages, rent, etc.

He also used Alexander’s abatement model to make his findings. Here’s a reminder of what that looks like.

We are looking at examples from his report.

Transitional housing for people released from the criminal justice system will cost Huntington, Cabell $8.7 million over 15 years.

A Law Enforcement Assisted Diversion program, which helps redirect low-level offenders, would be $40k in one year.

He is showing examples to explain how his model works before looking at the big picture.

He breaksdown the cost of every little subsection

They’re calling out a bunch of numbers about costs from a spreadsheet, but it’s difficult to follow AND this is what I’m looking at on my screen

Barrett estimates following Alexander’s 15 year plan, it will take $2.54 BILLION to abate the opioid crisis in Cabell, Huntington alone. To kick it off, the first year (2021 in his report) would cost $149 million alone.

This is the amount of money Barrett says needs to be spent each year to follow the 15 year abatement plan:

2021: $144 million
2022: $149 million
2023: $153 million
2024: $159 million
2025: $164 million
2026: $159 million
2027: $160 million
2028: $166 million
.........

2029: $170 million
2030: $174 million
2031: $178 million
2032: $183 million
2033: $188 million
2034: $192 million
20‘35: $197 million
______
Total: $2.54 billion

Sorry. That should say $144 million

Barrett had submitted four different copies of his report (the original and three revisions), but they all stayed within the $2.5-$2.6 billion price range. He had to make small changes like to housing costs formulas or make changes based on Alexander’s report revisions.

He said he did not consider opioid related spending by the city and county, subtract costs to current spending or apportion costs between prescription and illicit drug use.

He simply put numbers to Alexander’s report.

We are going to lunch and will be back at 2.

To put the severity of the $2.5 billion abatement number in perspective, Cabell County and Huntington have combined annual budgets of less than $87 million. It would take all of the county and city’s money for nearly 3 decades to pay for the abatement plan.

We are back with Barrett reading into the record the cost of every individual subcategory of resources needed, which amounts to the $2.54 billion. This is going to take a while and it’s hard to keep up with the typing/numbers.

One of the numbers is $30 million, ~$2 million a year, for drug courts. Cabell County’s drug courts have been successful on small budgets already. I couldn’t imagine what they could do with $2 million a year.

$32.9 million for school-based prevention programs.

$100 million to support and intervene with children living with parents with SUD.

$100+ million for support of children in foster care or adopted children.

I’ll try to get a copy of this so you all can see the picture as a whole, but these are numbers that stuck out to me.

The plaintiffs are finished and have passed Barrett to the defense.

The defense is making the argument Barrett is under qualified for the task he was given. He said Barrett has never completed an abatement case and the largest damage figure he’s ever proposed in a case was $34 million. He is not an expert in healthcare economics, they said.

They’re saying Barrett’s plan is inflated and sometimes calls for things that are already in place and controlled by the state/federal government.

Barrett said $12 million for 15 years would be needed to run a harm reduction program, but another witness said she was able to run one on $60k a year.

The current harm reduction at Cabell-Huntington Health costs about $225k annually, a 2019 budget report shows, but Alexander’s plan calls for services to be increased substantially. (H/t @TaylorStuckHD)

Huntigton, Cabell only need $1.8 billion to get started and the other billion will come from interest rates, If I understand correctly.

Barrett had been excused from the stand. A lot of his testimony this afternoon was repetitive. Only one witness is left - @HuntingtonMayor.

Williams will testify tomorrow morning. We will take the afternoon off and come back Thursday for arguments about summary judgement and other motions. The defense will present a witness Friday.

I should add only one witness is left *for the plantiffs*. Still have weeks of defense’s case presentment.

Williams has been mayor of Huntington since 2012, but previously served as the city manager and as a city council member. He has also served as a member of the West Virginia House of Delegates.

We are done for the day. Will return at 9 am. Working on story now.

FINAL STORY: A forensic economist testified Tuesday that a 15-year plan to abate the opioid crisis in Cabell County and the city of Huntington would cost $2.54 billion for governments whose combined annual budgets amount to less than $87 million. herald-dispatch.com/news/opioid-ab…