(1/16) 🧵 on the understanding the opioid settlement landscape & how #HarmReduction orgs can access desperately needed funding.

The opioid settlement process is a big ole mess, but the Coalition for Syringe Access & @AIDS_United created a slide deck to try & clear things up.
(2/16) To be clear, this is a very incomplete overview of the opioid settlement landscape.

This is just the preface of a book that we as a community still need to write & there is so much that I need to learn about the opioid settlement infrastructure. Image
(3/16) Y'all know the backstory:

Pharma did some shady 💩 around opioid marketing & distribution that supercharged the opioid epidemic. State, local & tribal governments sued, & now Pharma is on the hook for billions of dollars. Image
(4/16) I know Purdue pharma gets a lot of the press around the Rx opioid epidemic (and deservedly so), but there were a whooooole lot of bad actors & they're all paying to varying degrees. Image
(5/16) Think of state opioid settlement plans as movie adaptations of books.

Some states are going to be true to the original text.
Some states will actually improve upon the original.
And some will completely butcher it. Image
(6/16) The global opioid settlement is not perfect, but it is a hell of a lot better than what we've had similar settlements in the past.

This is not the Big Tobacco settlement. 70% of this money must go towards future efforts to end the opioid epidemic & serve PWUD. Image
(7/16) Look at all of these gorgeous things that the opioid settlement money can theoretically be used for:

Naloxone! MAT! Syringes for SSPs! Recovery services! Maternal care!

It's a beautiful thing to see. Image
(8/16) Unfortunately, there's a whole lot of badness & wasted spending that can come from this as well.

Police WILL get a lot of this money.

Abstinence-only prevention campaigns will get some too.

Absent our voices in the conversation, the same old programs will get funded. Image
(9/16) In the Global Settlement, a 70-15-15 split was proposed between a newly created opioid abatement accounts, direct funding to states, & direct funding to states.

But, this allocation breakdown is only as useful as a state's plans for the funding. Image
(10/16) Using the earlier movie adaptation analogy, California's settlement plan is No Country for Old Men: faithful to the original & amazing.

North Carolina's could wind up being Lord of The Rings, taking a good thing & making it even better depending on how the money is used. Image
(11/16) I'm pretty sure my analogy is running on fumes right now, but you can look at Missouri's opioid settlement distribution as Twilight & Louisiana's as 50 Shades of Gray.

Bad adaptation of a bad book vs. bad adaptation of bad fanfic vanilla erotica of a bad book. Image
(12/16) Where you live determines how you need to go about seeking opioid settlement money.

Some states & localities will make it easy for the best programs to get money...some will make it very hard. Image
(13/16) Opioidsettlementracker.com is going to be your opioid settlement funding bible. Bookmark it. Know it. Love it.

Much of the documentation you need to get an understanding of your state's settlement plans can be found on this site. Image
(14/16) If there are open grant portals in your state or locality, you're going to have to do work to find them.

Harm Reduction advocates across the country are working on collecting this information, but it doesn't exist yet. Image
(15/16) If your state has an active opioid settlement board, do your research on it.

If there's any way to influence the the activity of those boards, either from inside or the outside. Image
(16/16) If this all seems like too much, don't worry. That's because it is.

Making sure opioid settlement money actually benefits people who use opioids shouldn't be this hard.

If you have any questions, please reach out to me in the comments or message me.

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More from @SyringeAccess

Oct 14
🧵(1/19) Yesterday, we hosted a panel at the National Harm Reduction Conference to try and answer a direct, but complicated as hell question:

“How do we get money in the hands of drug user health organizations that actually care about people who use drugs?”

#HarmRed2022
(2/19) To try and answer this question we got myself, @ChristineRdrgz of @AIDS_United, Rafi Torruella of Intercambios Puerto Rico, Philomena Kebec of the Bad River Tribe, & Maya Doe-Simkins of @RemedyAlliance together to talk about federal & private harm reduction funding.
(3/19) We talked about the way things are with harm reduction funding, but also about the way things ought to be, outlining how governments need to change how they structure their grantmaking & reporting, & outlining ways we can game the system & support one another.
Read 19 tweets
Dec 27, 2021
(1/9) Mini 🧵on the amicus brief filed by @national_pain around physician liability for dispensing Rx drugs under the Controlled Substances Act.

Encourage y'all to read their thread & amicus if you have time, but wanted to talk about the chilling effect of federal opioid policy.
(2/9) In their amicus brief. @national_pain talks about the "chilling effect" of the CDC's harmful, albeit most likely well intentioned, 2016 Guideline for Prescribing Opioids for Chronic Pain & the sharp decline in opioid prescribing we have seen since: cdc.gov/mmwr/volumes/6…
(3/9) The amicus succinctly lays out the cascading impact of this document & federal policy more broadly on preventing physicians from acting in the best interest of their clients out of fear of scrutiny & censure from the government.

Bad guidance became a worse mandate. Image
Read 9 tweets
Sep 29, 2021
(1/21) 🧵So, it’s time we had a conversation about the war on drugs, capitalism, & xylazine.

Now, if you’re coming across this tweet, odds are good you have some familiarity with the 1st 2 things but might be wondering, "what’s xylazine?"

Well, it's complicated. #HarmReduction
(2/21) Xylazine was originally designed as a veterinary tranquilizer. It was never meant to be ingested by humans but, 20 years ago, some Puerto Rican folks who use drugs started using it as a heroin additive & the drug found its way to Puerto Rican neighborhoods in Philadelphia.
(3/21) According to the literature I was able to find, the main reasons for adding xylazine (known as Anastesia de Caballo or “horse anesthetic” in PR) were a mix of cost efficiency for dealers & enhanced effects for the user, but neither were big enough to create market changes.
Read 21 tweets

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