Addiction to prescription painkillers has been a leading cause of the opioid epidemic in the United States over the last two decades. File photo

As part of a $26 billion lawsuit settled last summer, Cumberland County will receive nearly $17 million to help communities harmed by the opioid epidemic.

The U.S. Food and Drug Administration defines opioids as “powerful pain-reducing medications that include oxycodone, hydrocodone and morphine, among others.”

According to the U.S. Department of Health and Human Services, the epidemic began around the turn of the 21st century, when increased prescriptions of these opioids led to widespread misuse despite reassurances from pharmaceutical companies in the years prior that patients would not become addicted to those medications.

Since 2001, 999 people living in Cumberland County have died from opioid overdose, reaching a high of 149 in 2020. That was 44 out of every 100,000 people in the county, higher than the state’s rate of 28 per 100,000, according to a state analysis of data from the N.C. Center for Health Statistics.

The lawsuit’s settlement proceeds are from the country’s three largest pharmaceutical distributors — McKesson, Cardinal Health and AmerisourceBergen — and Johnson & Johnson.

N.C. Attorney General Josh Stein announced in February that North Carolina would receive $750 million from the national lawsuit, of which the state government will receive 15%.

The remaining 85% will go to counties and municipalities; Cumberland will receive its $17 million from that allotment.

The funds, which will be distributed over 18 years, are required to be used to help with the harms created by the opioid epidemic.

Cumberland Health Director Jennifer Green said at a Board of Commissioners meeting Monday that the first two payments are expected in the coming weeks. The remaining payments will be made annually every summer until 2038.

The funds for Cumberland apply to the county government and not the geographic area. The city of Fayetteville will receive its own portion from the lawsuit, which is about $2 million, Green said.

The annual payments are higher over the first half of the settlement period, ranging from nearly $900,000 to more than $1 million. At the tail end of the period, payments plateau at just under $750,000 annually.

Green’s presentation on Monday was a preliminary overview of the funds. The board will give more feedback on plans for the proceeds at next week’s board meeting.

What money can be used for

Green laid out two disbursement options for the county.

The first option includes a list of evidence-based prevention and treatment options for those who have or may become addicted to opioids. That includes early intervention programs, addiction treatment for incarcerated people and distribution of naloxone, a medication used to treat an opioid overdose.

“The local government may choose from a short list of evidence-based strategies, things that we know work that are high impact, things that we’ve seen, that have data behind them,” Green said.

The other, longer-term option allows for a larger list of strategies that require more time and collaboration among stakeholders in the community, Green said.

She said the state recommends starting with the first option.

“Because we can get the work started without doing some additional work,” Green said.

Counties and municipalities can then switch to the second option after they have done the necessary work required under the lawsuit.

Cumberland County, along with others receiving funds, will be required to file an annual financial report that includes the expenditure of the proceeds from the lawsuit.

The settlement funds must be separate from anything else in the budget, creating a special revenue fund for the sole purpose of spending the proceeds.

To best determine how to spend the money, Green said the county Health Department is gathering input from other entities such as Cumberland County Schools, the Cumberland County Sheriff’s Office and recovery groups whose members have experienced opioid addiction.

Concerns from county commissioners

When asked by some of the commissioners, Green said the funds can only be used to treat those who are addicted specifically to opioids, therefore not including other drugs outside that designation.

Other options available under the settlement guidelines could incidentally reach those addicted to other drugs, Green said, such as criminal justice diversion programs that can be implemented with the money.

“There are some of these other strategies that are not about the treatment options specifically that would address other addictions,” she said. “The addiction treatment for opioids has to be for opioids.”

Commissioner Charles Evans said more needed to be done to treat those addicted to other drugs, along with those who have misused opioids.

“I really hope and wish that the county along with other bodies, entities, such as the Health Department, such as (Cape Fear Valley Health), and what-not would do more for the other issues,” he said. 

“Crack cocaine and addiction of alcohol is very prevalent in a number of communities, and it’s not being addressed as strong as it’s being addressed with opioids.”

Green said those separate addictions are often not mutually exclusive, and therefore an opioid-oriented strategy could cast a wider net beyond those only addicted to those specific medications.

“I think the hope here is that we know that people, when they have substance abuse, it’s not always ‘I’m only addicted to opioids or only addicted to alcohol,’” she said. “Those things interact quite frequently.”

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Ben Sessoms is a former Carolina Public Press reporter. To reach the Carolina Public Press newsroom, email

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