Plymouth got $78,300 from the state in opioid settlement funds in July 2022, with similar sums landing in the town coffers that October and November, all earmarked for opioid-related programs.
But the town faced administrative hurdles to spending the money. Plymouth, like most towns, is governed by an annual Town Meeting. So the money did not get officially appropriated until an October 2023 Town Meeting. The town lacked a Health and Human Services Department, and it was only this fall that Town Manager Derek Brindisi merged parts of two departments to create one.
On Feb. 1, Plymouth finally released a request for proposals to organizations seeking to use the money, and Brindisi expects awards to be made by May. “It’s not a lack of effort, just administrative issues we had to overcome,” Brindisi told the editorial board.
As the Globe recently reported, Massachusetts cities and towns have used just 5 percent of the $50 million they received from opioid settlements, according to an analysis of municipal spending reports from the fiscal year that ended June 30, 2023. The slow pace of government spending is frustrating advocates who say the dire opioid crisis calls for swifter action.
The state Legislature took an important step in that direction by enacting a budget bill late last year that authorized communities to put the settlement money into a special fund — rather than their general fund — so that they can spend it more quickly, without waiting for town meeting. Now the onus is on communities to develop plans that are thoughtful but that also recognize the urgency of the crisis.
“People are dying,” said state Senator John Velis, who cochairs the Joint Committee on Mental Health, Substance Use, and Recovery. “At some point in time you just need to get into the fight.”
The money comes from a $26 billion legal settlement the attorneys general from several states reached with opioid distributors and drug maker Johnson & Johnson; Massachusetts is expected to receive more than $500 million distributed over 18 years. If a settlement with Purdue Pharma is approved by the courts, more money could be forthcoming. That makes it important for communities to get it right and use the money to positively impact lives.
The state has already spent part of its share of the settlement, allocating $37 million over the past two years to fund initiatives including purchasing naloxone, distributing fentanyl test strips, setting up mobile health vans and mobile methadone clinics, repaying student loans for substance use clinicians, and expanding supportive housing, according to a state report. But more than 90 percent of municipalities hadn’t used any of their money as of July, the Globe found.
There are many reasons communities are taking their time. Andy Ottoson, public health planner at the Berkshire Regional Planning Commission, said smaller towns in his region were developing agreements to pool money for regional services. Some Berkshire communities got separate funding for opioid programs from an National Institutes of Health-funded study, and they are working to determine what remaining gaps the settlement money can fill.
“Especially for those of us in rural areas, a lot of agencies are working in this space already,” Ottoson said. “It can be difficult to coordinate efforts and not duplicate efforts.”
Data collected by the state found some communities are working faster than others. Worcester spent all $845,000 it received last year, launching a crisis response team, creating mobile access to substance use treatment, and helping residents experiencing homelessness. In contrast, Boston had not spent any money and is still engaged in a planning process.
To be sure, the data is not current. After the state forms were submitted, Lynn spent $5,000 on publicly accessible cabinets stocked with naloxone in high-overdose areas and entered a procurement process for a vending machine to distribute free naloxone, personal hygiene supplies, and other items.
Because of accounting issues, Springfield is listed as having spent none of the $1.5 million it got last year. But public health Commissioner Helen Caulton-Harris said the city actually spent about half a million dollars on a mobile medical van, equipment for the police and fire departments, and an opioid response coordinator. City officials are working with people with lived experience with substance use disorders to develop plans for the remaining money.
Officials in Lynn and Springfield said with so much money at stake, it is vital that immediate steps are coupled with a deliberate community engagement process that includes people with substance use disorders to understand long-term needs. The state’s Bureau of Substance Addiction Services has issued guidelines for municipalities on how to use the money, with a list of resources that suggest best practices.
“It makes sense people want us to spend quickly, but we also believe we should be spending money purposefully and in conjunction with community voices,” Caulton-Harris said.
That is good advice. Communities should move urgently but also smartly in spending the funds. Used well, the money could create a turning point in an epidemic that has killed more than 2,000 Massachusetts residents annually in recent years.
As Sarah Wakeman, medical director for substance use disorder at Mass General Brigham, said, “We always hear in the addiction space there’s not enough resources, not enough workforce, not enough treatment, there’s not enough housing. We have a huge influx of money coming in. This is the moment to use it to save people’s lives.”
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.