The Office of the Attorney General has announced that Guam will receive $279,049.44 from a $573 million multistate settlement with McKinsey & Company, one of the largest consulting firms for Purdue Pharma and other opioid companies, which helped them promote the drugs “and profited from the opioid epidemic.”
Out of the nearly $280,000, about $230,000 will come as an initial payment in the next 60 days, with the remaining $48,000 to be paid out over four years at $12,000 per year.
Attorney General Leevin Camacho, during a press conference Friday, said there is a need to fund those involved in drug rehabilitation on Guam and about $100,000 from the initial payment will go to organizations and services such as Oasis Empowerment Center, Lighthouse Recovery Center, New Beginnings at the Guam Behavioral Health and Wellness Center, the Department of Corrections Residential Substance Abuse Treatment Program and some courtroom programs.
Camacho said officials have identified these organizations and services because they not only deal with drug rehabilitation but also have populations struggling with opioid use disorder. Camacho said he could not specify how the money will be distributed among the organizations.
Another $80,000 will go toward performing toxicology reports on deceased individuals to get a better understanding of the opioid problem on Guam, he said.
“We are expressly excluded from (the U.S. Centers for Disease Control and Prevention) statistics on opioid overdose deaths and it has been to our detriment. Right now, most of our data is coming from those who voluntarily seek treatment or those who are arrested and are part of the court system,” Camacho said.
The AG’s office will be working with Guam Memorial Hospital and the office of the chief medical examiner on the reports, and will be communicating on software needs so toxicology data can be gathered in a useable form.
No permanent chief medical examiner
Guam is still without a permanent chief medical examiner, but GMH has the capability to prepare toxicology reports, according to AG’s spokeswoman Carlina Charfauros.
In December 2020, doctors testifying on a bill that would further regulate opioid use on Guam did agree that opioid abuse is taking place on Guam but said more information is needed to understand the scope of the issue.
Therese Arriola, the director of Behavioral Health, said at that time that 15% of substance abuse treatment at the agency related to opioid use. The vast majority relates to methamphetamine use, she said.
Absent toxicology reports, Camacho said his office has been tracking opioid abuse through the amount of drugs used to counteract opioid overdoses. Anecdotally, Camacho said his office has heard that between two and four patients are treated per month at GMH for opioid overdose.
“I made the comment that this is not a front-page problem, but that doesn’t mean this is not a problem,” Camacho said. “One of the things different about opioids is you can be legally addicted to opioids and law enforcement would have no reason to be involved in it. … You need resources to figure out how extensive the problem is and then you can direct more resources there.”
Sen. Telena Nelson, who introduced the opioid regulation bill in the 35th Guam Legislature, has reintroduced the measure in the form of Bill 6-36.
Camacho said there needs to be a balance between physician discretion with treating patients and combating opioid abuse, but he does believe Guam’s prescription drug monitoring program could use resources, and that may be another target for future funding.
“We can implement all these mandates, but unless you have the resources to execute it properly, you’re just creating more issues for more people to go through without knowing what the outcome is going to be. I would want to talk to the physicians and the pharmacists to see how pervasive it is and what we could do short of a very firm limit, seven days and you’ll have to come back,” Camacho said, referring to the initial limit on supply for opioid prescriptions in Bill 6.
About $50,000 out of the initial $230,000 payment will fund an outreach campaign. The remaining payments to come in over four years will fund supplies and equipment for direct service providers, Camacho said.
Guam’s AG’s office is involved in other national lawsuits relating to America’s opioid epidemic. The most important part for this case was being in the room, Camacho said.
“As these discussions are going on and allocations being brought up, there are proposals out there that the territories would get absolutely nothing, because we don’t have any metrics to explain just how bad the problem is here,” he added. “So going back to the importance of being in the room when these things are happening, … could we have gotten more? Possibly. But this is the first substantial settlement that any multistates have arrived at in this large of a bipartisan group, … and allocation is subject to very intense debate.”
Camacho could not comment much on other pending lawsuits, saying only that his office is actively involved in investigations. Guam filed against OxyContin maker Purdue Pharma, which was one of the manufacturers McKinsey advised for years.
Camacho said Purdue is currently in bankruptcy court, and the subsequent payment and distribution of assets will be the “big fight” between states, territories and others involved in the suit.
Filings describe how McKinsey contributed to the opioid crisis by promoting marketing schemes and consulting services to opioid manufacturers, according to a release from the AG.
In addition to payment, the settlement also calls for McKinsey to prepare tens of thousands of internal documents detailing its work for Purdue Pharma and other companies for disclosure online.
The consulting company also agreed to adopt a strict document retention plan, continue its investigation into allegations that two of its partners tried to destroy documents in response to investigations into Purdue, implement a strict code of ethics that all of its partners must agree to each year and stop advising companies on potentially dangerous Schedule II and Schedule III narcotics, according to the AG’s office release.