New Mexico has been hit particularly hard by the opioid crisis and, as of 2023, had the seventh highest overdose rate in the U.S. (Douglas Sacha/Getty Images)
The New Mexico Department of Health recently alerted the public about surging rates of drug overdoses in Taos, Santa Fe and Rio Arriba counties, with fentanyl use linked to the majority of the fatalities.
This latest evidence of the opioid epidemic’s ongoing impact in New Mexico comes as the state ranks poorly on transparency in disclosing how it will use more than $850 million in opioid settlement funds, according to a OpioidSettlementTracker.com, a clearinghouse and accountability tracker for opioid settlement information created in 2019 by public health advocate and attorney Christine Minhee.
According to New Mexico state law, settlement funds must be primarily used to address the damage the drugs have done and to prevent future harms. But agreements the state made in the settlements do not require public reporting on how the money is spent or public input in spending decisions. According to the Opioid Settlement Tracker, New Mexico stands among a minority of states that earned a “0%” on its Expenditure Report Tracker, indicating the state has not committed to any public reporting of settlement fund spending. The data is based on research that included calls to the state and ongoing investigations of publicly available documents related to the settlements.
The Tracker notes that settlement fund spending is subject to examination by the New Mexico State Auditor’s office, but that the results of those audits are not made public.
Patrick M. Brenner, president of nonprofit think tank Southwest Public Policy Institute, said New Mexico needs more guardrails to ensure accountability with its use of opioid settlement funds (Courtesy photo)
By comparison, Colorado makes 100% of its opioid fund spending public through its Colorado Opioid Settlement Dashboard. Arizona likewise posts its state settlement allocations online. Wyoming, California, Georgia, Iowa, Wisconsin and several other states have committed to making at least some state opioid spending public.
Patrick M. Brenner, president of nonprofit think tank Southwest Public Policy Institute, pointed to the importance of public understanding of the settlement funds’ purpose in creating an environment of accountability.
“The state has not done a decent enough job of educating the public about the success story of holding these pharmaceutical companies accountable,” he said, “so not as many people know to ask questions.”
The opioid settlements, which total more than $50 billion nationally, rank historically among the country’s highest-dollar public health settlements. Because states must use the settlement money for opioid remediation, the Johns Hopkins Bloomberg School of Public Health calls the settlements “an unprecedented opportunity” to address the decades-long opioid epidemic. States are receiving funds over 20 years from corporations including Johnson & Johnson, CVS and Walmart for their roles in creating, exacerbating and perpetuating the epidemic.
“The state has not done a decent enough job of educating the public about the success story of holding these pharmaceutical companies accountable, so not as many people know to ask questions.”
– Patrick M. Brenner, president of Southwest Public Policy Institute
New Mexico has been especially hard hit by the opioid crisis. In 2023, the most recent data available, the state had the seventh highest overdose rate in the U.S. While overdoses overall in the state have been declining since 2021, a recent state legislative analysis notes lack of evidence “that use of fentanyl or other opioids has also decreased.” Rather, the decline is attributable to increased use of harm-reduction medication such as Narcan to counter overdoses.
In 2023, Santa Fe County Community Services Department rolled out a public awareness campaign related to fentanyl that included “Never Use Alone” messaging. The New Mexico Health Department recently reported a surge of overdoses in Santa Fe, Rio Arriba and Taos counties, possibly linked to increased amounts of fentanyl in the supply in the three counties.
“I’ve had a lot of conversations with people who just felt so blindsided [by opioid addiction]. They didn’t see it coming,” said Claire Carmony, a social worker and program manager with the New Mexico Crisis and Access Line, which receives nearly 40 calls and texts a day from people across the state seeking help with addiction. “We get a lot of calls from concerned family members, loved ones, friends and community members that are impacted,” she said. “So opioid use disorder really has a big impact on our community as a whole, and people really struggle.”
Accountability
New Mexico’s management of opioid funds has been called into question before. A brief published last year by the state’s Legislative Finance Committee called attention to contingent-fee legal contracts that wiped out nearly $250 million from awards the state won against pharmacies. The brief also pointed out the relatively short period the state has to pay those fees.
“The lawyers received their money a lot faster than the state or local governments will ever get their money in,” Felix Chavez, a financial analyst and former LFC staff member who worked on the brief, told Source NM. “If [New Mexico] were to have the same payout structure that these attorneys did, a lot more could be done” to mitigate the crisis, he said.
The LFC brief followed a 2023 opinion by the New Mexico State Ethics Commission after the Walgreens judgement, from which lawyers were paid $159 million of the state’s $500 million award. The SEC wrote that “several public bodies” were illegally sidestepping the state’s procurement code in making deals with outside law firms. In a 2023 statement, New Mexico Department of Justice Chief of Staff Lauren Rodriguez said the Walgreens legal agreements “contained no limit on fees.” She added that Attorney General Raúl Torrez had “instituted a new policy that sets strict limits on contingency fee cases,” though she did not provide further details about what those limits were. She also noted that even with lawyers’ fees, “New Mexico ranks third nationally compared to other states’ total settlements (including their attorney’s fees).”
Brenner said that while the state is required to spend the settlement money on addiction prevention and treatment, safeguards to ensure that happens are lacking.
“Even if people are well-intentioned in handling these funds, they’ve got this relatively large infusion of money,” making accountability loopholes risky, he said.
This summer, another LFC report showed that state programs for medication-assisted treatment, or MAT, which are funded by opioid settlement money, were underused and lacked outcome data. MAT, in which people with opioid and other substance use disorders are treated with medication, is among the most effective ways to treat addiction.
Making a dent
The New Mexico Department of Health emphasizes the availability of Narcan, which can stop an opioid overdose, as part of its harm reduction program. (Danielle Prokop/Source NM)
Accountability notwithstanding, Josh Swatek, policy and performance director with the New Mexico Department of Health, calls the settlement funds “a game-changer.” He told Source NM that the funds allow for systemic advances in addiction prevention and treatment, including medications for incarcerated people; education in schools; harm reduction resources; and behavioral health services.
“Without the settlement funds we would have a much smaller scope,” Swatek said. “We wouldn’t have the link to harm reduction, and we would have less staff.”
Brenner pointed out that despite the state’s failure to safeguard accountability in spending, cities and counties have worked to ensure the money is allocated properly.
At a September meeting of the Legislative Health and Human Services Committee, Dona Ana County Health and Human Services Director Jamie Michael told legislators funds were being used for prevention and treatment, including ensuring availability of MAT in doctors’ offices and purchasing Narcan for first responders, state health offices and emergency departments to have on hand. She noted that in just the past month, four people had overdosed in the county, two of them fatally. “This seems like a lot of money over a long period of time,” she told lawmakers. “With all the needs, it’s not necessarily a lot of money.”
Last year, Bernalillo County and the City of Albuquerque teamed up with global health nonprofit Vital Strategies to create a strategic plan for dealing with the crisis, which includes bringing prevention education to middle school students. “People are dying from drug overdoses,” said Dr. Wayne Lindstrom, Bernalillo County’s deputy manager of behavioral health, who echoed Michael’s emphasis on harm reduction to save lives. “How many deaths is too many?”
Claire Carmony, a social worker and program manager with the New Mexico Crisis and Access Line, says the organization receives numerous calls from people whose lives have been impacted by opioid use. (Courtesy photo)
Like Michael, Lindstrom emphasized how important it is to be “laser focused” when allocating settlement funds. “People hear about these large sums of money and they get the perception that this is really a significant investment,” Lindstrom said. “Bottom line is that $2.2 million is not going to make a significant difference relative to the scale and scope of the problem overall,” he said.
With the Trump administration’s Medicaid cuts, poor transparency could make opioid funds vulnerable to diversion to other uses, said Brenner. Even if the state is well intentioned, “the absolute top level right thing is to make sure that these monies are only spent on what they are meant for—not plugging Medicaid budgets.”
Nationally, the final chapter in the opioid lawsuits is underway. In June, states across the U.S., including New Mexico, agreed to a $7.4 billion settlement with Oxycontin-maker Purdue Pharma and its owners, the Sackler family.
The Purdue settlement will likely infuse the state with additional resources for prevention, treatment and recovery. Rodgriguez declined to comment on New Mexico’s likely share, but states with similar populations like Nevada and West Virginia have announced expected funds in excess of $50 million over 15 years. The funds’ impact remains to be seen. “We never seem to have the resources that approach equivalency relative to the extent of the problem,” Lindstrom said.
