Graphic showing payouts from opioid settlements.
Wichita and surrounding communities are deciding how to spend money from opioid settlements. Often the choice comes down to cracking down on drugs or paying for treatment. (Naomi O'Donnell/The Beacon)

Sedgwick County Sheriff Jeff Easter has strong opinions about how the county should spend the windfall it expects from legal settlements with opioid makers, distributors and retailers.

“It has to be spent,” he said, “for recovery, rehab, that type of stuff.”

Law enforcement, Easter said, should not be getting any of it.

As local governments across the country begin spending millions in payouts from the opioid settlements, that’s the choice they  face.

Should they allocate more money to help police and sheriff’s departments track down drugs in an attempt to choke off the supply? Or should they shift dollars into treatment and harm-reduction efforts to reduce demand?

Public health experts overwhelmingly side with treatment, saying the country’s generations-long war on drugs has not worked. Easter, who has spent 35 years in law enforcement, agrees.

“When it comes to substance abuse,” he said, “it really shouldn’t be a law enforcement issue, but it is. And it’s going to be. Money needs to be spent on the backside to help (people) so they don’t have contact with law enforcement.”

Kansas expects $340 million of the $50 billion being paid out nationally to settle claims with companies accused of pushing prescription painkillers like OxyContin and Vicodin, which led thousands of Americans down the path to drug addiction. 

Cities and counties in the state are expecting an additional $85 million over the 18 years settlements will be paid out.

In Sedgwick County, payouts so far have ranged from about $1.3 million to both the county and the city of Wichita to just under $14,000 to Goddard.

Sedgwick County and Wichita are sharing the cost of a study, which began late last year, to consider the best uses for the money they will eventually receive. The County Commission and City Council aren’t likely to spend more opioid settlement money until the study is done, probably late this year.

But other towns in the area have started spending their shares.

Andover, for example, reported spending $33,000 of the $38,000 received in 2023 on drug testing equipment for first responders and the public. And Maize, which received just under $15,000 last year, spent about $9,000 on graduation T-shirts and other supplies for the D.A.R.E. (Drug Awareness Resistance Education) program, offered in elementary schools. Some of the town’s money also went to cover the cost of purchasing Narcan — a medication that can reverse an overdose — for police and first responders.

In Kansas, 75% of the opioid settlement money goes to the Kansas Fights Addiction Fund. That’s controlled by a grant review board that doles out the money to cities, counties, nonprofits and, beginning next year, for-profit entities. The remaining 25% of the state’s money gets divided between cities and counties.

Chris Teters, an assistant attorney general in Kansas, said many guardrails in place both in the settlement agreements and in state law are designed to keep money directed toward addressing the state’s opioid crisis.

“This is a lot of money,” he said. “But it’s not a lot of money.”

If it’s going to make a difference, he said, it needs to be spent wisely.

The Kansas grant review board is spending $1.5 million on a study to explore which investments will best fight the opioid epidemic.

“We’re not looking for utopia,” said Janine Hron, the University of Kansas researcher who is leading the study. “But we are looking for better.”

So far, the KFA board has awarded about $6 million in grants related to treatment programs and about $4 million for prevention. The statewide fund had received about $34.5 million at the end of June.

Most of the opioid settlements stipulate that the majority of the money must be spent on addiction treatment and prevention — and not to patch random budget holes. 

Public officials want to avoid what happened to the $246 billion tobacco settlement of the 1990s, which fell short on helping people quit or avoid smoking.

Spending guidelines for the opioid settlement money include harm-reduction efforts, like purchasing and distributing syringes and Narcan. Or treatment efforts, like providing medication-assisted care to help people recover, and training first responders to steer patients to treatment. 

Money can also go into public information campaigns. And local governments can use a certain amount to reimburse themselves for past costs related to the opioid crisis. 

But that’s not stopping local governments from allocating the dollars to sheriff and police departments, which some addiction experts worry won’t help slow the crisis. 

Legislators in Johnson County, for example, voted earlier this year to spend $235,000 on two mail scanners to check for drugs in letters coming to the jail. Since personal mail is already sent offsite to be scanned and returned to inmates digitally, the scanners would only be needed to scan legal mail, such as letters coming from inmates’ lawyers.

Johnson County Sheriff Calvin Hayden told county commissioners that cracking down on the drug supply was important.

“Every time my guys take a five- or 10-pound bag of fentanyl off the market,” he said, “those are lives saved.”

The sentiment is common, said Dr. Jeff Singer, a senior fellow at the Cato Institute. But he said local officials need to realize that if drugs can’t even be kept out of jails, spending more money on law enforcement to quash supply everywhere else is unlikely to work.

When police have tried to crack down on drugs, he added, they’ve only driven people to more dangerous drugs. 

Enforcement against illegal prescription painkillers led to a rise in heroin. Clampdowns on heroin were followed by a rise in fentanyl — something that could be made in a lab to be small, highly concentrated and deadly potent. And as fentanyl is targeted by law enforcement, more highly potent and dangerous opioid drugs, like xylazine, or “tranq,” spill into the market.

“The harder the law enforcement,” Singer said, “the harder the drug.”

Tearing down barriers that prevent organizations from offering harm-reduction services, like Narcan or clean needles, is a far wiser use of the opioid settlement money, Singer said.

The crisis isn’t abating. 

The U.S. Centers for Disease Control and Prevention says drug overdoses killed more than 110,000 people in the United States during the 12-month period that ended in October. Many of those deaths, experts said, were caused by fentanyl, and communities are struggling to help. Other drugs laced with fentanyl, which is 50 times stronger than heroin, are often a deadly combination.

Sedgwick County is among the hardest hit in Kansas. Between 2013 and 2022, the county reported 24 drug-related deaths per 100,000 people every year. Of those, 13 were caused by opioids and eight were caused by fentanyl or another synthetic opioid.

Easter said at least 70% of the people in the county’s jail have addiction issues.

“That’s just the folks housed with us,” he said, “not the folks who are booked and released within hours.”

For all of them, treatment can prove nearly if not impossible to find in Sedgwick County, especially if they don’t have health insurance, Easter said. Getting a spot at the one agency in the area that accepts people without insurance can require a two- to three-month wait. 

“That’s why we have this cyclical trend,” Easter said. “People get out (of jail) and while they’re waiting to go into treatment, they use again, go out and commit a crime, and they’re right back with us.”

Easter said it’s a pretty clear illustration of why money from the opioid settlement money should be going to help get more people out of that cycle.

So far, Sedgwick County has collected $1.3 million from the settlements. Last year, the county reported spending $364,000 on testing equipment for the Regional Forensic Science Center.  The equipment will let the county determine if fentanyl or a drug overdose caused a death, information that the county said would help “alleviate the crisis and abate substance use disorder.”

The county also put some of its early settlement dollars into a social media campaign meant to educate middle and high school students and their parents about risks associated with fentanyl.

Wichita has spent about $128,000 of the $1.3 million it’s taken in on drug prevention efforts, Narcan kits and to support the Homelessness Task Force.

Donte Martin, an assistant city manager in Wichita, said city officials recognize that the best approach will come from working with people in the community — from addiction experts to law enforcement — to determine how the dollars can make the most difference. That’s what the city and county are doing with the study, he said.

“This is a unique opportunity for the city of Wichita and Sedgwick County to collaborate and develop strategic plans that will make an impact in our community,” he said, “to address the challenges that we’re seeing related to opioids.”

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Suzanne King is The Kansas City Beacon’s health care reporter. During her newspaper career, she has covered education, local government and business. At The Kansas City Star and the Kansas City Business...