Arizona’s counties have started to sign off on a national, multi-billion-dollar opiate settlement — but no individual town or county yet has any clear idea how much the settlement will yield locally.

Navajo County became the first to sign on the bottom line, with all the state’s counties, 90 cities and the state itself lined up to sign. Gila County is expected to follow suit shortly.

The settlement nationally may top $50 billion, with at least 42 states, five territories and Washington, D.C. party to an agreement with an array of drug manufacturers and distributors.

The companies have been seeking a settlement for years to resolve complaints that an epidemic of opiate overdoses was spawned by misleading marketing, payoffs to prescribing doctors and efforts to minimize the risk of addiction.

Drug overdoses killed 90,000 Americans last year, with the great majority of those deaths linked to opiates – including painkillers, heroin and synthetic opiates like fentanyl. An epidemic that started with a surge in prescription painkillers morphed into a deadly increase in deaths from street drugs like heroin – often laced with fentanyl, which is a synthetic opiate. Many deaths nationally have involved a mixture of opiates and other drugs like meth and antidepressants.

The drug companies have been working for years to convince as many states and counties and towns as possible to sign on, hoping to settle most of the outstanding lawsuits all at once.

The lawsuit turns on claims the drug companies “misrepresented the addictive nature of drugs like OxyContin – which is how people get hooked into more serous drugs like heroin and fentanyls,” said Moore.

The agreement divides up any money the lawsuit ultimately produces. The state will get 44% of the money and the counties and cities 56%.

The counties and cities must spend the money on programs directly related to drug overdoses — including law enforcement, distribution of drugs to reverse an overdose and treatment programs.The settlement includes a provision for bonus payments depending on how many counties and cities sign on. The drug companies hope that provision will settle as many claims as possible – leaving less legal uncertainty for the future. If enough cities and counties sign on, it could boost the settlement by $11 billion, according to some published reports. Some 3,000 lawsuits are pending.

The long settlement negotiations have been intensely controversial.

Many of the drug companies involved have denied wrongdoing, saying that the U.S. Food and Drug Administration approved the use of the drug and that doctors, regulators and others are responsible for the ballooning sale of prescription drugs that kicked off the disaster.

Most of the money in the proposed settlement will go to states, counties and cities to fight the epidemic going forward, rather than to pay costs and damages already incurred.

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