Nevada Attorney General Aaron Ford has repeatedly announced the state has received millions of dollars for opioid settlements. Several press releases on the AG’s website boast massive payments from pharmaceutical companies for their responsibility in the opioid epidemic. Drug companies were accused of misleading patients about the addictive nature of opioid medications.

Ford said in July that more than $1.1 billion is set to be received by the state to date. 

“This money will go directly toward remediating the harms done to Nevada by the ongoing opioid epidemic and will give our state, our counties and our litigating cities access to the funding and tools they need to help the members of our Nevada family impacted by the horrors of addiction,” he said. 

People involved with making recommendations for how to spend the money said they are in the dark about where that money is going. Multiple attempts over six months to get the information from the AG were stalled or obfuscated. This Is Reno filed a public records order with the AG’s office in June. It sought an “accounting of opioid settlement funds to include income from settlements to date as well as expenditures.”

An anonymous “public records official” said it would take more than two months to respond to the request, not actually to produce the records. 

“We just really don’t know where the money is going.” 

After two months, on Aug. 3, an email sent by Shannon Johnson at the AG’s office called This Is Reno’s record order “over broad.” After reiterating the request—a basic accounting of the funds received and spent—Johnson replied that it would take another month to respond. A month later, Johnson said it would take yet another month.

In late October, the AG sent a single-page spreadsheet and closed the request.

Only after publication of this article did the AG’s office respond, however. John Sadler with the AG’s office said, “the statements from sources that there were no expenditures related to organizations or opioid mitigation strategies on the spreadsheet is true, but this is because we are not the agency that tracks this information.”

The Nevada Department of Health and Human Services is.

‘Pitiful and incomplete’

That spreadsheet lacked information, specificity and what the original request sought: a tally of how the $1.1 billion will be spent. A certified public accountant, speaking only on the condition of not using their name, called the list of expenses “pitiful and incomplete.”

“It doesn’t appear that any of the ‘costs’ shown on this spreadsheet were for the direct benefit of Nevadans,” the CPA said. “Nowhere on this spreadsheet does it list any expenditures for the benefit of Nevadans – maybe the Community Benefit Fund, but there are only ‘contributions’ listed. There is no indication on the 1-page document provided that those dollars have been dispersed.”

The AG’s office ignored follow-up requests to explain the spreadsheet and expenses.

“If this data response is complete, no expenditures are shown for disbursements from this fund—only ‘costs’ and attorney fees,” the CPA said.

Christine Minhee, who runs the Opiod Settlement Tracker website, has been trying to get information from all states about how they spend massive legal settlements from drug companies. Her website launched in 2019.

Only 16 states, she said, have promised to disclose how settlement funds are being used. Nevada is not among them. When presented with the AG’s spreadsheet, she called it “notably unyielding.”

“There are distributed amounts and deductions but no specific expenditures, so it is far from something that could yield any reliable insight as to how these monies have fared in any normative sense (were they spent ‘well’ or on ‘good’ things?),” she said.   

The AG’s office later disputed these criticisms.

“Our office litigates, and the litigation we pursued resulted in recoveries,” Sadler, the AG’s communications director, said. “After our office receives the money from the recoveries, we disburse it through the One Nevada Agreement. This disbursement includes depositing the state’s share into the Fund for a Resilient Nevada (FRN), a fund created by statute. Our office does not oversee the FRN.”

Data available

A memo provided to This Is Reno from last year, signed by Ford, has an attached spreadsheet showing how much Nevada counties received at that time—about $35 million. More than $7 million went to law firms as part of the various settlements. 

The dollars received are separated into two basic fund categories. The state health department is overseeing one fund being used for grants. A second fund goes to local governments—cities, tribes and counties—and some of that distribution has occurred. About 39% of the funds go directly to local jurisdictions, and the state gets 44%. Law firms, including Ford’s previous firm, where he was a partner, get a sizable chunk. 

“The attorney general’s office worked with Ford’s former law firm, Eglet Adams, throughout the opioid litigation, which Ford first announced in June 2019 with a complaint that named more than 40 defendants,” the Las Vegas Review-Journal reported in July. Sadler said Ford was prevented from taking part in the process.

The state health department’s most recent report—through last December—for its Fund for Resilient Nevada, the money to be granted, notes that most funding to date has gone to salaries, vacation and sick time for employees, office rent and a sizable amount to Mercer Health for “contracts.”

More than $45 milliion remained in the fund last year. That fund is the repository for the settlement funds meant to ensure local efforts can implement programs, prevent opioid abuse and provide treatment. 

“there are overdoses daily, and the longer they wait to pay out front-line agencies, the more people will overdose and possibly die.”

People familiar with the state’s committees charged with making recommendations for spending the opioid dollars said the process is disappointing mainly because money is not moving fast enough—and because no reliable accounting has been made public. People familiar with the committees said even committee members have been left in the dark.

“There’s a lot of consternation about that,” said one person with knowledge of the situation. “We just really don’t know where the money is going.” 

At least two people attributed the problem to a lack of adequate staffing, and with two state entities managing the money—the AG’s office and the state health department—no one person is in charge of the process. Attempts last week to reach somebody at the Nevada Department of Health and Human Services (DHHS) were unsuccessful.

At a recent meeting of the AG’s Statewide Substance Use Response committee, a member of Ford’s staff said, after being asked, more information about expenditures is coming next year.

“The next report projected for next February will have a lot more detail on what is actually being funded,” Mark Krueger said, according to the committee’s meeting notes. 

Ford chimed in and said, “The reporting is transparent through public posting and through presentations to groups…”

Ford’s spokesperson reiterated, however, that the AG’s office is not the agency that tracks opioid mitigation efforts.

“The statements from sources that there were no expenditures related to organizations or opioid mitigation strategies on the spreadsheet is true, but this is because we are not the agency that tracks this information,” Sadler said.

“The state plan is required to be updated every four years,” Sadler added. “DHHS is also required to create an annual report on funds that have been spent pursuant to the state plan, as well collect and compile a report on how each of the One Nevada Agreement signatories have spent their share of the recoveries. To be clear: we do not make decisions on how this money is spent.”

Bodies continue to pile up

Opioid abuse was declared a public health crisis in 2017, and at that time, Nevada received a C rating for opioid death rates, according to the Nevada Medical Center, a nonprofit. A UNLV study in 2017 also noted that “the rate of death from opioid overdoses in Nevada has exceeded national averages.”

Nevada is one of the top states in the U.S. for drug use in various categories, but the state stands out in particular for its percentage of people misusing pain relievers—the highest of any western state, according to the most recent data provided by the Substance Abuse and Mental Health Services Administration. 

“In 2016, Nevada had one of the highest rates of opioid pain medication prescribing at 87.5 prescriptions per 100 state residents compared to 66.5 prescriptions per 100 residents nationally, ranking second highest in hydrocodone and oxycodone prescribing,” the UNLV report noted. “Fewer than 1 in 10 Nevada residents identified with a substance use disorder are receiving treatment.”

That translates to bodies piling up while substance-use nonprofits beg for help since, as substance abuse experts have noted and data show, the problem has not improved in the past six years. 

The state has announced two rounds of funding to put the opioid money to use, but the pace to fund programs has been glacial, critics said.

Joseph Engle, who runs the There is No Hero in Heroin Foundation (TINHIHN), said more transparency and urgency are needed.

“I believe the issue is the speed on which it has been spent, there are overdoses daily, and the longer they wait to pay out front-line agencies, the more people will overdose and possibly die,” he told This Is Reno. “This is an opportunity to save a lot of families from pain.”

Engle’s son died at age 19 from an overdose. He has applied for funding from the state—the application is due Dec. 4—and said he is hopeful.

“It seems an injustice to small nonprofits like myself [that] have to be stressed out each month to make ends meet,” Engle added. “We deliver lifesaving services to a vulnerable population; our numbers are increasing, and we could benefit greatly with some sustainable funding.”

UPDATE: The AG’s office provided statements after initial publication, and comments were added to this article. The $1.1 billion figure was corrected to indicate the total is what the state will receive, not what it has received.