Opinion: NYC must account for opioid fund spending

My colleagues and I have worked hard to deliver record levels of funding for our schools, hospitals, public transit and much more – a record I’m very proud of. But the reality is: There’s often not as much as we’d like to go around.

That’s why I’m so disturbed by recent reporting about New York City’s spending of resources from the Opioid Settlement Fund. Thanks to the diligent efforts of state Attorney General Letitia James, we’ve secured over $2.6 billion from companies who have recklessly flooded our communities with dangerously addictive opioids. In this instance, our resources are plentiful. Why, then, isn’t it clear these funds are being spent efficiently to manage this growing crisis?

In 2021, I proudly voted to establish New York’s Opioid Settlement Fund as a secure, centralized repository for the proceeds from settlements against the opioid industry. These funds are specifically meant to go toward “treatment, recovery and prevention efforts,” at a moment where our mental health and addiction crisis is in plain view of many New Yorkers. We also established an advisory board to make recommendations on how funds are allocated. To date, New York City has received at least $90 million from the fund.

Yet neither the New York City Health Department, nor the Health and Hospitals Corporation – the two entities tasked with spending the bulk of this funding – have provided detailed information on how this money is being used to help New Yorkers in crisis. Reports on how these funds are being used – required by a 2022 law sponsored by City Council Member Linda Lee – provide only vague overviews without a detailed accounting of spending. Nor has the New York City Comptroller’s Office conducted an audit or analysis of how these funds are being spent.

Meanwhile, the opioid crisis in our city is reaching an all-time high. We’ve seen a modest decline this year, but the past two years have seen record high numbers of opioid-related deaths, more than double the number of deaths in 2019. There are more self-inflicted drug overdose deaths today than there were killings at the peak of New York City’s murder rate in 1990. The highest rates of overdose are in the neighborhoods in Bronx and East Harlem, but parts of my district – in Bed-Stuy and Crown Heights – have emerged recently as a “new area of concern.” Poor New Yorkers of color are especially vulnerable. When people struggling with addiction cannot access the treatment they need, they are more likely to cause harm to themselves or others.

In the face of this crisis, and the funds allocated to combating it, New Yorkers should expect a transparent, multifaceted effort to spend the funding in the most efficient way possible. However, the required reports describe a grab-bag of programs without specific spending levels on each. 

An undisclosed amount of settlement funding went to the City’s new telehealth program, where only 7% of patients treated this fiscal year had a substance use disorder and only 32 prescriptions were issued for buprenorphine, a common medication for opioid use disorder. Other counties across the state have reportedly used opioid settlement funding to bolster law enforcement budgets, or simply to shore up county reserves. This was not our intent when we established the Opioid Settlement Fund – we expect better.

This lack of detail does not simply reflect mismanagement in the face of a rapidly escalating crisis. It also prevents us from learning lessons about which expenditures are most impactful, and which are less effective. Without granular detail about how settlement fund allocations are being spent, how can we know what’s working and what isn’t?

The opioid crisis can be difficult to talk about for families and loved ones of those impacted. It disproportionately impacts the poorest communities of color – though by no means exclusively. But all New Yorkers struggling with addiction deserve our compassion and our sustained commitment to ensuring they receive the services they need.

In 2021, I wrote the nation’s first state law to allow reckless gun companies to face civil liability for their actions – finally giving New Yorkers a fair chance to get justice after a tragedy. By doing so, we took on the most irresponsible actors in a harmful industry and ensured they will pay penalties for their negligence. Thanks to the hard work of our state attorney general, we already have that level of accountability from the drug industry which has profited from our current opioid crisis. 

It’s rare to have this level of funding available at the ready to confront a full-blown crisis in our communities. We should be using it to address the opioid crisis, which imperils both behavioral health and public safety. The city must now do its part to ensure we spend those funds efficiently, effectively and transparently.