Mind and Body

Recovery community creates sea change in laws, policy

RI Attorney General will challenge bankruptcy ruling involving Purdue Pharma

Photo by Richard Asinof, file photo

R.I. Attorney General Peter Neronha successfully advocated for a legal change in the felony drug laws, and participated in a ceremonial signing event for the new law last week. He also announced last week that he will be appealing the bankruptcy decision in the Purdue Pharma case.

By Richard Asinof
Posted 10/4/21
A sea change in the relationship that the recovery community has with the McKee administration was celebrated in part by the ceremonial signing of new legislation changing possession of small amounts of drugs to a misdemeanor, not a felony.
What will other community advocates learn from the recovery community’s success in finding leverage to influence decision-making around funding of programs, particularly in the current debate around how $1.1 billion in unspent federal funds should be allocated? With the potential for millions of dollars to flow to Rhode Island as a result of Attorney General Peter Neronha’s appeal of the federal bankruptcy court decision on Purdue Pharma and the Sacklers, is there a way to ensure that the money be used to address the harms caused by the opioid epidemic in Rhode Island? Will health insurers and managed care organizations be willing to raise their reimbursement rates for providers for behavioral health and mental health services? Which candidates running for Governor in the 2022 election will seek to align themselves with the recovery community?
The latest federal court trial will take place in Ohio next week, where two counties will face off against four of the nation’s largest chain pharmacies in a trial that could serve as a litmus test for how to hold them accountable for their role in the nation’s opioid crisis, according to a report in The Washington Post.
The counties are claiming that CVS, Walgreens, Walmart and Giant Eagle failed to stop mass quantities of opioid drugs from reaching the black market.
Here in Rhode Island, Attorney General Peter Neronha is preparing to go to trial in January to pursue claims against three major opioid distributors – McKesson, AmerisourceBergen, and Cardinal Health.
The continuing legal actions against the manufacturers, distributors and pharmacies involved in the opioid epidemic raise questions about how best to hold companies accountable for their business practices, particularly as the rising costs of prescription drugs has been identified as the key driver in higher medical costs in Rhode Island.

PROVIDENCE – The facts are nothing without their nuance. When Gov. Dan McKee, R.I. Attorney General Peter Neronha, Senate Majority Leader Michael Mc Caffrey and state Rep. Scott Slater journeyed to South Providence on Tuesday morning, Sept. 28, to the offices of Project Weber/RENEW on Broad Street, in order to take part in the ceremonial signing of legislation amending the Unified Controlled Substances Act, reclassifying the simple possession of 10 grams or less of certain controlled substances as a misdemeanor charge, rather than a felony, it marked a dramatic sea change that had taken place in the way that Rhode Island was now addressing recovery, putting the emphasis on treatment rather than jail.

Just three years earlier, the previous R.I. Attorney General, Peter Kilmartin, had introduced legislation that would give a mandatory life sentence to anyone who sold an illicit substance that led to a fatal overdose, known as Kristen’s law. [See link below to ConvergenceRI story, “Is a drug overdose murder?”] The author of the story was Annajane Yolken, who covered a legislative hearing. Three years later, Yolken was one of the principal advocates lobbying for the new legislation, receiving one of the pens used by the Governor to sign the legislation.

Gov. McKee and Attorney General Neronha spoke with passion about the changes in attitude. “This legislation is about breaking the cycle and getting help for those suffering from addiction,” Gov. McKee said. “It’s a matter of public health to allow individuals to allow individuals to get treatment, not prison time.”

“I believe that possession of small amounts of drugs for personal use is much more of a public health issue than a law enforcement one,” Attorney General Neronha said, recalling how when he first began working as a prosecutor in 1996, people were being charged with a felony for possession of a needle and syringe, without any drugs.

Changes in attitude
The ceremonial signing [the actual signing had occurred in July] also marked a significant sea change in the relationship between the McKee administration and the recovery community. The subtext for the event had been a remarkable victory achieved by the recovery community, which had staged a walk out over more than $2 million in cuts in funding to programs, forcing the administration to rescind the cuts with the promise of greater transparency.

Although the speakers at the ceremonial signing made no mention of what had occurred, the most recent edition of the RICARES newsletter published on Friday, Oct. 1, offered a detailed analysis of what had happened.

“September is always a big deal for us in the recovery and treatment communities. It’s National Recovery Month, a time for community celebration with our Rally4Recovery events, and the opportunity to be joyful public faces and voices of recovery. And, it is time to collectively remember our friends, family members, and others who have died as a result of their addictions – this reminds us to continue our focused gratitude for our recovery.”

“Our celebration this year, as in recent past years, was tempered by the prediction that more of us will die from accidental overdose this year than any previous year. It was tempered by the disproportionate impact of fatal overdoses in the Black and Hispanic communities; by the COVID epidemic that just won’t go away; by economic and social uncertainty in what has become a divided nation; and by a sudden and perplexing shortage of Naloxone, the life-saving medication that many of our organizations have been distributing throughout the state for the past few years. But we were determined, this September, to Rally On.”

Then, suddenly, September became the cruelest month. The headline in the September 6th weekly newsletter ConvergenceRI read, “BHDDH cuts more than $2 million in funding for recovery programs.”

For those of us who had partial or no knowledge, the ConvergenceRI story gave us a complete picture of a shocking reality – that a range of life-saving recovery and treatment programs were either being cut or eliminated.

Strength in unity
The RICARES newsletter then explained what happened next: The ConvergenceRI story was widely disseminated that day, and our emails and texts started blowing up. The recovery and treatment communities spontaneously mobilized with one goal, that the cuts be restored.

A strategy quickly developed. We would insist that the agenda of Task Force meeting scheduled for Wednesday the 8th be altered to address the cuts. And, if BHDDH did not agree to reinstate the funding, we would walk out of the meeting and not participate in any further Task Force activities.

At the meeting, attended by approximately 75 people in person and a reported 160 tele-attendees, affected recovery and treatment providers spoke with specificity, with conviction, and with passion and emotion, about the effect of the funding loss on their ability to provide crucial services to people with behavioral health disorders.

As the meeting neared its conclusion, the BHDDH Director was asked to explicitly state that the affected programs would be level funded. The Director demurred and all the attendees, except the state folks, departed the meeting.

Needless to say, it was a difficult decision to take this kind of action. It was not our preferred type of action. It was a decision made from a sense of desperation, and also from a long-simmering sense of frustration related to the lack of transparency about how the millions of dollars of BHDDH is spent.

On September 15, we received an email from the Governor’s Task Force stating that the affected recovery and treatment programs would be level funded through FY 2022. The Task Force co-chairs also promised to be more transparent about funding decisions. There was a collective sigh of relief, but it was a temporary sigh, as we recognize that a relationship has fundamentally changed.

The article in the RICARES newsletter continued, reflecting on the impacts of the changed relationships moving forward.

The point of this article is not to re-live those 9 days in from crisis to resolution. Rather, it is to affirm and to celebrate the power and influence that we have when we work together. The reality is that in our recovery and treatment communities [as in all communities] there are rivalries, competition, and conflicting priorities, even as we share a set of common goals. But this September, this Recovery Month, we came together, developed a consensus, and took action in solidarity.

We again recognize the unmeasurable value of our friends and allies as part of our communities. This all would not have happened without the reporting of Richard Asinof of ConvergenceRI, who broke and continued the story, and Steve Ahlquist of UpRiseRI, the only other media person to comprehensively cover the story.

The Substance Use and Mental Health Leadership Council has stepped up to offer a space where we can work together to “embrace this opportunity for change.”

And, how many other states have an Attorney General who is as strong an ally as Peter Neronha, who took the EOHHS superstructure off the hook, and potentially saved many Rhode Island lives, by announcing that he was directing $1 million of opioid settlement dollars to purchase Naloxone? How many other states have as strong a legislative champion as Senator Josh Miller?

Jonathan Goyer, in a subsequent ConvergenceRI interview, said, “I daydream of a world where we don’t have to go to work every day and fight to keep what we had yesterday.”

This will only happen if we focus on a simple goal. We must recognize, operationalize, and internalize the imperative to shelve our rivalries and competition, to minimize our differences, and to develop a strong and unified voice.

The power of consensus, unity
At the ceremonial legislation signing event, Colleen Daley Ndoye, the executive director of Project Weber/RENEW, shared her reaction to the events that occurred in September, reflecting on the changed landscape.

“It was everyone who learned the power of the recovery community, which was really exciting. It was bigger than just one person,” she said. “I think the key is to remain together,” she continued, “to remain united, recognizing that the people who are on the ground doing the work are the experts.”

Further, Daley Ndoye stressed, “The people who are in the administration and in positions of power, they have to listen to us, because we really understand and we know.”

Burying the lede
Beyond the ceremonial signing, two other major, significant events occurred last week in the recovery universe:

• R.I. Attorney General Peter Neronha made the decision to challenge the ruling by the federal bankruptcy judge in the Purdue Pharma case involving the Sackler family, filing his intent to appeal the decision. [See link below to ConvergenceRI story, “Marking 50 years of the failed war on drugs.”]

In an interview with ConvergenceRI, Neronha explained his rationale. “What was proposed, what was being imposed, was simply insufficient to compensate Rhode Islanders who were harmed by the bad conduct of Purdue Pharma and the Sacklers,” he said.

Not only should this settlement, or discharge of bankruptcy, Neronha continued, “compensate the state of Rhode Island and its people for the harm caused by Purdue, but it ought to have an element of punishment in it, meaning there ought to be some element of pain imposed on the Sacklers. If we don’t know how much money they have, we can’t really tell how much this is really impacting them.”

In addition, Neronha raised the legal issue of “whether family members, or individuals, can be discharged of bankruptcy when there has been no showing that they are bankrupt.”

To Neronha, there was something fundamentally wrong with someone getting a discharge of bankruptcy when they are not bankrupt. “The bankruptcy protections are intended for corporations or individuals who can’t pay their debts. And, the Sacklers clearly can pay their debts. They are not paying to the full extent that I think they should pay them.”

New federal office of recovery established
On Thursday, Sept. 30, the Substance Abuse and Mental Health Services Administration [SAMHSA] announced that it is launching an Office of Recovery, within the Office of the Assistant Secretary for Mental Health and Substance Use, to advance the agency’s commitment to, and support of, recovery for all Americans.

In organizing this new office, SAMHSA will now have a dedicated team with a deep understanding of recovery to promote policies, programs and services to those in or seeking recovery.

Tom Coderre, a long-time recovery community advocate who has worked at both the local, state, regional and national level, talked with ConvergenceRI about the importance of this new initiative.

“As a person in recovery myself, this announcement is so empowering,” Coderre said. “SAMHSA, the federal agency responsible for advancing behavioral health of our nation, has been investing in recovery support services for more than two decades. However, the establishment of a new Office of Recovery will help us take our efforts to the next level, infuse recovery into everything we do and ultimately make recovery the expectation for people with mental illness and substance use disorders.”

Coderre continued: “I get emotional thinking about how historic this is and how grateful I am to the Biden administration for making it a priority.”

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