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In California, opioid settlement money helps fund lifesaving drugs and police projects

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In California, opioid settlement money helps fund lifesaving drugs and police projects

Sonja Verdugo lost her husband to an opioid overdose last year. She regularly delivers medical supplies to people using drugs who are living — and dying — on the streets of Los Angeles. And she advocates at Los Angeles City Hall for policies to address addiction and homelessness.

Yet Verdugo didn’t know that hundreds of millions of dollars annually are flowing to California communities to combat the opioid crisis, a payout that began in 2022 and continues through 2038.

The money comes from pharmaceutical companies that made, distributed or sold prescription opioid painkillers and which agreed to pay about $50 billion nationwide to settle lawsuits over their role in the overdose epidemic. Even though a recent Supreme Court decision upended a settlement with OxyContin maker Purdue Pharma, many other companies have already begun paying out and will continue doing so for years.

California, the most populous state, is in line for more than $4 billion.

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“You can walk down the street and you see someone addicted on every corner — I mean it’s just everywhere,” Verdugo said. “And I’ve never even heard of the funds. And to me, that’s crazy.”

Across the nation, much of this windfall has been shrouded in secrecy, with many jurisdictions offering little transparency on how they’re spending the money, despite repeated queries from people in recovery and families who lost loved ones to addiction.

Meanwhile, there’s plenty of jockeying over how the money should be used. Companies are lobbying for spending on products that range from medication bottles that lock to full-body scanners to screen people entering jails. Local officials are often advocating for the fields they represent, whether it’s treatment, prevention, or harm reduction. And some governments are using it to plug budget gaps.

In California, local governments must report how they spend settlement funds to the state’s Department of Health Care Services, but there’s no requirement that the reports be made public.

KFF Health News obtained copies of the documents via a public records request and is now making available for the first time 265 spending reports from local governments for fiscal year 2022-23, the most recent reports filed.

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The reports provide a snapshot of the early spending priorities, and tensions.

Naloxone an early winner

As of June 2023, the bulk of opioid settlement funds controlled by California cities and counties — more than $200 million — had yet to be spent, the reports show. It’s a theme echoed nationwide as officials take time to deliberate.

The city and county of Los Angeles accounted for nearly one-fifth of that unspent total, nearly $39 million, though officials say that since the report was filed they’ve begun allocating the money to recovery housing and programs to connect people who are homeless with residential addiction treatment.

Among local governments that did use the cash in the first fiscal year, the most popular object of spending was naloxone, a medication that reverses opioid overdoses and is often known by the brand name Narcan. The medication accounted for more than $2 million in spending across 19 projects.

One of those projects was in Union City, in the San Francisco Bay Area. The community of about 72,000 residents had five suspected fentanyl overdoses, two of them fatal, within 24 hours in September.

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The opioid settlement money “was invaluable,” Corina Hahn, the city’s director of community and recreation services, said in her report. “Having these resources available helped educate, train and distribute the Narcan kits to parents, youth and school staff.”

Union City bought 500 kits, each containing two doses of naloxone. The kits cost about $13,500, with an additional $56,000 set aside for similar projects, including backpacks containing Narcan kits and training materials for high school students.

Union City also plans to expand its outreach to homeless people to fund drug education and recovery services, including addiction counseling.

Those are the sorts of lifesaving services that Verdugo, the Los Angeles advocate, said are desperately needed as deaths of people living on the streets pile up.

She lost her 46-year-old husband, Jesse Baumgartner, in June 2023 to an addiction that started after he was prescribed pain medications for a high school wrestling injury. He tried kicking his habit for six years using methadone, but each time prescribers lowered his dosage the cravings drove him back to illicit drugs.

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“It was just this horrible roller coaster of him not being able to get off of it,” Verdugo said.

A woman holds a framed photograph of a man and a woman

Sonja Verdugo lost her 46-year-old husband, Jesse Baumgartner, in June 2023 to complications from an opioid addiction. She’s now a community organizer for Ground Game LA.

(Arlene Mejorado / For KFF Health News)

By then the couple had survived 4½ years of being homeless and had been in stable housing for about two years.

Fentanyl use, particularly among homeless people, “is just rampant,” she said. People sometimes are initially exposed to the cheap, highly addictive substance unknowingly when it is mixed with something else.

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“Once they start using it, it’s like they just can’t backtrack,” said Verdugo, who works as a community organizer for Ground Game LA.

So she leaves boxes of naloxone at homeless encampments in the hope of saving lives.

“They definitely use it, because it’s needed right then — they can’t wait for an ambulance to come out,” she said.

Cities backtrack on spending for law enforcement

By contrast, the cities of Irvine and Riverside listed plans to prioritize law enforcement by buying portable drug analyzers, though neither city did so in the first fiscal year, 2022-23. Their inclination mirrored patterns elsewhere in the country, with millions in settlement funds flowing to police departments and jails.

But such uses of the money have stirred controversy, and both cities backed away from the drug analyzer purchase after the Department of Health Care Services issued rules that opioid settlement funds may not be used for certain law enforcement efforts. The rules specifically excluded “equipment for the purpose of evidence gathering for prosecution, such as the TruNarc Handheld Narcotics Analyzer.”

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In Hawthorne the police department had already spent about $25,000 of settlement funds on an initial installment to buy 80 BolaWraps, devices that shoot Kevlar tethers to wrap around a person’s limbs or torso.

After the state said BolaWraps were not an allowable expense, the city said it would find other funding sources to pay the remaining installments.

Santa Rosa, in California’s wine country, spent nearly $30,000 on police officer wellness and support.

The funds allowed the police department to boost its contracted wellness coordinator from a part-time to a full-time position, and to buy a mobile machine to measure electrical activity in the brain, said Sgt. Patricia Seffens, a spokesperson.

The goal is to use the technology on police officers to help “assess the traumatic impact of responding to the increasing overdose calls,” Seffens said in an email.

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In Dublin, east of San Francisco, officials are using part of their $62,000 settlement for a DARE program.

DARE, which stands for Drug Abuse Resistance Education, is a series of classes taught by police officers in schools to encourage students to avoid drugs. It was initially developed during the “Just Say No” campaign in the 1980s.

Studies have found inconsistent results from the program and no long-term effects on drug use, leading many researchers to dismiss it as “ineffective.”

But on its website, DARE cites studies since the program was updated in 2009, which found “a positive effect” on fifth- graders and “statistically significant reductions” in drinking and smoking about four months after completing the program.

“The DARE program when it first came out looks a lot, lot different than what it looks like right now,” said Nate Schmidt, the Dublin police chief.

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Schmidt said that additional settlement money will be used to distribute naloxone to residents and to stock it at schools and city facilities.

Other local governments in California spent modest sums on a wide range of addiction-related measures. Ukiah, in Mendocino County, north of San Francisco, spent $11,000 for a new heating and air conditioning system for a local drug treatment center. Orange and San Mateo counties spent settlement funds in part on medication-assisted treatment for people incarcerated in their jails. The city of Oceanside spent $16,000 to showcase drug prevention art and videos made by middle school students in local movie theaters, public spaces, and on buses and taxis.

The Department of Health Care Services said it plans to release a statewide report on how the funds were spent, as well as the individual city and county reports, by year’s end.

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U.S. Efforts to Cut Emissions Stalled in 2024 as Power Demand Surged

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U.S. Efforts to Cut Emissions Stalled in 2024 as Power Demand Surged

America’s efforts to cut its climate change pollution stalled in 2024, with greenhouse gas emissions dropping just a fraction, 0.2 percent, compared to the year before, according to estimates published Thursday by the Rhodium Group, a research firm.

Despite continued rapid growth in solar and wind power, emissions levels stayed relatively flat last year because demand for electricity surged nationwide, which led to a spike in the amount of natural gas burned by power plants.

The fact that emissions didn’t decline much means the United States is even further off-track from hitting President Biden’s goal of slashing greenhouse gases 50 percent below 2005 levels by 2030. Scientists say all major economies would have to cut their emissions deeply this decade to keep global warming at relatively low levels.

Since 2005, United States emissions have fallen roughly 20 percent, a significant drop at a time when the economy has also expanded. But to meet its climate goals, U.S. emissions would need to decline nearly 10 times as fast each year as they’ve fallen over the past decade. That seems increasingly unlikely, experts say, especially since President-elect Donald J. Trump has promised to dismantle Mr. Biden’s climate policies and promote the production of fossil fuels, the burning of which generates greenhouse gases.

“On the one hand, it is notable that we’ve now seen two years in a row where the U.S. economy grew but emissions went down,” said Ben King, an associate director at the Rhodium Group. “But it’s far from enough to achieve our climate targets.”

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The biggest reason that U.S. emissions have fallen in recent years is that electric utilities have been retiring their older, dirtier coal-fired power plants and replacing them with cheaper and less-polluting natural gas, wind and solar power. That trend mostly continued last year, with a few unexpected ups and downs.

The nation’s demand for electricity, which has stayed more or less flat for two decades, suddenly jumped by roughly 3 percent in 2024, in large part because scorching heat during the summer caused many Americans to crank up their air-conditioners. A smaller factor was that tech companies have been building more energy-hungry data centers in states like Virginia and Texas.

While power companies installed large numbers of wind turbines, solar panels and batteries last year to meet rising demand, natural gas use also rose to record highs, while coal use declined only slightly. The net result was that emissions from the power sector increased an estimated 0.2 percent, according to the Rhodium Group.

At the same time, transportation, the nation’s largest source of greenhouse gases, saw an 0.8 percent rise in emissions last year. Gasoline and jet fuel consumption both increased as Americans continued to drive and fly more after the pandemic. Nearly 10 percent of new car sales in 2024 were less-polluting electric vehicles, but those models still make up a small fraction of total cars on the road and have yet to put a major dent in transportation emissions.

On the flip side, emissions from America’s industrial sector — which includes steel, cement and chemicals — fell by 1.8 percent in 2024. Some of that may have been the result of lost output, as two hurricanes and a strike at the nation’s ports disrupted some factory activity in the fall, Mr. King said.

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“It’s a reminder that there’s always some bumpiness in emissions,” Mr. King said. “It’s not just a question of how many electric vehicles are on the road or how much solar we’ve installed. A big portion of our economy still relies on fossil fuels.”

One of the most striking findings in this year’s data was that emissions from oil and gas operations dropped roughly 3.7 percent in 2024. Even though the United States produced record amounts of oil and near-record amounts of natural gas last year, many companies appear to have curbed leaks of methane, which is the main ingredient in natural gas and which can seep into the atmosphere and contribute significantly to global warming.

Over the past few years, the Biden administration and several states have adopted new regulations that require oil and gas producers to detect and fix methane leaks. Many companies also have financial incentives to capture methane to sell rather than vent it into the air.

Between 2014 and 2024, U.S. companies appear to have reduced the amount of methane that escaped, per each cubic feet of gas they produced, by 40 percent, according to the Rhodium Group.

Several experts have estimated that greenhouse gases generated in the United States could start dropping sharply in the years ahead if many clean energy policies stay in place, particularly the 2022 Inflation Reduction Act that pumped hundreds of billions of dollars into low-carbon energy technologies such as electric vehicles, wind turbines, solar panels, nuclear reactors, green hydrogen and batteries.

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While Mr. Trump has pledged to scrap many of Mr. Biden’s subsidies and tax credits for electric vehicles and low-carbon energy, it remains to be seen whether Congress will agree.

That law has not yet had a major impact on the country’s emissions, said Mr. King, since it takes time for new factories to open and power plants to get built. But, he said, data shows that low-carbon energy and transportation now make up fully 5 percent of total U.S. private investment.

“That’s a leading indicator that things are changing quickly,” he said.

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How to protect yourself from the smoke caused by L.A. wildfires

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How to protect yourself from the smoke caused by L.A. wildfires

You don’t have to live close to a wildfire to be affected by its smoke. With severe winds fanning the fires in and around Pacific Palisades, the Pasadena foothills and Simi Valley, huge swaths of the Southland are contending with dangerous air quality.

Wildfire smoke can irritate your eyes, nose, throat and lungs. The soot may contain all kinds of dangerous pollutants, including some that may cause cancer. The tiniest particles in smoke can travel deep into your lungs or even enter your bloodstream.

Conditions like these aren’t good for anyone, but they’re particularly bad for people in vulnerable groups, including children, those with asthma or other respiratory conditions, people with heart disease and those who are pregnant.

Here’s what you should know to keep yourself safe.

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Stay indoors

Minimize your exposure to unhealthy air by staying inside and keeping your doors and windows shut.

If you have a central heating and air conditioning system, you can keep your indoor air clean by turning it on and keeping it running. Make sure the fresh-air intake is closed so that you’re not drawing in outdoor air.

Keep your pets inside

They shouldn’t breathe the unhealthy air either.

Check your air filters

Clean filters work better than dirty ones, and high-efficiency filters work better than regular ones. The California Air Resources Board and the South Coast Air Quality Management District recommend filters with a MERV rating of 13 or higher.

You might consider using portable high-efficiency air cleaner in a room where you spend the most time. The U.S. Environmental Protection Agency has information about them here, and CARB has a list of certified cleaning devices here.

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Don’t pollute your indoor air

That means no burning candles or incense. If your power is out and you need to see in the dark, you’re much better off with a flashlight or headlamp.

If you’re cold, bundle up. This is not the time to start a cozy fire in the fireplace. Don’t use a gas stove or wood-fired appliances, since these will make your indoor air quality worse, not better, the AQMD says.

The CDC also advises against vacuuming, since it can stir up dust and release fine particles into the air.

Take care when cleaning up

You don’t want your skin to come into contact with wildfire ash. That means you should wear long sleeves, pants, gloves, socks and shoes. The AQMD even wants you to wear goggles.

If you’re sweeping up ash outdoors, get a hose and mist it with water first. That will keep it from flying up in the air as you move it around. Once the ash is wet, sweep it up gently with a broom or mop. Bag it up in a plastic bag and throw it away.

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It’s a good idea to wash your vehicles and outdoor toys if they’re covered in ash. Try not to send ashy water into storm drains. Direct the dirty water into ground areas instead, the AQMD advises.

Those with lung or heart problems should avoid clean-up activities.

Discard spoiled food…

If you lost power for a significant length of time, the food in your refrigerator or freezer may be spoiled.

Food kept in a fridge should stay safe for up to four hours if you’ve kept the door closed. If you’ve been without power for longer than that, you’ll need to toss all perishable items, including meat, poultry, fish, eggs, milk and cut fruits and vegetables. Anything with “an unusual smell, color, or texture” should be thrown out as well, according to the U.S. Centers for Disease and Control Prevention.

Refrigerated medicines should be OK unless the power was out for more than a day. Check the label to make sure.

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…even if it was in the freezer

Your freezer may be in better shape, especially if it’s well-stocked. Items in a full freezer may be safe for up to 48 hours if it’s been kept shut, and a half-full freezer may be OK for up to 24 hours. (The frozen items help keep each other cold, so the more the better.)

If items have remained below 40 degrees Fahrenheit (4 degrees Celsius) or you can still see ice crystals in them, they may be OK to use or refreeze, according to the federal government’s food safety website.

Ice cream and frozen yogurt should be thrown out if the power goes out for any amount of time. Meat, poultry, seafood, eggs, milk and most other dairy products need to go if they were exposed to temperatures above 40 degrees F for two hours or longer. The same goes for frozen meals, casseroles, soups, stews and cakes, pies and pastries with custard or cheese fillings.

Fruit and fruit juices that have started to thaw can be refrozen unless they’ve started to get moldy, slimy or smell like yeast. Vegetables and vegetable juices should be discarded if they’ve been above 40 degrees F for six hours or more, even if they look and smell fine.

Breakfast items like waffles and bagels can be refrozen, as can breads, rolls, muffins and other baked goods without custard fillings.

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Consider alternative shelter

If you’ve done everything you can but your eyes are still watering, you can’t stop coughing, or you just don’t feel well, seek alternative shelter where the air quality is better.

Hold off on vigorous exercise

Doing anything that would cause you to breathe in more deeply is a bad idea right now.

Mask up outdoors

If you need to be outside for an extended time, be sure to wear a high-quality mask. A surgical mask or cloth mask won’t cut it — health authorities agree that you should reach for an N95 or P-100 respirator with a tight seal.

Are young children at greater risk of wildfire smoke?

Very young children are especially vulnerable to the effects of wildfire smoke because their lungs are still rapidly developing. And because they breathe much faster than adults, they are taking in more toxic particulate matter relative to their tiny bodies, which can trigger inflammation, coughing and wheezing.

Any kind of air pollution can be dangerous to young children, but wildfire smoke is about 10 times as toxic for children compared to air pollution from burning fossil fuels, said Dr. Lisa Patel, clinical associate professor of pediatrics at Stanford Children’s Health. Young children with preexisting respiratory problems like asthma are at even greater risk.

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Patel advises parents to keep their young children indoors as much as possible, create a safe room in their home with an air purifier, and try to avoid using gas stoves to avoid polluting the indoor air.

Children over the age of 2 should also wear a well-fitting KN95 mask if they will be outdoors for a long period of time. Infants and toddlers younger than that don’t need to mask up because it can be a suffocation risk, Patel said.

What are the risks for pregnant people?

Pregnant people should also take extra precautions around wildfire smoke, which can cross the placenta and affect a developing fetus. Studies have found that exposure to wildfire smoke during pregnancy can increase the risk of premature birth and low birth weight. Researchers have also linked the toxic chemicals in smoke with maternal health complications including hypertension and preeclampsia.

What about other high-risk populations?

Certain chronic diseases including asthma, chronic obstructive pulmonary disease or other respiratory conditions can also make you particularly vulnerable to wildfire smoke. People with heart disease, diabetes and chronic kidney disease should take extra care to breathe clean air, the CDC says. The tiny particles in wildfire smoke can aggravate existing health problems, and may make heart attacks or strokes more likely, CARB warns.

Get ready for the next emergency

Living in Southern California means another wildfire is coming sooner or later. To prepare for the bad air, you can:

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  • Stock up on disposable respirators, like N95 or P-100s.
  • Have clean filters ready for your A/C system and change them out when things get smoky.
  • Know how to check the air quality where you live and work. The AQMD has an interactive map that’s updated hourly. Just type in an address and it will zoom in on the location. You can also sign up to get air quality alerts by email or on your smartphone.
  • Know where your fire extinguisher is and keep it handy.
  • If you have a heart or lung condition, keep at least five days’ worth of medication on hand.

Times staff writer Karen Garcia contributed to this report.

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Punk and Emo Fossils Are a Hot Topic in Paleontology

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Punk and Emo Fossils Are a Hot Topic in Paleontology

Mark Sutton, an Imperial College London paleontologist, is not a punk.

“I’m more of a folk and country person,” he said.

But when Dr. Sutton pieced together 3-D renderings of a tiny fossil mollusk, he was struck by the spikes that covered its wormlike body. “This is like a classic punk hairstyle, the way it’s sticking up,” he thought. He called the fossil “Punk.” Then he found a similar fossil with downward-tipped spines reminiscent of long, side-swept “emo” bangs. He nicknamed that specimen after the emotional alt-rock genre.

On Wednesday, Dr. Sutton and his colleagues published a paper in the journal Nature formally naming the creatures as the species Punk ferox and Emo vorticaudum. True to their names, these worm-mollusks are behind something of an upset (if not quite “anarchy in the U.K.”) over scientists’ understanding of the origins of one of the biggest groups of animals on Earth.

In terms of sheer number of species, mollusks are second only to arthropods (the group that contains insects, spiders and crustaceans). The better-known half of the mollusk family tree, conchiferans, contains animals like snails, clams and octopuses. “The other half is this weird and wacky group of spiny things,” Dr. Sutton said. Some animals in this branch, the aculiferans, resemble armored marine slugs, while others are “obscure, weird molluscan worms,” he said.

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Punk and Emo, the forerunners of today’s worm-mollusks, lived on the dark seafloor amid gardens of sponges, nearly 200 million years before the first dinosaurs emerged on land. Today, their ancient seafloor is a fossil site at the border between England and Wales.

The site is littered with rounded rocky nodules that “look a bit like potatoes,” Dr. Sutton said. “And then you crack them open, and some of them have got these fossils inside. But the thing is, they don’t really look like much at first.”

While the nodules can preserve an entire animal’s body in 3-D, the cross-section that becomes visible when a nodule is cracked open can be difficult to interpret “because you’re not seeing the full anatomy,” Dr. Sutton said.

Paleontologists can use CT scans to see parts of fossils still hidden in rock, essentially taking thousands of X-rays of the fossil and then stitching those X-ray slices together into one digital 3-D image. But in these nodules, the fossilized creatures and the rock surrounding them are too similar in density to be easily differentiated by X-rays. Instead, Dr. Sutton essentially recreated this process of slicing and imaging by hand.

“We grind away a slice at a time, take a photo, repeat at 20-micron intervals or so, and basically destroy but digitize the fossil as we go,” Dr. Sutton said. At the end of the process, the original fossil nodule is “a sad-looking pile of dust,” but the thousands of images, when painstakingly digitally combined, provide a remarkable picture of the fossil animal.

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Punk and Emo’s Hot Topic-worthy spikes set them apart from other fossils from the aculiferan branch of the mollusk family. “We don’t know much about aculiferans, and it’s unusual to find out we’ve suddenly got two,” Dr. Sutton said.

Stewart Edie, the curator of fossil bivalves at the Smithsonian National Museum of Natural History, said that Punk and Emo’s bizarre appearances shook up a long-held understanding of how mollusks evolved. Traditionally, scientists thought that the group of mollusks containing snails, clams and cephalopods “saw all of the evolutionary action,” said Dr. Edie, who was not involved with the new discovery. “And the other major group, the aculiferans, were considerably less adventurous.” But Punk and Emo “buck that trend,” he said.

The new alt-rock aculiferans reveal the hidden diversity of their group in the distant past and raise questions about why their descendants make up such a small part of the mollusk class today. “This is really giving us an almost unprecedented window into the sorts of things that were actually around when mollusks were getting going,” Dr. Sutton said. “It’s just this little weird, unexpected, really clear view of what was going on in the early history of one of the most important groups of animals.”

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