New Hampshire lawmakers have proposed diverting millions of dollars meant to address opioid addiction to help close the state’s budget gaps – alarming advocates who say it would upend a wide range of treatment, recovery and prevention programs.
At the same time, some advocates are also raising concerns about a separate plan from Gov. Kelly Ayotte to use some of the opioid settlement money for law enforcement activities in the North Country.
At issue is the state’s Opioid Abatement Trust Fund, which is funded by a series of legal settlements with drug companies accused of fueling a wave of opioid addiction. Under the settlement terms, that money must be used to address the opioid crisis.
The House budget plan that was finalized earlier this month includes plans to withdraw $21.4 million from that fund over two years, ultimately in order to fund other state expenses not related to opioid treatment, prevention or recovery.
The lawmaker who came up with that plan told NHPR he wasn’t fully informed about legal restrictions on that money until after the House budget was finalized. He now says the Senate — which is now in control of the budget process — should put the money back in the opioid fund.
It’s unclear how the Senate will proceed, but the governor and other top state officials are also calling for the money to be restored.
The debate over this funding reflects a broader concern playing out around the country: that cash-strapped state governments will use opioid settlement funds to plug budget holes or steer the money toward law enforcement, rather than strengthening treatment and recovery services.
Earlier coverage: How New Hampshire is using its opioid lawsuit payouts
Backfilling the alcohol fund with the opioid fund
New Hampshire depends on a mix of funding sources to pay for substance use services. Two key pools of money are the Opioid Abatement Trust Fund, funded with settlement payments, and the Alcohol Abuse Prevention and Treatment Fund, which receives a portion of state liquor sale profits.
The final version of the House budget takes $10.7 million per year from the alcohol fund to address the state’s overall revenue shortfall. Then it backfills the alcohol fund with the same amount from the opioid fund.
The net effect is a $10.7 million annual cut to substance use funding overall, but the problems go beyond that, said Kate Frey, the vice president of advocacy for the health policy organization New Futures.
“It really would disrupt the whole system,” Frey said.
Because opioid settlement money can only be used to address opioid use, the alcohol fund would have to stop funding services for people dealing with alcohol or stimulant misuse. Meanwhile, another provision in the House budget would cancel any grants awarded by the opioid fund with effective dates on or after May 1.
That would cut off funding to a number of existing programs supported by the opioid fund. Earlier this month, the state renewed $4.6 million in grants to nonprofits and local governments working to improve access to treatment, provide recovery housing, steer youth away from substance use and expand the behavioral health workforce, among other efforts. Because those contract extensions are effective May 4, they would be canceled under the House budget.
The opioid fund is also a key funding source for New Hampshire’s network of peer-led recovery centers and other efforts to build more recovery housing.
'So unfortunately, we passed a provision that the Senate needs to remove.'Rep. Jess Edwards, who oversaw the plan to reshuffled the substance use funds
Rep. Jess Edwards, who oversaw the plan to reshuffle the substance use funds, said he saw it a way to shore up the general fund — while still using what he described as “an excess of opioid abatement funds” to support the alcohol fund.
Edwards, an Auburn Republican, said legislative staff assured him it was legal. He said it wasn’t until last week – after the House budget had passed – that the attorney general’s office informed him those funds couldn’t legally go to non-opioid-related programs.
“So unfortunately, we passed a provision that the Senate needs to remove,” Edwards said.
But key stakeholders had raised those very concerns with lawmakers before the House budget was final — including the chair of the Governor’s Commission on Alcohol and Other Drugs, which oversees the alcohol fund.
“Proposed shifts in how the Governor’s Commission is funded eliminates our ability to meet the needs of citizens struggling with alcohol, simulants, methamphetamines and other non-opioid substances,” the chair, Patrick Tufts, wrote in an April 4 letter to House and Senate leadership.
The commission overseeing the Opioid Abatement Trust Fund – which is led by an official from the New Hampshire Attorney General’s Office – is also planning to send a letter to legislative leaders outlining its legal concerns with rerouting the money away from its original purpose.
Earlier coverage: New Hampshire continues to make millions off alcohol, but spends little to curb impact
Using opioid money for emergency shelter, police overtime
Ayotte, meanwhile, has proposed other changes to how the state spends its opioid settlement money. One provision, adopted in the House budget, would appropriate $10 million over two years for emergency shelter for people with substance use disorder.
Another – perhaps more controversially – would allow opioid abatement funds to cover police overtime costs for drug enforcement operations in northern New Hampshire. Ayotte, like her predecessor, Gov. Chris Sununu, has made beefing up law enforcement along the northern border a priority.
The House budget plan authorizes the state to use the settlement money for that purpose, but without specifying an amount – leaving it unclear how much of the fund could be spent on drug interdiction efforts. Ayotte initially proposed $1 million over two years.
The governor’s office did not answer questions about whether she consulted with the opioid commission on those proposals, or how specifically the money for emergency shelter would be used.
“In her budget, the Governor directed opioid abatement funds to be used for opioid interdiction efforts and opioid recovery programs,” John Corbett, a spokesperson for Ayotte’s office, said in a statement. “These uses are aligned with the mission of the settlement fund.”
But members of the opioid abatement commission have expressed some technical concerns about whether the money can legally be used in that way.
'New Hampshire does not want to repeat the mistakes we made with the master settlement agreement for tobacco.'Kate Frey, New Futures
The proposal also worries Rep. Jodi Newell, a Keene Democrat who became an advocate for treatment and recovery after losing her fiance to an overdose years ago and has worked on substance use policy in the Legislature. She argued that such spending runs counter to the intent of the settlement funds, which should prioritize expanding treatment and recovery programs – not diverting money to routine drug enforcement.
“We fund law enforcement. And part of their job is enforcing our laws around drug sales and drug use and those kind of things,” Newell said. “That is part of their normal function. That is not what these funds are for.”
Newell, who does not sit on the opioid abatement commission, put forward an amendment to remove that and the other changes to the opioid fund from the budget before it passed, but the amendment failed in the House.
Frey, with New Futures, said it’s important to learn the lessons of the settlements with cigarette companies more than two decades ago. Little of that money went to tobacco prevention in the end – one reason the opioid settlements contain more stringent restrictions.
“New Hampshire does not want to repeat the mistakes we made with the master settlement agreement for tobacco,” she said.
