Joseph Scarpone returned from a 30-day stint at a Massachusetts V.A. clinic with a handful of pill bottles.
His deployment in Afghanistan, where he was a sergeant with the Marines, left him with a host of mental illnesses, including depression and post-traumatic stress disorder. A doctor at the VA prescribed seven medications to help him cope, including a powerful opioid called oxycodone, which is now known to be highly addictive.
Within a few years, Scarpone had become hooked on the potent drug, switched to heroin when the prescriptions ran dry, bounced in and out of rehab facilities and eventually overdosed on fentanyl and died in 2015.
That’s the story that landed his mother, Kay Scarpone, a front-row seat to the recent government settlement with the Sackler family and their company, Purdue Pharma, which continued to market OxyContin as a less-addictive pain medication, despite knowing that the drug was being widely abused, in order to make billions of dollars in profits.
Throughout the settlement process, Scarpone, a Kingston resident, has served on an opioid victim group. In early June, she stood in front of three prominent members of the Sackler family and told Joseph’s story.
In settlement negotiations with the Sackler family, states have tentatively agreed to a $6 billion payout, while a separate fund of $750 million was allocated to victims and survivors. Divided between all of the families impacted by opioid overprescribing, victims won’t get much, Scarpone said.
To Scarpone and other families who watched powerlessly as they lost a loved one to addiction, there is a glaring problem with the settlement.
“I think the victims definitely got screwed in the deal,” she said. “We really were the losers in the whole thing. We got the smallest piece of the pie out of anyone. It’s really not fair, but it is what it is and at least it’s something.”
The negotiations have left victims of the opioid crisis disappointed and caused turmoil in advocacy groups. After the negotiations, a group once united by common loss splintered into two factions.
Some, like Scarpone, thought about the grandparents caring for their grandchildren and the families who lost a breadwinner and decided that it was better to accept some money than to risk receiving none.
The decision to accept the offer was deeply unpopular with some victims, who believed the Sacklers, who as a family are worth $11 billion, were getting off with a slap on the wrist.
“It’s just it’s been a huge division,” she said. “There’s two sides to this whole story, and there’s been a lot of division amongst people that used to care about each other and work with each other.”
One parent involved in the settlements with whom she used to be friendly insinuated that Scarpone didn’t believe her son’s life was worth more than tens of thousands of dollars.
“That’s the part that hurts, because of course my son’s life is worth more than (that), I understand that,” she said. “My argument to him was, ‘Well, what about these grandparents that are raising their kids?’ It’s something to help, and he doesn’t agree.”
An epidemic
Hundreds of people have fatally overdosed on opioids in New Hampshire every year since Joseph Scarpone died.
Years later, the state is in the throes of the “third wave” of the epidemic, marked by a surge in fatal overdoses fueled by the same synthetic opioid that killed Scarpone.
Associate Attorney General James Boffetti, who is heavily involved in the state’s numerous lawsuits against pharmaceutical companies and opioid distributors, said many of the state’s opioid addiction stories follow a similar trajectory that starts with prescription opioids and ends with heroin and fentanyl.
“You have to ask: How did this begin? And for so many people, it began with the overprescribing of opioids,” Boffetti said. “People would say, ‘I would go to my dentist and I would get a tooth extracted and they would give me 30 Percocets.’ ”
The majority of the money from the state’s numerous opioid cases will go into the Opioid Abatement Trust Fund, while about 15% will go to N.H. counties, cities and towns that brought their own opioid lawsuits. The funding is overseen by a commission comprised of victim advocates, legislators and recovery experts, among others.
The money flowing into the state will not go into the pockets of victims of the opioid epidemic. The settlements have been structured so that state money focuses on helping the living instead of compensating families of the dead.
“It’s also a recognition that there are people that are dying every day, and no amount of money would ever be sufficient to compensate for the harm that was done here,” Boffetti said. “We’re gonna have a limited amount of money we want to focus on and how we can provide services to people who today are struggling.”
Families who have lost someone to the opioid epidemic know that no money could bring back their loved ones, but it would be a tangible acknowledgment of their loss. For those who spend tens of thousands of dollars trying to help their loved ones recover from an opioid addiction, the money wouldn’t just be a symbolic gesture— it would help them financially recover.
By the time Anne Marie Zanfagna’s 25-year-old daughter, Jacqueline, died from a heroin and fentanyl overdose in 2014, the couple had spent a large portion of their retirement savings.
They spent thousands sending her to addiction treatment programs, paying for medication and bailing her out of jail. Twice, Jacqueline started cosmetology school and then dropped out because of her addiction. Each enrollment cost the Zanfagnas $10,000.
“A lot of people that were in my position at the time have no money because they’ve been spending it all on their kids,” she said.
Troubled track record
This isn’t the first time New Hampshire has come into money as a result of highly addictive products.
Mike Rolo, the government relations director for the New Hampshire Cancer Action center, recalled the Big Tobacco settlement with a dry cynicism. New Hampshire received an annual allotment of about $42 million a year from that settlement, but most of the money goes into the education trust fund, which gives grants to public schools and helps lower-income residents afford private school.
A large portion of the settlement money also goes toward offsetting property taxes, Rolo said.
“It goes to everything but tobacco control,” he said.
Even as tobacco addictions have skyrocketed, fueled by the rising popularity of e-cigarettes, recovery programs largely rely on funding from the Centers for Disease Control, not the settlement money from big tobacco companies.
“We have people that die every single year from tobacco-related diseases,” he said. “That’s a number that has not been going down.”
Similarly, a 2003 state law allocated 5% of revenue from state liquor sales for alcohol addiction prevention, treatment and recovery. Kate Frey, vice president of advocacy for the health nonprofit New Futures, said advocates still struggle to get the state to make good on that promise.
After the money intended for alcohol treatment was diverted to fund Medicaid expansion, the New Hampshire Hospital Association volunteered $50 million over the next five years to fill the gap in funding. After that funding runs out, advocates will return to the Legislature to beg lawmakers to use the money as intended.
“We would have to consistently have our voices heard at the State House saying, ‘You’re not fulfilling your end of the bargain,’ ” Frey said. “Here we are, 20 years later, still having that same discussion.”
The Opioid Abatement Trust Fund has intentionally been set up to be a separate fund within the state treasury so that it can’t be entered into general fund discussions.
“As an individual have who has been watching closely how our state spends revenue from addictive products and how little of it goes to the intended cause, I’m really thrilled with this structure,” Frey said.
Rolo said the new model is promising, but his experience with tobacco settlement money has made him skeptical of the state’s funding promises.
“I would hope the state has learned his lesson and will take this issue very seriously,” Rolo said. “I can tell you that they need to be very careful, because money can disappear very quickly.”
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