JOHNSON CITY, Tenn. (WJHL) — Dr. Stephen Loyd was in danger of losing it all to an opioid addiction when he got the best help money could buy 18 years ago. The former East Tennessee State University (ETSU) faculty member hopes opioid lawsuit settlement dollars can create an “ecosystem” that gives ordinary Tennesseans the same chance.

“I get to sit here in front of you today because I stepped into a system that was designed for me to be here,” Loyd said. “And I want that opportunity for every Tennessean.”

Loyd, a Jonesborough native who said ETSU leaders helped connect him with recovery resources, chairs the state’s new Opioid Abatement Council (OAC). The 15-member board will oversee disbursement of hundreds of millions of dollars in coming years to programs designed to improve the lives of Tennesseans trying to overcome substance use disorder.

Dr. Stephen Loyd chairs Tennessee’s Opioid Abatement Council, which will oversee distribution of about 70% of the state’s opioid settlement funds. (WJHL photo)

“I think it’s the time to look at basically our dream list that we’ve known for a long time, ‘Hey, these are things that we think can make an impact in a recovery ecosystem,’ but we’ve never had the money for it,” Loyd told News Channel 11 during a holiday visit to his hometown. “Now we have the money for it.”

Roughly two-thirds of the funds flowing into the state from those settlements will be routed through the OAC. It meets quarterly and has already developed a rubric for funding applications as it prepares to distribute about $60 million in 2023.

“Our goal for the Opioid Abatement Council is to help to construct an ecosystem that no matter where you touch the system, you get to help that’s right for you,” Loyd said.

“If that help is medication then that’s what we get you,” he said. “If that help is abstinence-based treatment through a court system or through supportive measures otherwise, then absolutely.”

Loyd said the council, which meets quarterly and also includes local representation in Families Free Director Lisa Tipton, is finalizing an application process. Opioid funds will be distributed over an 18-year period according to the terms of the settlements with participating states, so the OAC’s work is just beginning.

“For the first time, I think we have an opportunity to look at some things that are innovative, that involve multiple things within our communities that we can start to start to bridge together this ecosystem … in recovery,” Loyd said.

While he said the funds are a “drop in the bucket” compared to the challenges of substance use disorder and the harm they’re causing, Loyd said he’s hopeful.

“I know that there’s lives out there that we’re going to change,” he said.

Evidence-based, innovative and ‘all the above’ approach

“I haven’t figured out how to treat dead people,” Loyd said bluntly. “That’s my line. If you want to understand harm reduction, let’s start there.

“If we can keep people alive, and we can hold them in the treatment process, we can start to help them change things that they’ve never had any help with.”

Many funds going toward the effort will help people who’ve relapsed multiple times. Both Loyd and Rob Pack, the director of ETSU’s nationally recognized Addiction Science Center, said that’s because while a solid percentage of people who become addicted to drugs eventually recover, that journey is often long and filled with failures as well as successes.

“On average, it takes three to five times of attempts at recovery, and on average, it takes several years, but the majority of people do recover from substance use disorder,” Pack said.

He said ETSU’s center is working to help “change the thinking in the community” about addiction being a life sentence or a moral failing.

“It’s a brain disease,” Pack said. “And … we need to attend to it in such a way in which we tackle the social determinants of that brain disease, and we begin to set the conditions so that people can be healthier.”

Because of that, Loyd said the OAC is taking an “all of the above” approach to proposals and basing its decisions on evidence.

“We’re just looking at things that are innovative and things that are scalable … to other parts of the state,” Loyd said.

Substance use disorder, when it reaches the level of addiction, tends to impact every part of a person’s life and so successful funded programs will probably run the gamut, Loyd said. They can be as simple as recovery community centers like one that’s opening in Johnson City, where people can just spend time while they’re not at work.

“The opposite of addiction is not recovery,” Loyd said. “The opposite of addiction is community and relationship. And that’s the truth.”

“People in recovery need to hang out a lot of times with other people who were struggling with some of the same things and engage in activities that don’t involve those things.”

The council is also likely to see proposals for everything from supportive housing and job supports to programs to help people complete further education. Prevention programs are also likely to be in the mix.

“Helping people with job training, high school education, plugging them into housing, the basic needs, because we’ve been able to address those things on a very limited basis at the state level,” Loyd said.

Loyd said the details and evidence behind proposals will trump which side of the abstinence/medication assisted treatment divide they’re on. The OAC will probably see applications from abstinence-based live-in programs like one being developed in Roan Mountain and medication-assisted programs.

“We get into these two warring factions within the recovery world of medication versus not medication,” Loyd said. “And who’s caught in the middle? Suffering families, suffering Tennesseans, and that is not okay.”

“So we have to pool our resources together and help people find the path that’s right for them, and that’s what my job.”

Loyd said he “loves” much of what is occurring in abstinence-based treatment. But he also said medication assisted treatment, such as suboxone, is providing great benefits as well when it’s approached scientifically and ethically.

He described the medication-assisted work “in Gray at Overmountain (Recovery Center) with the cooperation between Ballad and East Tennessee State” as “a good thing for our community. And it will start to heal some broken lives.”

In fact, while he can’t play favorites Loyd said he believes Northeast Tennessee has laid a great foundation for strong applications.

“I think the big thing we have in our corner is the College of Public Health at East Tennessee State and the direction that they have led this in East Tennessee, because they’re actually a national leader and we happen to have them right here in the Tri-Cities,” Loyd said.

“Some of our elected politicians, particularly Senator (Rusty) Crowe and representatives (Rebecca) Alexander and (Tim) Hicks, they understand this issue at a very visceral level.”

Multiple representatives, judges and county mayors worked together to spend a different tranche of funds — these from the “Baby Doe” opioid suit — using a vetting process similar to what the state will use.

“I think leadership in Northeast Tennessee is moving in the right direction,” Loyd said.

‘I don’t think there’s any question that greed played into this’

Loyd saves no pity for the various defendants that have settled lawsuits. Those include drug manufacturer Purdue Pharma and the consultant, McKinsey, which allegedly helped them continue moving opioids in the face of evidence they were being overprescribed. They also include retailers with pharmacy chains like Walgreens and CVS.

“When you look at the extent of the lawyers and the money that was spent to try to keep this going (defending lawsuits), I don’t think there’s any question that greed played into this and destroyed countless lives in my home, which is Southern Appalachia,” he said. “And really now the rest of the United States.”

Loyd said he believes the defendants consider the fines and settlement amounts “a cost of doing business.”

“The truth is, you’re not going to get anybody’s attention until some of them go to prison,” he said. “And was prison warranted in these cases? In my opinion, yes. I would like you to find a crime in the United States that’s killed more than the mismarketing of Oxycontin in particular and opioids in general.”

Loyd is convinced the decisions that exacerbated the opioid crisis “came from the highest levels, and I think some of that is coming out now.”

Loyd said he’s glad to be in his role working with funds that he said should get beyond scratching the surface of the problem.

“If you look at somebody who is addicted and in jail, look at all the services and the resources that have to go to support that outside of the incarceration if they have a family, if they have a kid.”

“You don’t have to look far in the state of Tennessee to see issues in all these areas and a lot of that, the root cause of it’s the opioid crisis. So the money’s justified for sure. Isn’t enough. Nowhere close.”

He’s looking forward to the OAC’s next quarterly meeting as members really begin digging into the meat of applications from programs large and small.

“I’m an optimist,” he said. “I think that we’re going to come out on the other end. I also think that too many people are going to die before we get there, and we can’t do anything to bring them back.

“Do I remain hopeful? Absolutely. If I wasn’t hopeful I wouldn’t have accepted the job.”

More information about the council’s work as it prepares for its next meeting in March can be found here.