Summary:
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North Carolina will receive ten of millions of dollars a year from a multi-state opioid epidemic settlement
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Unsavory entrepreneurs and swindlers are already targeting the money
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Uncertain whether state lawmakers will respond
Like many states, North Carolina has been hard-hit by the national opioid epidemic. Between 2000 and 2020, more than 28,000 North Carolinians died from an opioid overdose – and that is very likely an undercounting. Epidemiologists estimate that more than 600,000 people across the United States and Canada have died of an opioid overdose since 1999, with numbers still rising from “third wave” drug derivatives, like the synthetic opioid fentanyl.
At long last, a measure of good news: some of the drug manufacturers and distributors responsible for creating the opioid epidemic are finally being forced to clean up their act. North Carolina has already begun to receive the first payments of an enormous, $26 billion multi-state settlement against the drug companies. But while the funds are intended to be used strictly for addiction recovery and treatment, scammers and opportunists have also sniffed out a money grab.
Several political figures are now circling North Carolina’s opioid settlement money looking for a score. State leaders must act to ensure this money goes to those who need it – not those in it for self-enrichment.
Background
In 2021, Attorney General Josh Stein played a key role in negotiating a historic, $26 billion multi-state settlement against Johnson & Johnson, a major opioid manufacturer, and three leading drug distributors – Amerisource Bergen, Cardinal Health, and McKesson – for their roles in creating the epidemic. Under the settlement, North Carolina is set to receive a whopping $750 million over the next 18 years (over $40 million a year). The terms of the settlement dictate that the bulk of the settlement money must be used primarily to support opioid drug addiction treatment and recovery.
(Note: Attorney General Josh Stein has also helped negotiated separate multi-state settlements with firms ranging from McKinsey & Company ($573 million) to CVS and Walgreens ($11 billion) and others over their responsibility for the opioid epidemic. These are very significant, but different from the $26 billion settlement with J&J.)
A Memorandum of Agreement between the state and local governments spells out a process for how settlement funds must be used. Importantly, 85% of funds will go directly to local governments, in all 100 counties, to disburse at their discretion from a list of acceptable evidence-based treatment options.
But now, politically connected entrepreneurs – several with criminal records for fraud – are pushing a scheme to claim settlement money for “faith based” drug rehabilitation.
The Bridge to Nowhere
In 2021, Robin Hayes – the Republican former state lawmaker, Congressman, and chairman of the North Carolina Republican Party – was pardoned by Donald Trump for his role at the center of the biggest bribery scandal in modern state history. Hayes had pled guilty after first lying to the FBI about being “happy to help” facilitate $2 million in bribes to Insurance Commissioner Mike Causey in 2018. Later, text message evidence emerged indicating that now-U.S. Senator Ted Budd seemed to trade his vote to object to certifying the 2020 Presidential election in exchange for a Presidential pardon for Hayes.
Without skipping a beat, in 2022, Hayes and some partners formed a group called “Bridge to 100” that seeks to connect local county governments and faith-based rehabilitation groups in its network. The group is very ambitious – the “100” in the name is from its goal to expand to all 100 counties (because each is eligible for its own share of settlement funds). Importantly, “Bridge” will not, itself, operate any rehabilitation centers, but rather acts as a middleman between them and county governments.
For this venture, Hayes has also named a man named Daniel Williford to the “Bridge” board. Williford is a former Salisbury businessman who was sentenced to nine years in federal prison for running a multi-million dollar Ponzi scheme. Williford’s prison sentence only formally ended last November.
Its leadership issues aside, the other big red flag at Bridge to 100 is that the exclusively faith-based treatments offered by most of its rehabilitation centers simply do not work:
Most of the faith-based groups Hayes said he’s partnering with use a 12-step approach to treating addiction, meaning they do not use medications. One addiction treatment program in Stanley County emphasizes its use of abstinence-only treatment, incorrectly claiming on its website that medication for opioid use disorder “DOESN’T WORK.”
Another addiction treatment group in Brunswick County includes “regular church attendance” in its definition of addiction recovery and its treatment model includes “a relationship with Jesus Christ.” (NC Health News)
This approach has raised major concerns among addiction recovery experts.
Evidence, not wishing
Addiction recovery has been studied by medical science for a very long time. While religious faith (presumably of any denomination) may offer spiritual comfort patients recovering from addiction, the evidence is clear that treatment including medication (known as “Medication-Assisted Treatment,” or MAT), paired with professional counseling, is by far the most effective route. Much like in sex education, an “abstinence-only” approach simply does not work for most people.

As shown in this slide from a presentation to county commissioners across the state, approximately 90% of addiction patients who undergo a detox and then drug abstinence program will return to using within 6-12 months. With standard, proven medication (as well as ongoing therapy), return to use can rise to as few as half.
And yet, Robin Hayes’ Bridge to 100 group has mostly chosen not to partner with established addiction recovery clinics that provide medication and therapy, but rather a number of fly-by-night groups that seem to ignore the standard of care for addiction recovery in lieu of sectarian evangelism.

Nor is Hayes the first. The “Bridge to 100” scheme follows a similarly murky situation in Robeson county, where Republican State Senator Danny Britt was revealed to have funneled whopping $10 million taxpayer-funded state grant for opioid addiction treatment to a brand new organization in his district called “Hope Alive.” Hope Alive, which had no background in addiction treatment, nor even a physical location, was run by several leaders with criminal records for embezzlement. Even more puzzling was how such a large state grant was given to an unknown organization less than a mile from UNC Health Southeastern in Lumberton, a major hospital that already provided professional addiction recovery. Unanswered questions still swirl.
At what point will state lawmakers intervene to ensure that public funds intended to treat opioid addiction recovery actually make it to the victims of the epidemic – and not in profiteers’ pockets?