Opioid pain pills are highly addictive, and they contributed to a nationwide high death-by-drug-abuse rate in 2021. HASTY WORDS FROM PIXABAY/Contributed

Monroe County has moved to settle its part in a nationwide class-action lawsuit against distributors and a manufacturer of opioid pain pills. According to the December 2021 county commissioner meeting’s agenda paperwork, though the overall amount of the settlement is still being finalized, the current figure is approximately $26.5 billion. Of that amount, Monroe County would receive $206,000 annually, while the Keys’ five municipalities will get a total of $22,000 annually, over a period of about 17.5 years.

“On balance, the proposed settlement is a good deal for Monroe County,” said assistant county attorney Cynthia Hall. “It will provide approximately $206,000 per year to the county, and another $22,000 collectively to the five municipalities, over a period of 17.5 years, for use on substance abuse abatement. Monroe County would receive a slightly higher share than its pro rata share based on population.”

Another lawsuit that the county has against three other opioid manufacturers, including the Sackler family’s Purdue Pharma — which made the highly addictive pill OxyContin — is still pending. That suit has been complicated by the fact that the three manufacturers have declared bankruptcy, Hall told Keys Weekly.

This news comes on the heels of recent nationwide headlines that declared the opioid epidemic led to the highest annual rate of drug-abuse death rates ever.

“In the 12-month period that ended in April, more than 100,000 Americans died of overdoses,” a Nov. 17, 2021, New York Times article said. “The figure marks the first time the number of overdose deaths in the United States has exceeded 100,000 a year, more than the toll of car crashes and gun fatalities combined. … The vast majority (was) caused by synthetic opioids.” 

Florida and Monroe County are not immune to this trend. According to paperwork submitted by the county to receive a grant for its jail drug abuse treatment program, “Monroe County (has) drug abuse rates higher than both the state and national averages. The Drug Enforcement Administration noted in their 2019 Opioid Report that from 2006 to 2012 there were 30,791,325 prescription pain pills, enough for 60 pills per person per year, supplied to Monroe County.”

Attorney Hall explained that around 2018, the county decided to file a complaint — along with other cities, counties and states nationwide — against pain pill manufacturers and distributors after considering the effect the opioid epidemic had with its employees. 

“We were talking about the expenditure of Monroe County’s health plan to treat opioid addictions, the amount of dollars and staff time necessary to treat people who were suffering from opioid problems, including the expenditure for Narcan,” said Hall.

Narcan, the brand name for naloxone, is a nasal spray that can treat a narcotic overdose.

Hall emphasized that any money received from a settlement would not be an attempt to get money back that the county had already paid out of pocket to help opioid users. “Instead, it would be forward-facing dollars available for treatment programs, forward-looking things as opposed for things that happened in the past,” she said.

Once the settlement money is received, Hall said, the county would also like to arrange talks among the municipalities to make sure the money is split equitably for drug treatment programs within the Keys, since the county is getting the lion’s share of the settlement in the area.

The defendants in this lawsuit include three national distributors: Amerisource Bergen Corporation, which is partnered with Walgreens, among other entities; McKesson, which is partnered with CVS, among others; and Cardinal Health, which is partnered with CVS, among others. One manufacturer is also included in this suit: Johnson & Johnson, through its parent company Janssen.

Monroe County is also involved in another multi-district lawsuit, which is still tangled up in court due to the fact that the three defendants have all declared bankruptcy: manufacturers Purdue Pharma, Insys and Mallinckrodt. 

According to, a federal judge threw out a $4.5 billion settlement that legally shielded members of the Sackler family — who own Purdue Pharma — from future opioid lawsuits. In national news coverage, the Sackler family name has become synonymous with their product OxyContin, a pain pill that added fuel to the fire of the epidemic.

“There cannot be two forms of justice – one for ordinary Americans and a different one for billionaires,” Washington State Attorney General Bob Ferguson said in a Dec. 17, 2021, article, in response to the settlement being thrown out. “I’m prepared to take this fight all the way to the Supreme Court, if necessary, to ensure true accountability for the Sackler family.”

Monroe County Sheriff Rick Ramsey and his staff have borne witness to the local wreckage of the opioid epidemic. He pointed out doctors have over-prescribed opioid pain pills to patients, who would then become addicted.

Ramsay expressed concern that users of opioids see Narcan as a safety net and therefore feel more comfortable abusing drugs. He pointed out that Narcan is available over the counter in CVS and said that addicts often use in pairs. They make a deadly pact to use their drug of choice one at a time. If one person looks like they are overdosing, the other person will revive them with Narcan. 

“It encourages people to use drugs at higher volumes,” Ramsay explained. “Last year, we had a couple in a trailer with three kids. In a garbage trailer. They had Narcan, and they had the same pact. But they were so high, one passed out while the other overdosed. The husband died.”

Charlotte Twine fled her New York City corporate publishing life and happily moved to the Keys six years ago. She has written for Travel + Leisure, Allure, and Offshore magazines;; and the Florida Keys Free Press. She loves her two elderly Pomeranians, writing stories that uplift and inspire, making children laugh, the color pink, tattoos, Johnny Cash, and her husband. Though not necessarily in that order.