An ice rink to fight the opioid crisis? Some regrets over settlement cash spending
A Kentucky county nestled in the heart of Appalachia, where the opioid crisis has wreaked devastation for decades, spent $15,000 of its opioid settlement money on an ice rink.
That amount wasn't enough to solve the county's troubles, but it could have bought 333 kits of Narcan, a medication that can reverse opioid overdoses. Instead, people are left wondering how a skating rink addresses addiction or fulfills the settlement money's purpose of remediating the harms of opioids.
Like other local jurisdictions nationwide, Carter County is set to receive a windfall of more than $1 million over the next decade-plus from companies that sold prescription painkillers and were accused of fueling the overdose crisis.
County officials and proponents of the rink say offering youths drug-free fun like skating is an appropriate use of the money. They provided free entry for students who completed the Drug Abuse Resistance Education (D.A.R.E.) curriculum, recovery program participants, and foster families.
But for Brittany Herrington, who grew up in the region and became addicted to painkillers that were flooding the community in the early 2000s, the spending decision is 'heartbreaking.'
'How is ice-skating going to teach [kids] how to navigate recovery, how to address these issues within their home, how to understand the disease of addiction?' said Herrington, who is now in long-term recovery and works for a community mental health center, as well as a regional coalition to address substance use.
She and other local advocates agreed that kids deserve enriching activities, but they said the community has more pressing needs that the settlement money was intended to cover.
Carter County's drug overdose death rate consistently surpasses state and national averages. From 2018 to 2021, when overdose deaths were spiking across the country, the rate was 2.5 times as high in Carter County, according to the research organization NORC.
Other communities have used similar amounts of settlement funding to train community health workers to help people with addiction, and to buy a car to drive people in recovery to job interviews and doctors' appointments.
Local advocates say $15,000 could have expanded innovative projects already operating in northeastern Kentucky, like First Day Forward, which helps people leaving jail, many of whom have a substance use disorder, and the second-chance employment program at the University of Kentucky's St. Claire health system, which hires people in recovery to work in the system and pays for them to attend college or a certification program.
'We've got these amazing programs that we know are effective,' Herrington said. 'And we're putting an ice-skating rink in. That's insane to me.'
A yearlong investigation by KFF Health News, along with researchers at the Johns Hopkins University Bloomberg School of Public Health and the national nonprofit Shatterproof, found many jurisdictions spent settlement funds on items and services with tenuous, if any, connections to addiction. Oregon City, Oregon, spent about $30,000 on screening first responders for heart disease. Flint, Michigan, bought a nearly $10,000 sign for a community service center building , and Robeson County, North Carolina, paid about $10,000 for a toy robot ambulance.
Although most of the settlement agreements come with national guidelines explaining the money should be spent on treatment, recovery, and prevention efforts, there is little oversight and the guidelines are open to interpretation.
A Kentucky law lists more than two dozen suggested uses of the funds, including providing addiction treatment in jail and educating the public about opioid disposal. But it is plagued by a similar lack of oversight and broad interpretability.
Chris Huddle and Harley Rayburn, both of whom are elected Carter County magistrates who help administer the county government, told KFF Health News they were confident the ice rink was an allowable, appropriate use of settlement funds because of reassurances from Reneé Parsons, executive director of the Business Cultivation Foundation. The foundation aims to alleviate poverty and related issues, such as addiction, through economic development in northeastern Kentucky.
The Carter County Times reported that Parsons has helped at least nine local organizations apply for settlement dollars. County meeting minutes show she brought the skating rink proposal to county leaders on behalf of the city of Grayson's tourism commission, asking the county to cover about a quarter of the project's cost.
In an email, Parsons told KFF Health News that the rink — which was built in downtown Grayson last year and hosted fundraisers for youth clubs and sports teams during the holiday season — serves to 'promote family connection and healing' while 'laying the groundwork for a year-round hockey program.'
'Without investments in prevention, recovery, and economic development, we risk perpetuating the cycle of addiction in future generations,' she added.
She said the rink, as well as an $80,000 investment of opioid settlement funds to expand music and theater programs at a community center, fit with the principles of the Icelandic prevention model, 'which has been unofficially accepted in our region.'
That model is a collaborative community-based approach to preventing substance use that has been highly effective at reducing teenage alcohol use in Iceland over the past 20 years. Instead of expecting children to 'just say no,' it focuses on creating an environment where young people can thrive without drugs.
Part of this effort can involve creating fun activities like music classes, theatrical shows, and even ice-skating. But the intervention also requires building a coalition of parents, school staffers, faith leaders, public health workers, researchers, and others, and conducting rigorous data collection, including annual student surveys.
About 120 miles west of Carter County, another Kentucky county has for the past several years been implementing the Icelandic model. Franklin County's Just Say Yes program includes more than a dozen collaborating organizations and an in-depth annual youth survey. The project began with support from the Centers for Disease Control and Prevention and has also received opioid settlement dollars from the state.
Parsons did not respond to specific questions about whether Carter County has taken the full complement of steps at the core of the Icelandic model.
If it hasn't, it can't expect to get the same results, said Jennifer Carroll, a researcher who studies substance use and wrote a national guide on investing settlement funds in youth-focused prevention.
'Pulling apart different elements, at best, is usually going to waste your money and, at worst, can be counterproductive or even harmful,' she said.
At least one Carter County magistrate has come to regret spending settlement funds on the skating rink.
Millard Cordle told KFF Health News that, after seeing the rink operate over the holidays, he felt it was 'a mistake.' Although younger children seemed to enjoy it, older kids didn't engage as much, nor did it benefit rural parts of the county, he said. In the future, he'd rather see settlement money help get drugs off the street and offer people treatment or job training.
'We all learn as we go along,' he said. 'I know there's not an easy solution. But I think this money can help make a dent.'
As of 2024, Carter County had received more than $630,000 in opioid settlement funds and was set to receive more than $1.5 million over the coming decade, according to online records from the court-appointed settlement administrator.
It's not clear how much of that money has been spent, beyond the $15,000 for the ice rink and $80,000 for the community arts center.
It's also uncertain who, if anyone, has the power to determine whether the rink was an allowable use of the money or whether the county would face repercussions.
Kentucky's Opioid Abatement Advisory Commission, which controls half the state's opioid settlement funds and serves as a leading voice on this money, declined to comment.
Cities and counties are required to submit quarterly certifications to the commission, promising that their spending is in line with state guidelines. However, the reports provide no detail about how the money is used, leaving the commission with little actionable insight.
At a January meeting, commission members voted to create a reporting system for local governments that would provide more detailed information, potentially opening the door to greater oversight.
That would be a welcome change, said John Bowman, a person in recovery in northeastern Kentucky, who called the money Carter County spent on the ice ink 'a waste.'
Bowman works on criminal justice reform with the national nonprofit Dream.org and encounters people with substance use disorders daily, as they struggle to find treatment, a safe place to live, and transportation. Some have to drive over an hour to the doctor, he said — if they have a car.
He hopes local leaders will use settlement funds to address problems like those in the future.
'Let's use this money for what it's for,' he said.
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The Guardian
29-05-2025
- The Guardian
‘Flooding could end southern Appalachia': the scientists on an urgent mission to save lives
The abandoned homes and razed lots along the meandering Troublesome Creek in rural eastern Kentucky is a constant reminder of the 2022 catastrophic floods that killed dozens of people and displaced thousands more. Among the hardest hit was Fisty, a tiny community where eight homes, two shops and nine people including a woman who uses a wheelchair, her husband and two children, were swept away by the rising creek. Some residents dismissed cellphone alerts of potential flooding due to mistrust and warning fatigue, while for others it was already too late to escape. Landslides trapped the survivors and the deceased for several days. In response, geologists from the University of Kentucky secured a grant from the National Science Foundation (NSF) and raced around collecting perishable data in hope of better understanding the worst flooding event to hit the region in a generation. On a recent morning in Fisty, Harold Baker sat smoking tobacco outside a new prefabricated home while his brother James worked on a car in a makeshift workshop. With no place else to go, the Baker family rebuilt the workshop on the same spot on Troublesome Creek with financial assistance from the Federal Emergency Management Agency (Fema). 'I feel depressed, everyone else is gone now. The days are long. It feels very lonely when the storms come in,' said Baker, 55, whose four dogs also drowned in 2022. With so few people left, the car repair business is way down, the road eerily quiet. Since the flood that took everything, Harold and James patrol the river every time it rains. The vigilance helped avert another catastrophe on Valentine's Day after another so-called generational storm. No one died but the trauma, like the river, came roaring back. 'I thought we were going to lose everything again, it was scary,' said Baker. At this spot in July 2022, geologist Ryan Thigpen found flood debris on top of two-storey buildings – 118in (3 metres) off the ground. The water mark on Harold's new trailer shows the February flood hit 23in. Troublesome creek is a 40-mile narrow tributary of the north fork of the Kentucky River, which, like many waterways across southern Appalachia, does not have a single gauge. Yet these rural mountain hollers are getting slammed over and over by catastrophic flooding – and landslides – as the climate crisis increases rainfall across the region and warmer waters in the Gulf of Mexico turbocharge storms. Two years after 45 people died in the 2022 floods, the scale of disaster grew with Hurricane Helene, which killed more than 230 people with almost half the deaths in Appalachia, after days of relentless rain turned calm streams into unstoppable torrents. Another 23 people died during the February 2025 rains, then 24 more in April during a four-day storm that climate scientists found was made significantly more likely and more severe by the warming planet. The extreme weather is making life unbearable and economically unviable for a chronically underserved region where coal was once king, and climate skepticism remains high. Yet little is known about flooding in the Appalachian region. It's why the geologists – also called earth scientists – got involved. 'This is where most people are going to die unless we create reliable warning systems and model future flood risks for mitigation and to help mountain communities plan for long-term resilience. Otherwise, these extreme flooding events could be the end of southern Appalachia,' said Thigpen. Amid accelerating climate breakdown the urgency of the mission is clear. Yet this type of applied science could be derailed – or at least curtailed – by the unprecedented assault on science, scientists and federal agencies by Donald Trump and his billionaire donors. Danielle Baker, Harold's sister-in-law (James's wife), had her bags packed a week in advance of the February flood and was glued to local television weather reports, which, like the geologists, rely on meteorological forecasting by the taxpayer-funded National Weather Service (NWS). She was 'scared to death' watching the creek rise so high again. But this time the entire family, including 11 dogs and several cats, evacuated to the church on the hill where they waited 26 hours for the water to subside. 'The people in this community are the best you could meet, but it's a ghost town now. I didn't want to rebuild so close to the creek, but we had nowhere else to go. Every time it rains, I can't sleep,' she said, wiping away tears with her shirt. Danielle was unaware of Trump's plans to dismantle Fema and slash funding from the NWS and NSF. 'A lot of people here would not know what to do without Fema's help. We need more information about the weather, better warnings, because the rains are getting worse,' she said. A day after the Guardian's visit in mid-May, a NWS office in eastern Kentucky scrambled to cover the overnight forecast as severe storms moved through the region, triggering multiple tornadoes that eventually killed 28 people. Hundreds of staff have left the NWS in recent months, through a combination of layoffs and buyouts at the behest of Trump mega-donor Elon Musk's 'department of government efficiency' (Doge). Yet statewide, two-thirds of Kentuckians voted for Trump last year, with his vote share closer to 80% in rural communities hit hard by extreme weather, where many still blame Barack Obama for coal mine closures. 'It doesn't matter if people don't believe in climate change; it's going to wallop them anyway. We need to think about watersheds differently. This is a new world of extremes and cascading hazards,' said Thigpen, the geologist. The rapidly changing climate is rendering the concept of once-in-a-generation floods, which is mostly based on research by hydrologists going back a hundred years or so, increasingly obsolete. Geologists, on the other hand, look back 10,000 years, which could help better understand flooding patterns when the planet was warmer. Thigpen is spearheading this close-knit group of earth scientists from the university's hazards team based in Lexington. On a recent field trip, nerdy jokes and constant teasing helped keep the mood light, but the scientists are clearly affected by the devastation they have witnessed since 2022. The team has so far documented more than 3,000 landslides triggered by that single extreme rain event, and are still counting. This work is part of a broader statewide push to increase climate resiliency and bolster economic growth using Kentucky-specific scientific research. Last year, the initiative got a major boost when the state secured $24m from the NSF for a five-year research project involving eight Kentucky institutions that has created dozens of science jobs and hundreds of new student opportunities. The grant helped pay for high-tech equipment – drones, radars, sensors and computers – the team needs to collect data and build models to improve hazard prediction and create real-time warning systems. After major storms, the team measures water levels and analyzes the sediment deposits left behind to calculate the scale and velocity of the flooding, which in turn helps calibrate the model. The models help better understand the impact of the topography and each community's built and natural environment – important for future mitigation. In these parts, coal was extracted using mountaintop mine removal, which drastically altered the landscape. Mining – and redirected waterways – can affect the height of a flood, according to a recent study by PhD student Meredith Swallom. A paleo-flood project is also under way, and another PhD student, Luciano Cardone, will soon begin digging into a section of the Kentucky riverbank to collect layers of sediment that holds physical clues on the date, size and velocity of ancient floods. Cardone, who found one local missionary's journal describing flooding in 1795, will provide a historical or geological perspective to catastrophic flooding in the region, which the team believe will help better predict future hazards under changing climatic conditions. All this data is analyzed at the new lab located in the Kentucky Geological Survey (KGS) department where super-powerful computers are positioned around a ceiling-to-floor black board, with a groovy lamp and artwork to get the creative mathematical juices flowing. So far the team has developed one working flood risk model for a single section of the Kentucky River. This will serve as a template, as each watershed requires its own model so that the data is manageable, precise and useful. This sort of applied science has the capacity to directly improve the lives of local people, including many Trump voters, as well as benefiting other mountainous flood-prone areas across the US and globally. But a flood warning system can only work if there is reliable meteorological forecasting going forward. Reports suggest NWS weather balloons, which assess storm risk by measuring wind speed, humidity, temperature and other conditions that satellites may not detect, have been canceled in recent weeks from Nebraska to Florida due to staff shortages. At the busiest time for storm predictions, deadly heatwaves and wildfires, weather service staffing is down by more than 10% and, for the first time in almost half a century, some forecasting offices no longer have 24/7 cover. Trump's team is also threatening to slash $1.52bn from National Oceanic and Atmospheric Administration (Noaa), the weather service's parent agency, which also monitors climate trends, manages coastal ecosystems and supports international shipping, among other things. 'To build an effective and trusted warning system we need hyper-local data, including accurate weather forecasts and a more robust network of gauges,' said Summer Brown, a senior lecturer at the University of Kentucky's earth and environmental sciences department. 'The thought of weakening our basic weather data is mind-boggling.' It's impossible not to worry about the cuts, especially as the grand plan is to create a southern Appalachian flood and hazard centre to better understand and prepare the entire region's mountain communities for extreme weather and related hazards, including flash floods, landslides and tornadoes. For this, the team is currently awaiting a multimillion-dollar grant decision from the NSF, in what until recently was a merit-based, peer-reviewed process at the federal agency. The NSF director resigned in April after orders from the White House to accept a 55% cut to the $9bn budget and fire half of its 1,700-person staff. Then in an unprecedented move, a member of the governing body stepped down, lambasting Musk's unqualified Doge team for interfering in grant decisions. The NSF is the principal federal investor in basic science and engineering, and the proposed cut will be devastating in the US and globally. 'Rivers are different all over Appalachia, and if our research continues we can build accurate flood and landslide models that help communities plan for storms in a changing climate,' said Jason Dortch, who set up the flood lab. 'We've submitted lots of great grant proposals, and while that is out of our hands, we will continue to push forwarded however we can.' Fleming-Neon is a former mining community in Letcher county with around 500 residents – a decline of almost 40% in the past two decades. The town was gutted by the 2022 storm, and only two businesses, a car repair shop and a florist, reopened. The launderette, pharmacy, dentist, clothing store and thrift shop were all abandoned. Randall and Bonnie Kincer, a local couple who have been married for 53 years, run the flower shop from an old movie theater on main street, which doubles up as a dance studio for elementary school children. The place was rammed with 120in of muddy water in 2022. In February it was 52in, and everything still reeks of mould. The couple have been convinced by disinformation spread by conspiracy theorists that the recent catastrophic floods across the region, including Helene, were down to inadequate river dredging and cloud seeding. The town's sorry plight, according to the Kincers, is down to deliberate manipulation of the weather system paid for by mining companies to flood out the community in order to gain access to lithium. (There are no significant lithium deposits in the area.) Bonnie, 74, is on the brink of giving up on the dance classes that she has taught since sophomore year, but not on Trump. 'I have total confidence in President Trump. The [federal] cuts will be tough for a little while but there's a lot of waste, so it will level out,' said Bonnie, who is angry about not qualifying for Fema assistance. 'We used all our life savings fixing the studio. But I cannot shovel any more mud, not even for the kids. I am done. I have PTSD, we are scared to death,' she said breaking down in tears several times. The fear is understandable. On the slope facing the studio, a tiered retainer wall has been anchored into the hill to stabilize the earth and prevent an avalanche from destroying the town below. And at the edge of town, next to the power station on an old mine site, is a towering pile of black sludgy earth littered with lumps of shiny coal – the remnants of a massive landslide that happened as residents cleaned up after the February storm. Thomas Hutton's house was swamped with muddy water after the landslide blocked the creek, forcing it to temporarily change course towards a residential street. 'The floods have made this a ghost town; I doubt it will survive another one. If you mess with mother nature, you lose,' said Hutton, 74, a retired miner. The geologists fly drones fitted with Lidar (Light Detection and Ranging) – a remote sensing technology that uses pulsed lasers to create high-res, 3D, color models of the Earth's surface, and can shoot through trees and man-made structures to detect and monitor changes in terrain including landslides. The affordability and precision of the China-made Lidar has been a 'game-changer' for landslides, but prices have recently rocketed thanks to Trump's tariff war. The Lidar picked up fairly recent deforestation above the Fleming-Neon power plant, which likely further destabilized the earth. The team agrees that the landslide could keep moving, but without good soil data it's impossible to know when. Last year's NSF grant funded new soil and moisture sensors, and mini weather stations, which the landslide team is in the process of installing on 14 steep slopes in eastern Kentucky – the first time this has been done – including one opposite Hutton's house. Back at the lab, the geologists will use the data the sensors send back every 15 minutes to create models – and eventually a website where residents and local emergency managers can see how the soil moisture is changing in real time. The end goal is to warn communities when there is a high landslide risk based on the soil saturation – and rain forecast. 'We have taken so many resources from these slopes, we need to understand them better,' said Sarah Johnson, a landslide expert. 'We're not sitting in an ivory tower making money from research. The work we do is about making communities safer.'
NBC News
21-05-2025
- NBC News
Addiction programs at risk under proposed federal budget cuts
Harm reduction advocates in Nashville are scrambling as proposed federal budget cuts threaten programs that provide life-saving services like Narcan, HIV testing and syringe exchanges. While overdose deaths are declining nationwide, groups like Mending Hearts and HOPE warn that cuts to SAMHSA funding could put hundreds at risk and undo years of progress in addiction 21, 2025
The Independent
25-04-2025
- The Independent
Trump looks to end $56 million grant to give Narcan to first responders to help save lives during an overdose
The Trump administration is looking at plans to end a $56 million annual grant program that distributes the overdose-countering medication Narcan to first responders across the country, according to a draft proposal. A preliminary budget document, obtained by The Washington Post, reportedly calls for deep cuts to federal health programs and targets multiple addiction prevention and treatment programs, including training of community responders to administer Narcan. Narcan – known generically as naloxone – is a nasal spray that works to reverse the effects of an opioid overdose in two to three minutes. It is widely used to combat overdoses from serious drugs, including fentanyl. Though state and local governments have alternative resources than federal programs to obtain Narcan, experts are concerned that the axing of the grant may send a message about the government's view on such training. 'Reducing the funding for naloxone and overdose prevention sends the message that we would rather people who use drugs die than get the support they need and deserve,' Dr Melody Glenn, an addiction medicine physician and assistant professor at the University of Arizona, told The New York Times. The grants were awarded through the Substance Abuse and Mental Health Services Administration, an agency within the Department of Health and Human Services. The administration would be eliminated under the draft budget proposal, per the Post 'Narcan has been kind of a godsend as far as opioid epidemics are concerned, and we certainly are in the middle of one now with fentanyl,' Donald McNamara of the Los Angeles County Sheriff's Department told The Times. 'We need this funding source because it's saving lives every day.' According to the Substance Abuse and Mental Health Services Administration, 66,000 police officers, firefighters and other emergency responders were trained in 2024 using the grant money. Over 282,500 Narcan kits were distributed. The proposal to cut the program and other treatment programs comes in somewhat surprising contrast to the views of newly instated health secretary, Robert F. Kennedy Jr., who has been vocal in his desire to address America's drug crisis. Last year, during his independent presidential campaign, Kennedy, who has spoken publicly of his own heroin addiction, produced a documentary that outlined addiction support with federal backing.
