We have money to fight Kentucky's opioid crisis. Let's not waste it.
Thanks to landmark settlements with pharmaceutical manufacturers and distributors, states and municipalities across the country will receive over $50 billion in opioid abatement funding over the next 18 years. Kentucky alone is poised to receive more than $800 million. These funds represent an unprecedented opportunity to reverse the damage done and build a recovery system that works — not only for those battling substance use disorder (SUD) today but for future generations as well.
But with this opportunity comes a responsibility that we cannot afford to squander.
Already, we're seeing the warning signs. A yearlong investigation by KFF (Kaiser Family Foundation) Health News, along with researchers at the Johns Hopkins University Bloomberg School of Public Health and the national nonprofit, Shatterproof, found many jurisdictions used settlement funds on items and services with tenuous, if any, connections to addiction.
These choices may help balance ledgers, but they fundamentally betray the purpose of these funds. This money was not awarded to maintain the status quo. As Robert Kent, former general counsel for the Office of National Drug Control Policy, put it, 'Certainly, the spirit of the settlements wasn't to keep doing what you're doing. It was to do more."
Kentucky must not follow this path.
To be sure, the temptation is real. Counties face budgetary constraints, state agencies are stretched thin and public servants are overdue for raises. But the long-term cost of misusing these funds will far exceed any short-term relief. Not only could such decisions lead to clawbacks of funds or disqualifications for future disbursements under the terms of the settlement agreements, they would also represent a tragic missed opportunity to finally turn the tide in our battle against addiction.
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Fortunately, Kentucky has already shown it knows how to lead.
In 2022, our legislature passed a landmark initiative — the Behavioral Health Conditional Dismissal Program. Backed by $10.5 million in opioid settlement funds, this four-year pilot program provides an alternative to incarceration for individuals charged with certain non-violent, non-sexual misdemeanors and Class D felonies. Instead of jail, eligible participants are evaluated by medical professionals and offered treatment for SUD and/or other mental health conditions. The goal is to use data to create a replicable, collaborative model that breaks the cycle of addiction, reduces recidivism and restores lives.
Early signs are promising, and the legislature is rightly considering expansion. This is exactly the kind of innovative, evidence-based programming that Kentucky should prioritize as we distribute settlement funds.
Other models from across the country offer inspiration as well. In several jurisdictions, police departments are now pairing with mental health professionals for real-time crisis intervention. These partnerships reduce trauma for both officers and individuals in crisis, lead to more humane outcomes and, ultimately, save taxpayer dollars by reducing unnecessary hospitalizations and incarcerations.
The opioid epidemic has already claimed more than 600,000 lives nationally. While recent data from the CDC show a hopeful 17% decline in opioid overdose deaths between July 2023 and July 2024, this drop is not a sign to become complacent — it's a sign that smart policy and targeted investment can work.
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And we'll need them. More potent synthetic opioids like nitazenes and dangerous additives like xylazine ('tranq') are beginning to enter the illicit drug supply. Without aggressive investment in innovative treatment options and infrastructure, public education, harm reduction and law enforcement support, we risk falling behind again just as we're beginning to catch up.
Let this be a turning point — not a footnote.
Kentucky's business leaders, health care providers, civic institutions and elected officials must all align around one unifying principle: These funds will be used for their intended purpose — to address the opioid crisis.
That means rejecting the temptation to misuse funds to paper over fiscal problems or bankroll unrelated projects. It means providing accountability and transparency. And it means staying focused on building a future in which fewer families grieve, fewer children are left behind and more Kentuckians live free from the grip of addiction.
This is our shot. Let's not waste it.
Vickie Yates Glisson is a lawyer and arbitrator who focuses her practice on health care and health insurance issues. She is president and founder of VYBG Consulting, PLLC and former secretary of the Kentucky Cabinet for Health and Family Services
This article originally appeared on Louisville Courier Journal: KY can't afford to waste funds to fight the opioid crisis | Opinion
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More employers are giving workers money to buy their own health insurance
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It's rude to ask if someone is taking Ozempic. Here's why.
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Subscribe to The Post Most newsletter for the most important and interesting stories from The Washington Post. (Full disclosure: I was prescribed a GLP-1 for a cluster of medical conditions: prediabetes, insulin resistance and cardiovascular disease.) I talked to two physicians who prescribe the meds, two well-known advice columnists and two dozen GLP-1 users for their take on the big etiquette questions on the table. Here's what I learned. - - - Is it okay to ask someone if they're taking a GLP-1 inhibitor? Two years ago, I reconnected with a former colleague who'd lost so much weight I barely recognized him. My first thought was, 'Did he have cancer' or 'Was something wrong?' Lucky me, he beat me to the punch by confiding that he'd been using Ozempic. 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For that reason, I'm also inclined to serve buffet style, letting everyone decide how much they want on their plate. Bottom line: Be prepared to communicate your needs ahead of time and don't pry for details if a friend's eating habits change. I've faced many well-meaning but intrusive questions myself, which is why I smiled when Hax told me: 'Too bad there isn't a GLP-1 for ignorance.' Related Content Ukraine scrambles to roll back Russian eastern advance as summit takes place Her dogs kept dying, and she got cancer. Then they tested her water. D.C.'s homeless begin to see the effects of Trump's crackdown Solve the daily Crossword
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There's a new kind of nosy parker on the rise in the United States, a person who thinks it's fine to blurt out 'Are you on Ozempic?' to those they barely know. This is probably a reflection of how many Americans are taking this class of medications known as GLP-1 inhibitors. Twelve percent of adults in the United States have taken them at some point, according to a 2024 KFF Health Tracking Poll, and prescriptions have soared every year in the past decade. This class of medications includes tirzepatide (brand names Zepbound and Mounjaro) and semaglutide (Wegovy and Ozempic), and I know numerous friends and colleagues who take one. They have been lifesavers for many people with Type 2 diabetes or who want to lose weight for medical reasons. As with other medications, like Botox, some thorny social dilemmas have followed: Is it rude to ask if someone is taking one? And what do you say if someone asks you that question? (Full disclosure: I was prescribed a GLP-1 for a cluster of medical conditions: prediabetes, insulin resistance and cardiovascular disease.) I talked to two physicians who prescribe the meds, two well-known advice columnists and two dozen GLP-1 users for their take on the big etiquette questions on the table. Here's what I learned. Two years ago, I reconnected with a former colleague who'd lost so much weight I barely recognized him. My first thought was, 'Did he have cancer' or 'Was something wrong?' Lucky me, he beat me to the punch by confiding that he'd been using Ozempic. While some of those on GLP-1 inhibitors say it doesn't bother them to be asked, Randy Jones, an author and podcast host, who is currently taking one, told me: 'I absolutely don't think people should be empowered to ask someone about their medications without an invitation to do so.' Lizzie Post, the great-great-granddaughter of etiquette guru Emily Post and co-president of the institute that bears her name, agrees, explaining the medications we take and the procedures we undergo are private. 'You don't walk up to a friend and ask if they're on Botox,' she says. Bottom line: Don't ask, mostly. (And it's probably a good idea to avoid speculating on social media about celebrities' mysterious weight loss, too. It's practically a sport for some people, but that doesn't make it okay.) Not really. Context matters, and you may not have all the details to navigate that tricky conversation without being offensive. A friend of mine, a pastor who is in front of a large congregation every Sunday, lost 52 pounds in nine months. She says she's been asked by just about everybody at one point or another, how she lost weight. While she appreciates the well-wishers who say, 'You look great! Do you feel good?' she also would prefer that people didn't make that big a deal out of it. For example, some people seem compelled to comment on her body every time they see her. 'Are you buying a whole new wardrobe?' 'You've gotten so little.' That gets under her skin because 'I don't like having my body size be the most interesting thing about me in their eyes.' David Wiss, a registered dietitian nutritionist who is based in Los Angeles and counsels patients on issues of weight and mental health, says he recommends avoiding 'body talk' of any kind. 'Body sovereignty describes the freedom and autonomy to make choices about your own body and health,' he said. Carolyn Hax, the longtime Washington Post advice columnist, says that if you're just being nosy, there's no good way to ask. But if you've struggled with weight yourself or know someone well enough to believe you can ask without giving offense, frame your question that way. Otherwise, Hax suggests, 'If people look well, look happy, look great in that color, then by all means say that.' But don't comment on their bodies. Bottom line: As I've often said, if it's curiosity that's driving you, curb it. Matt Hughes, a town commissioner in Hillsborough, North Carolina, told me he's hesitant to make the disclosure about using a GLP-1 because 'it's almost as if someone worked less hard to lose the weight,' he said. Even if that's not your intention, asking people if they are taking a GLP-1 might be mistaken for 'Ozempic shaming,' which is when people are criticized or judged for taking a drug to lose weight rather than relying on diet and exercise, even though lifestyle changes don't work for the vast majority of people. 'Weight stigma is deeply ingrained and almost unconscious,' said Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital. She reminded me that GLP-1s are treatments for medical conditions — just like those for high blood pressure, cancer or anything else — which can empower those to reply to intrusive queries by being direct, humorous or just deflecting the question. Some snappy responses I've heard include: Bottom line: It's no one's business but your own, and you don't need to discuss your prescriptions with anyone but your doctor. People who start taking GLP-1s often experience major changes in appetite or have side effects like nausea, which can limit how much they want to eat. Some people find they are less interested in drinking alcohol as well. That means in social situations, you may not be able to eat or drink like you have in the past. If you're dining at a friend's house and can't eat as much as you used to, a simple 'no, thank you' should suffice — and a considerate host won't press the issue. When dining out, there's the age-old dilemma about splitting the check: 'I only had a salad. You had a steak.' Or, 'I don't drink alcohol, and you had three cocktails.' When someone is having smaller portions or fewer courses, splitting a check can be even more difficult. Hax reminds people 'to be mindful of fairness and not hide behind expediency to get the 'sober dieting vegans' to cover their champagne and lobster.' She also suggests 'reading the room,' which means sometimes you can get separate checks, or take half of your meal home, and sometimes you just overpay, for the pleasure of everyone's company. Post also has some specific strategies, like telling friends you dine with regularly: 'Hey guys, I'm eating a lot less these days. Is it okay if I get my own check?' Or offer to use check-sharing apps like Billr or Divvy so that all diners pay what they owe. When I host, I've started asking guests not only if they have any food allergies or preferences, but also: 'Is there anything else I need to know in preparing dinner?' That allows room for someone to let me know either that they're on a GLP-1, or simply that they're only able to eat certain amounts or types of food these days. For that reason, I'm also inclined to serve buffet style, letting everyone decide how much they want on their plate. Bottom line: Be prepared to communicate your needs ahead of time and don't pry for details if a friend's eating habits change. I've faced many well-meaning but intrusive questions myself, which is why I smiled when Hax told me: 'Too bad there isn't a GLP-1 for ignorance.'
