Top New York state officials will review recommendations from the Opioid Settlement Fund Advisory Board about how the state should spend up to $1.5 billion in opioid settlement funds.

The 21-member board adopted and published its final report of recommendations late Tuesday.

The money is required to be used for treatment, recovery and reduction efforts.

"We all had different strenghts, but I do believe that we had a common goal of ending the suffering of New Yorkers and really trying to curb this epidemic of overdoses that we're in," said board member Ashley Livingston, who co-chairs Friends of Recovery Warren & Washington.

Livingston has been in recovery for nine years after she was first prescribed opiates as a junior in high school. She overdosed on her prescribed pain medication at the age of 23. 

"Humans have been using substances for as long as humans have existed — it's just a reality," she said.

State Attorney General Letitia James secured billions of dollars in damages last summer after winning extensive national lawsuits against opioid manufacturers and distributors for their role in the opioid epidemic.

The board recommended 22% of the state's share of up to $1.5 billion in damages from opioid manufacturers go toward harm reduction, followed by funding for care organizations at 16%.

About 15% will be used to invest in priority populations like people in the criminal justice system, parents, minors, young adults, veterans and others, as well as 12% of the funding for treatment, 10% each for housing and recovery, 7% for prevention, 5% for transport, 2% for public awareness and 1% toward research.

A new report released by the state comptroller's office this week found opioid-related deaths have increased by 68% to almost 5,000 people in New York from 2019 to 2021, or amid the COVID-19 pandemic. The vast majority of these deaths, 85%, involved either fentanyl or a similar synthetic opioid.

Opioid Settlement Fund Advisory board member Dr. Justine Waldman says the group correctly focused on marginalized communities and agencies paying attention to co-occurring disorders, and the need for syringe service programs to save lives.

"People think that people just go in there to get needles, but that's where the service happens," said Waldman, the CEO and chief medical officer at REACH Medical in Ithaca. "That's where they ask like, who will, who will help me, who will be nice to me, who won't be stigmatizing?"

The advisory board is slated to meet again in December, and will continue to meet quarterly. The settlement funds will continue to be paid out over the next 18 years, and the board will issue a report each fall about how it's being spent.

Board members were appointed for three-year terms, and include health and substance-use professionals, parents of people who died due to their addiction and people recovering from drug use, like Livingston.

She hopes the process will end the stigma and help others treat people who use drugs with dignity.

"When you treat a human with dignity and respect, they begin to have dignity and respect for themselves, and they can grow," Livingston said.

Gov. Kathy Hochul, legislative leaders and state Office of Addiction Services and Support staff will review the recommendations. The state is required to notify the board if the recommendations are rejected within 14 days of their release. The board will only be notified upon a decision to not accept them, according to OASAS.

Office of Addiction Services And Supports Commissioner Chinazo Cunningham commended the board's hard work on the recommendations since June.

“We applaud them for their thoughtful deliberation and commitment, which resulted in the recommendations put forward," Cunningham said in a statement. "We will continue to work with our partners in the state Legislature and local governments to get these funds to the many community-based organizations on the frontlines of addressing the opioid epidemic."

The Legislature would be required to adopt the recommendations into state law for OASAS or other agencies make permanent changes based on the suggestions. Lawmakers return to Albany at the beginning of January.