The city’s health department on Thursday received hundreds of thousands of dollars to address opioid addiction and overdoses in San Antonio through 2025.
Also on Thursday, City Council approved $909,000 in opioid settlement funds — the first allocation of millions of dollars from opioid lawsuit settlements funneled to cities and municipalities — for the Metropolitan Health District to use over two years on substance abuse and harm reduction initiatives.
The dollars come as San Antonio continues to reel from overdose rates, largely driven by methamphetamine, heroin and fentanyl poisoning.
San Antonio anticipates it will get more than $6 million from the settlements, paid out over 18 years, but some funds could be cut, or eliminated, due to pharmaceutical companies declaring bankruptcy.
Here’s how Metro Health plans to use the $909,000: $434,000 will be used for substance use outreach and community capacity building initiatives; $175,000 for harm reduction supplies and Narcan kits; $150,000 for targeted provider education to address stigma for pregnant people with addiction or in recovery. Only $100,000 will go to medical treatment for street outreach clients. Metro Health also plans to use $50,000 to create a substance use resource portal.
Jennifer Sharpe Potter, founding director of the Be Well Institute on Substance Use and Related Disorders in San Antonio, said the need to mitigate opioid deaths is urgent, but so is the need for treatment.
“We can’t treat someone who is dead,” said Potter, who also is a professor of psychiatry and behavioral sciences at UT Health San Antonio.
But those who live with addictions and survive overdoses will often develop substance use disorders, and evidence-based treatment infrastructure needs to be available, she said.
Potter, a national expert in opioid use disorder and researcher on prevention and treatment, said the landscape for addictions in San Antonio has changed over the years to include stimulant use disorders caused by drugs such as methamphetamines and cocaine, often involved in San Antonio’s overdose deaths.
“If we focus the settlement dollars only on opioids, we are missing what we truly need to do to address substance use morbidity or mortality in our community because the landscape has changed,” she said.
Currently, San Antonio isn’t at a capacity to receive people who could benefit from substance abuse treatment, Potter said.
The opioid settlement funds could help fill that gap, at least for street outreach clients in San Antonio. Metro Health plans to partner with the research-focused Addiction Research Institute, Bexar County, Center for Health Care Services, Corazon Ministries, San Antonio Nexus Connection, St. Luke Baptist Church and the Texas Harm Reduction Alliance to do that.
Most of the partners “work closely to refer or connect people with treatment services provided by other organizations,” said Cleo Garcia, public information officer for Metro Health.
Potter said teens are particularly at risk, as they have “no access to treatment.”
“We do not have access in San Antonio, nor do we have that access in Texas for adolescent [substance use disorder] treatment. We have support services, but some young people will need treatment.
At the Be Well Texas Clinic, a UT Health San Antonio clinical program that Potter oversees, people under 18 call, but the treatment isn’t available, she said. Organizations like the San Antonio Recovery Center and Rise Recovery also don’t offer treatment, but the Center for Health Care Services refers teens to other options — like Complex Care at CommuniCare, which has one counselor which focuses on substance use disorders — depending if they have insurance or not.
The clinic is bringing an adolescent addiction medicine specialist to San Antonio, a possible first for the city, she said.
“This very young, very vulnerable group of individuals that are relatively new to substance use … are at risk for death but also at risk for a lifetime disorder that is life-threatening,” she said.
The health department will also present a proposed resolution to designate drug overdoses as a public health crisis in San Antonio and a follow-up on the distribution of funds at the City Council’s June 5 Community Health Committee meeting.
Bexar County’s plans
Bexar County has received about $14.4 million in opioid settlement dollars. It has allocated $3.4 million, with $11 million remaining.
In March 2023, a fund policy framework for spending the money included prevention, intervention, treatment and recovery, evaluation and administration.
At a March 12 Commissioners Court meeting, Andrea Guerrero-Guajardo, director of the Bexar County Preventative Health and Environmental Services Department, said the county has allocated $1.5 million to the Casa Mia project, a recovery home for mothers and their children recovering from substance abuse disorders; $95,000 went to hiring a substance use program coordinator; more than $47,000 went to purchasing Narcan for the Bexar County Sheriff’s Office; and $1.7 million funded the Center for Health Care Services contract for the 2024 fiscal year.
Bexar County in March put a call out to organizations interested in applying for funding. Funding awards to area agencies will be presented to commissioners later this year. Organizations focused on Bexar County’s fund policy framework, including prevention, intervention, treatment and recovery and evaluation, will be considered.
The focus on drug overdoses comes from the death rate for opioids in Texas, which has “increased dramatically” over the past 15 years, Metro Health said; It’s now at more than four deaths per 100,000 population in Texas.
Garcia said the rate is higher in Bexar County: Today, there are more than five deaths per 100,000 residents living in Bexar County. In 2022, more than 2,000 people died from fentanyl in Texas — more than five a day.
Metro Health said 246 overdose deaths were reported in Bexar County in 2021.
Applications for the funding are available online through May 28.
