News Photo by Julie Riddle Pharmacist Keith Misiak sorts hydrocodone pills at The Drug Store in Alpena on Thursday.

ALPENA — Local leaders will have to decide how best to spend upwards of $2 million slated to begin flowing into Northeast Michigan this spring, the result of a years-long fight against several national pharmaceutical companies.

The region’s four counties each opted in to lawsuit settlements agreed to in July by Johnson and Johnson and the country’s three largest pharmaceutical distributors. Come April, the region should see a piece of the $26 billion promised by the companies in compensation for their roles in pushing addictive drugs into the consumer marketplace.

The Michigan Attorney General’s Office estimates Alpena County will receive $1.1 million from the settlement in payments that may stretch over as many as 18 years.

Another $1 million should reach the surrounding counties, with $500,000 anticipated to go to Presque Isle County and about $300,000 each to Montmorency and Alcona counties.

In addition to each Michigan county, cities of at least 10,000 residents qualify to receive part of the settlements. In the 2019 U.S. Census Bureau estimates used to determine eligibility, the City of Alpena fell 44 people below that mark, according to Lynsey Mukomel, press secretary for the attorney general.

Recipients must spend the settlement money on efforts to treat or prevent opioid misuse. Such efforts could include training for first responders and health care providers, hiring of behavioral health workers, and services for pregnant women battling substance use disorders.

Alpena County leaders will seek professional guidance as they decide how to spend the settlement money, Bob Adrian, board of commissioners chairman, said.

A glut of prescription opioids began filling patients’ pockets nationwide in the late 1990s as pharmaceutical companies vouched for the safety of their medications.

The ensuing widespread misuse of both prescription and non-prescription opioids resulted in hundreds of thousands of opioid-related deaths nationally in the past 20 years, according to the U.S. Department of Health and Human Services.

Local physicians used to readily prescribe opioid medications as pain relief for knee replacements, oral surgeries, and other medical procedures and conditions, said Keith Misiak, pharmacist at The Drug Store in Alpena.

Once the medical community understood the dangers of opioid addiction, doctors changed their prescribing habits, choosing less-addictive medications and calling for significantly smaller dosages to try to prevent addiction, Misiak said.

He now fills far fewer opioid prescriptions than in previous years, when the pills poured into Northeast Michigan at a pace that put Montmorency County at among the highest pill-per-resident rates in the state, according to a 2019 analysis of U.S. Drug Enforcement Administration data from 2006 to 2012 by the Washington Post.

Improved tracking systems have helped those who dispense medications to curb the legal flow of the drug into the market, Misiak said.

The drug finds other ways into illicit use, however, from medicine cabinet thefts to illegal manufacturing of synthetic opioids, including those involving the deadly drug fentanyl.

Some pharmacists have faced break-ins and thefts of large quantities of opioids, Misiak has heard.

Now, the settlement money should go toward cleaning up some of the mess created by the pharmaceutical companies, the Attorney General’s office said.

Alpena County officials could benefit from using that money to support the county’s drug court, to bolster anti-drug efforts in schools, and to connect incarcerated people with support to break the addiction-to-crime cycle, Adrian suggested.