During his 2020 campaign, President Joe Biden pledged to get serious about holding pharmaceutical companies accountable for their role in creating the opioid crisis.

However, that promise appears to have been fraudulent as a recent report contends the Biden White House has since "gone mostly quiet" on the issue. 

Administration held opioid meeting in 2021

According to KFF Health contributor Aneri Pattani, Biden said he would appoint an "opioid crisis accountability coordinator" who would assist states in their lawsuits against pharmaceutical firms.

What's more, his administration hosted a virtual meeting in 2021 featuring "300 State, local, and Tribal leaders" to discuss "how funds from the opioid litigation can be spent to address addiction and the overdose epidemic, while advancing equity."

Pattani noted that the administration even went so far as to "create a model law that states could adopt in anticipation of receiving funds."

Yet she added that "as billions of dollars actually start to flow and state and local leaders make crucial decisions on how to spend the more than $50 billion windfall to tackle this entrenched public health crisis, the federal government has gone mostly quiet."

No recent action on opioid settlements

Pattani pointed to the absence of any opioid crisis accountability coordinator as well as the fact that the Office of National Drug Control Policy has failed to release any statements regarding settlements in upwards of a year.

This has created a concern among some observers that without federal leadership, states may repeat mistakes made after tobacco companies paid out billions of dollars two decades ago.

Those observers include Bill Pierce, who served as deputy assistant secretary for public affairs at the Department of Health and Human Services (HHS) under President George W. Bush.

"States get wide eyes when they get these huge pots of money," Pattani quoted Pierce as saying. He added that cash "starts to seep out to other areas that could be completely unrelated."

Tobacco settlements went to subsidize tobacco farmers

As an example of this phenomenon, Pierce explained that the billions in tobacco money have gone to everything from fixing infrastructure to subsidizing tobacco farmers, with less than 3% of annual payouts being earmarked for anti-smoking efforts.

While the opioid settlements have more parameters surrounding how the money can be used, pharmaceutical companies are the ones responsible for holding states accountable.

Michele Gilbert is a senior policy analyst with the think tank Bipartisan Policy Center, and she conceded that "there hasn’t been a lot of federal government action on the settlement."