University Health is putting millions of dollars from nationwide opioid settlements into addiction recovery services for Bexar County inmates, babies impacted by substance use during pregnancy, and the distribution of naloxone, a life-saving opioid overdose medication commonly sold under the brand name Narcan.
To date, Texas has secured $3.3 billion as a part of nationwide legal settlements with drug manufacturers, distributors and retailers for their role in the decades-long opioid crisis across the U.S, according to the state Office of the Attorney General.
Many of the settlements have not been finalized, so it remains to be seen how much the state and local governments will receive over the next two decades. Most of the money has to be spent on addiction treatment and recovery services.
A portion of the money the state receives is allocated to local governments and hospital districts. As of June, Texas has authorized $80 million in settlement money to 154 hospital districts and $100 million to cities and counties, according to the Texas Comptroller’s Office.
So far, University Health, Bexar County’s public hospital district, has received $5.6 million through allocations.
The city of San Antonio has received $1.6 million in opioid settlement money to date; the city expects to receive $6.1 million in total paid out over the next 18 years. Bexar County has received about $14.5 million so far.
The Texas Opioid Abatement Fund also distributes some of the money the state receives through competitive grants.
In 2024, University Health was awarded a $25 million grant from the abatement fund for its statewide distribution of naloxone to prevent drug overdoses. University Health is sending the life-saving drug along with training on how to use it to counties across Texas.
The grant includes $3.1 million specifically targeting more rural counties with populations of less than 100,000 people. Rural counties in North Texas like Young, Childress and Wilbarger counties have historically seen more opioid pills distributed per capita, according to a Washington Post analysis of federal data.
Much of the $5.6 million is going toward improved access to opioid addiction treatment for Bexar County’s inmate population, according to Serina Rivela, University Health’s chief legal officer.
And it’s helping the hospital system offset costs associated with caring for babies with neonatal abstinence syndrome, or NAS. The syndrome affects babies whose mothers took opioids or other addictive drugs during pregnancy.
Babies born with NAS can experience body shakes, seizures, fever and other potentially deadly complications, depending on how much and what kind of substances are in their system. They are also more likely to have low birth weight, respiratory and feeding issues.
The mothers, too, face greater risk of extended hospital stays and complications following birth.
From 2017-2021, Bexar County had a NAS rate of 7.7 out of 1,000 hospital births, the highest of any county, accounting for 23 percent of all NAS cases in Texas, according to data from the Texas Department of State Health Services.
“This is just additional funding that we now have in order to offset the costs associated with that, because sometimes they end up being born with multiple conditions,” Rivela said. “And it takes a multi-faceted medical care training team, 24/7, in order to properly care for this baby.”
