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Methadone clinic in Breckinridge Hills

People line up outside the St. Louis Metro Treatment Center at 5 a.m. to get their daily dose of methadone on Monday, April 3, 2017. The clinic opens its doors to clients at 5:15 a.m. Many in line come early to get their dose before going to work for the day. Photo by David Carson, dcarson@post-dispatch.com

ST. LOUIS − Better access to medication-assisted treatment, housing and peer supports. Drug prevention classes starting as early as kindergarten.

These were among top funding priorities that experts named Monday to best use a settlement windfall that may come to Missouri from lawsuits against opioid painkiller companies that allegedly misrepresented the addictive nature of the prescription drugs.

The group spoke at a roundtable with Missouri Attorney General Eric Schmitt, who said he’s on a listening tour to better understand the opioid epidemic. He estimated that “tens of millions of dollars” could possibly come to Missouri within the next few years from ongoing cases.

Mallinckrodt Plc alone, the St. Louis-based drug manufacturer, faces more than 2,500 state and local government lawsuits, according to Bloomberg News. Purdue Pharma, the producer of OxyContin, also faces numerous lawsuits and has filed for bankruptcy protection.

While there will likely be many competing interests for the funds, Schmitt said he wanted to ensure any payout would “go to the right place and have the maximum impact.”

“We are working with the other states to make sure that Missouri’s interests are protected in bankruptcy court,” Schmitt said. “There are robust settlement discussions going on nationally and we are certainly a part of that.”

“We are hear to listen,” he added. “We want to be helpful.”

The roundtable was held at the former Anheuser-Busch Employees Credit Union, 1001 Lynch Street, which is being turned into the new headquarters for Places for People, a nonprofit organization that works with people struggling with mental illness.

A dozen drug addiction, treatment and recovery experts were part of the discussion, along with a few dozen more stakeholders in the audience.

Mark Stringer, director of the Missouri Department of Mental Health, told the group that once funds are received the money needs to be integrated into community services as soon as possible.

“We cannot afford to waste any time, as you well know,” he said. “When and if we get the funds we need to get them out in the most effective way possible, and that will include prevention services, treatment services, recovery services. Certainly the use of medications in treating people with opioid use disorders.”

Ned Presnall, a clinician at Clayton Behavioral who also does research on substance use disorders at Washington University, said buprenorphine and methadone “are the only thing we know” that reduces mortality risk in people addicted to opioids.

“In Missouri, if a person calls to try to get buprenorphine or methadone on any given day almost anywhere in the publicly funded system, there is a waitlist,” Presnall said. “So one of the things we have not done is integrate medical treatment of opioid use disorder within the normal mainstream medical system.”

Schmitt is expected to have a similar stop in Kansas City on Wednesday at Swope Health.