Mashantucket ― Pequot Health Care, the Mashantucket Pequot-owned pharmacy health service, has begun distributing the first of some 400,000 free doses of life-saving naloxone, an anti-opioid it will send out over the next decade to federally recognized Indian tribes across the country.

The distribution is part of the settlement of tribal lawsuits against Teva Pharmaceuticals, one of the drugmakers involved in the nation’s massive opioids litigation.

In addition to agreeing to pay the tribes about $119 million over 13 years, Teva agreed to provide up to 400,000 doses of naloxone, known by the brand name Narcan. The drug, used in the emergency treatment of opioid overdoses, comes in the form of a nasal spray administered in the case of a suspected or known overdose.

Teva will provide up to 20,000 boxes of naloxone a year for 10 years, each box containing two doses.

Teva’s shipments of the drug began arriving here shortly before Christmas, and Pequot Health Care is nearly done sending out allotments to tribes that expressed interest in receiving them, Dr. Setu Vora, the Mashantuckets’ chief medical officer, said Monday.

About 99% of the 574 federally recognized tribes in the United States signed up for the drug, according to Vora, including the Mashantuckets, the Mohegans and, in Rhode Island, the Narragansetts. The number of doses each tribe gets is largely based on its population.

Tribes that receive naloxone can decide whether to provide it to first responders and police departments, as is the case in many communities, or to make it available to patients and families of patients, Vora said.

The drug is effective as a life-saving antidote to an overdose of a prescription, pain-killing opioid like oxycodone or a nonprescription one like heroin. It is not used to treat addiction.

Pequot Health Care was chosen to distribute the drug because of the service’s capabilities, Vora said.

A subsidiary of the Mashantucket tribe, it oversees the tribe’s health care program and operates both a retail pharmacy and a mail-order pharmacy. It serves tribes and other employers around the country as a third-party administrator.

The federal government considered other entities, including federal agencies and national organizations, before approaching Pequot Health Care.

“They came to us,” Vora said. “It’s a big undertaking.”

He said Pequot Health Care has 45 employees and is unique in the sense that it is tribally owned and operated and has no affiliation with pharmaceuticals or insurance companies.

Back in 2019, the Mashantuckets and the Mohegans filed separate lawsuits against dozens of pharmaceutical companies, drug distributors and big-chain pharmacies over their roles in the prescription opioids crisis. In 2022, tentative settlements totaling $590 million were reached between many tribes who filed lawsuits and drugmaker Johnson & Johnson and three major drug-distribution companies.

“The Tribe has seen substantial increases in child welfare and social services costs associated with opioid addictions,” the Mashantuckets said in their suit. “Its health services have been significantly impacted and education and addiction therapy costs have substantially increased.”

b.hallenbeck@theday.com