WOONSOCKET, R.I. — The sun barely rises when John Hayes gets behind the wheel of a 27-foot-long RV and starts to rev up the engine.

Hayes sits on the edge of a mostly empty parking lot in Providence, Rhode Island, right outside of a methadone treatment clinic where, even at 5 a.m., patients start lining up.

But Hayes is not there to help people inside the brick-and-mortar clinic. Instead, he's taking the converted RV about 30 minutes north— to Woonsocket, Rhode Island. It's a community with some of the highest opioid use rates in the state.

"They’re just nice people that hit a bump," Hayes said.

It does not take long for patients to arrive.

One of the first people to arrive is Raul Rodriquez. Addicted to drugs for more than 20 years, Rodriquez use to have to travel 30 minutes to Providence to receive the methadone treatment he needs to get better.

But now, this first-in-the-nation mobile methadone clinic is bringing the medicine to him.

"It's wonderful. I live around the corner, you don't have to drive. It's right here," he said.

Methadone is a medication used to help people reduce or quit their use of heroin or other drugs. By increasing ease and access, the mobile medical unit hopes to keep patients on the right path.

"Substance use disorder is just a disease of the brain," said Linda Hurley, president of CODAC Behavioral Health, which owns and operates the mobile unit.

Last month, CODAC received approval from the Drug Enforcement Administration (DEA) to dispense methadone at mobile treatment sites. Aside from the convenience, it's a more cost-effective way for treatment centers to operate. Instead of $4 million for a new building, CODAC can spend closer to $400,000 to renovate an RV.

"This is a highly effective, efficient and kind way to provide care to individuals that are dying," Hurley said.

This type of innovative methadone treatment couldn't come at a more critical American juncture. According to the Centers for Disease Control and Prevention, an estimated 107,000 people died of drug overdoses in the U.S. in 2021. An estimated 75 percent of those deaths involved an opioid but only 18 percent of people with an opioid use disorder received medication as treatment.

"With a mobile unit, we go to individuals and see them when they can be seen, and that’s really important," Hurley noted.

There's another layer to all of this. It's keeping patients from having to go to a traditional doctor's office setting, which comes with its own set of stigmas.

As a physician specializing in addiction medicine, the mobile medical unit is a new frontier for Dr. Cara Zimmerman.

"This is definitely meeting someone where they're at," Dr. Zimmerman said.

Not only can she offer patients methadone treatment, but she can also help with wound care or write a prescription.

"This is more we're here; we're coming to you on your schedule and whatever, as much or as little as you need," she added.

Communities across the country are visiting the mobile clinic to see what's working as more treatment centers apply for DEA approval to get other mobile methadone clinics rolling nationwide.

"Most of them are just regular people who are coming in early to go to work. They're coming in before their day starts, so they can get their methadone and live a life," Hayes said.

NEW YORK (AP) — A federal judge has rejected OxyContin maker Purdue Pharma’s sweeping deal to settle thousands of lawsuits over the toll of opioids.

U.S. District Court Judge Colleen McMahon in New York found flaws in the way the bankruptcy settlement protects members of the Sackler family from lawsuits.

The Sacklers own Purdue Pharma.

The decision Thursday sides with one federal government office, eight states and a handful of other parties over thousands who had claims against Purdue and came to support the settlement.

The Sacklers would have funded much of the settlement in exchange for the legal protections.

The case is likely to be appealed to another court.

A group of states' Attorneys General announced a proposed $26 billion opioid crisis settlement Wednesday that, if approved, will resolve claims against the "big three" drug distributors — McKesson, Cardinal Health and AmerisourceBergen Drug — as well as manufacturer Johnson & Johnson.

The proposed agreement, if approved by enough state and local governments, would resolve the claims of nearly 4,000 entities that have filed lawsuits in federal and state courts against the four companies, according to a press release from New York Attorney General Letitia James.

The three distributors collectively will pay up to $21 billion over the next 18 years.

Johnson & Johnson will pay up to $5 billion over nine years, with up to $3.7 billion paid during the first three years, according to the release.

The proposed agreement would result in court orders requiring Johnson & Johnson to stop selling opioids, not fund or provide grants to third parties for promoting opioids, and not lobby for any activities related to opioids. It would also prohibit sales staff from influencing decisions related to identifying suspicious opioid orders.

McKesson, Cardinal Health and AmerisourceBergen will be required to share their data with an independent clearinghouse. The distributors would need to account for their own shipments and the shipments of the other distributors to detect, stop and report suspicious orders.

The three companies released a joint statement Wednesday: "While the companies strongly dispute the allegations at issue in the trial, they believe this resolution will allow the companies to focus their attention and resources on the safe and secure delivery of medications and therapies while delivering meaningful relief to affected communities, and will also support efforts to achieve a broad resolution," they said, in part.

Johnson & Johnson released a statement saying it would contribute $5 billion to the settlement, depending on the number of state and local governments that decide to opt into the agreement.

"We recognize the opioid crisis is a tremendously complex public health issue, and we have deep sympathy for everyone affected," said Michael Ullmann, Johnson & Johnson's executive vice president and general counsel. "This settlement will directly support state and local efforts to make meaningful progress in addressing the opioid crisis in the United States."

New York will specifically receive up to $1.25 billion to fund prevention, treatment and recovery programs.

"The numerous companies that manufactured and distributed opioids across the nation did so without regard to life or even the national crisis they were helping to fuel," said James, the New York attorney general.

A total of fourteen states — New York, California, Colorado, Connecticut, Delaware, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Ohio, Pennsylvania, Tennessee and Texas — were involved in reaching the proposed settlement agreement, according to the release.

Pennsylvania Attorney General Josh Shapiro said during a press conference, "We collectively took on some of the most powerful companies in the world to fight for you," speaking to the families who have lost loved ones to the opioid crisis.

Cases against Mallinckrodt and Rochester Drug Cooperative will move forward separately through US bankruptcy court.

The trial against the three remaining defendants — Endo Health Solutions, Teva Pharmaceuticals USA and Allergan Finance — is currently underway and will continue in state court.