A new tool aims to help communities spend their opioid settlement money wisely

“Something so boring it’s genuinely kind of hot,” joked the comedian John Oliver as he dove into the topic of opioid settlements earlier this month on his HBO show, “Last Week Tonight.” Oliver, in a departure from his usual format, was looking at the massive task before state and local governments to allocate and spend the billions of dollars coming their way.

Thousands of state and local governments have been awarded more than $50 billion to be paid out over 18 years by companies accused of pumping opioid painkillers into communities and leaving millions addicted or dead. “Theoretically,” Oliver said of the money, “it will be used to mitigate the damage that opioids are doing. [...] But when you don’t have a plan for your money, it can be easy to spend it in a thoughtless way.”

That’s where the National League of Cities is hoping to help. Last week, NLC debuted a new tool to help municipalities and counties estimate the total amount their communities can expect from the national $26 billion opioid settlement with the pharmaceutical manufacturer Johnson & Johnson. The interactive dashboard also offers data-backed investment recommendations based on the amount a jurisdiction can expect in settlement dollars.

“Municipalities have been ground zero for the opioid epidemic,” said Sarah Minster, research specialist at NLC. “We created this tool wanting to make sure local governments are well equipped for when these dollars start flowing into their communities. These settlement documents are legalese, and we want to provide transparency and information about what cities can expect. We offer tailored solutions based on funding. It’s not a one-size-fits-all approach. We want to help turn these dollars into action.”

In addition to calculating how much a city can expect from the settlement, the dashboard also provides information on how to access the funds, which are being distributed in most states by the law firm BrownGreer. Not every local government is set to receive money; it is up to each state to decide how the funds are allocated.

NLC decided to create the dashboard following its annual spring conference last year. The settlement “was the talk of the town,” said Christine Baker-Smith, director of research at NLC. “Cities were broadly aware, but very much in the dark about what it meant for city leaders and how they were going to capture the funds.”

The organization’s recommendations fall into four areas: collaboration, research & data, treatment & harm reduction, and prevention & recovery. The recommendations in each section are then organized from low- to high-cost. And if a city doesn’t like what it sees or wants more, NLC provides the full menu of recommendations separately. 

Minster said the recommendations are evidence-based and drawn from the organization’s extensive work with cities. “We know that a city of a certain size, based on our experience, has the capabilities to [undertake the recommendations targeted to them],” she said, adding, “These are just some things that everybody should be doing.”

But it is clear that not everybody knows what the best practices are. In the “Last Week Tonight” episode on opioid settlements, Oliver zoomed in on one such place: Vienna, West Virginia, “a city in a state absolutely hammered by the opioid crisis.” 

Specifically, Oliver looked at the city’s decision to spend its settlement money on a new police dog and two midsize or full-size SUVs for the Vienna Police Department. In both instances, elected officials raised the need to have a more solid plan in place for spending their portion of the settlement funds. 

“This is the first time the council has been informed that we’ve even received those funds,” one city council member said. “I would hate to see that money get whittled away $13,000-$15,000 at a time without being thoughtful about the impact this money could have for the city of Vienna.”

“It’s about prevention,” said another council member, “and we want to see those prevention dollars filter into our community.”

“But honestly,” Oliver said, “I do have some sympathy for the people making these decisions. You can imagine town councils full of members who feel an enormous responsibility to spend this money well but don’t know where to start.”

And that is the void that NLC wants to fill with its new dashboard, said Minster and Baker-Smith.

According to the NLC tool, Vienna is set to receive $347,000. It recommends that the city, among other things, use the funding to collaborate with neighboring cities to pool resources, create a public dashboard to track key opioid use metrics in the city, invest in naloxone and support access to medication-assisted treatment, and provide direct aid to residents, including cash grants for families who have lost loved ones.

For now, the NLC tool just includes data from the first national opioid settlement with Johnson & Johnson in 2021.  But NLC plans to update it with information from the other national opioid settlements in the future. (To learn more about the breakdown of yearly settlement payouts in each state, visit the data available via KFF Health News.)

Until then, Minster said, “this is an opportunity to make really innovative, targeted decisions with this funding. No amount can address the lives lost, but hopefully this is a first step in working toward remediation to help communities.”