Increasing the impact of opioid settlement funds

Public health workers got some good news last month when provisional data from the Centers for Disease Control and Prevention showed a drop in drug overdose deaths across the U.S. The agency found a decline in drug deaths of roughly 10.6%—a notable reversal from recent years when fatal overdoses were increasing by double-digit percentages.

The data comes as the nation continues to grapple with an ever-evolving fight against synthetic opioids and other illicit drugs that are still leading to the untimely deaths of thousands of Americans.

Fortunately, in the coming years billions of dollars from opioid settlement funds are expected to pour into state and local government coffers to help combat the epidemic. This funding—and the resulting services—will provide an unprecedented opportunity to relieve communities suffering from the ravages of opioid abuse and deaths. The funding also imposes a heavy responsibility on states and local jurisdictions to administer and leverage the settlement funds for the public’s benefit.

To do this most effectively and successfully , it is necessary for public health leaders to use data and technology to guide the best use of the funds and guard against misuse of the funds.

Opportunities and Challenges

Very little guidance, however, has been given around how states must use the money. That’s not necessarily bad news, as it affords states the flexibility to tailor their approach to the unique needs of their communities.

Take Nevada. It has created the Overdose Data to Action Program to gather high-quality data on opioid prescribing and mortality that it uses to inform its prevention and interventions efforts. In addition, Nevada is using funds to implement an overdose data mapping application, modeled after a Drug Enforcement Agency program, to provide vital information to stakeholders in real time. Public health leaders, for instance, can set up spike alerts to notify them if the total overdoses in an area exceeds a predetermined threshold within a 24-hour period.

Cities like Baltimore are using their funds to implement a tailored, five-pronged strategy for responding to the opioid epidemic. The City Health Department has prioritized bringing in community members to the process, noting a community in crisis requires a community solution. The strategy includes saving lives with naloxone, increasing access to on-demand treatment, educating the public, early intervention strategies and leveraging data to inform decisions.

For resource-constrained state and local governments, these kinds of flexible spending capabilities are critical to maximizing the funding’s impact and ensuring each community gets the resources it needs.

On the other hand, this approach opens the door to potential fraud, waste and abuse challenges, as inefficient distribution and misallocated funds are more likely to go unnoticed and unchallenged. We’ve seen this play out before with big health-related settlements—more than 90% of the $200 billion settlement received by states from the tobacco industry was redirected to projects completely unrelated to tobacco, including state debts, infrastructure projects and tax cuts.

To balance the ability for organizations to use this funding freely against the risk of financial mismanagement, states need other ways to ensure funds are used correctly to allow for effective change in their respective communities.

Data-driven Action and Fund Modeling

Thanks to advances in data collection, there are a myriad of steps state and local agencies can take to mitigate risk and maximize effective use of opioid abatement funds. 

To start, they can lean into analytics to inform decisions and support business or funding modeling to see how much, and specifically where, funding should be prioritized. They can then use the data to answer questions like:

·   Does our community need more online resources?

·   Do we need more in-person treatment centers?

·   Should we be focusing more on pregnant or postpartum patients?

Further, analyzing data can help state and local governments see the whole funding picture beyond just what they are receiving from the settlement. Organizations can make those dollars go even further if they know how to integrate that money with preexisting programs.

For example, the Centers for Medicare & Medicaid Services now allows federal matching funds to aid individuals recovering from addiction—that could double the funding of certain qualifying programs. Also, in 2023, the Department of Health and Human Services, through the Substance Abuse and Mental Health Services Administration, awarded $127.7 million to expand Certified Community Behavioral Health Clinics across the country. These grant awards supported ongoing efforts to tackle the country’s mental health crisis and beat the opioid epidemic.

Technology solutions that offer simulation or predictive modeling can help organizations better prepare for adverse outcomes—or even avoid them altogether—by enabling data-driven decisions around questions like which regions need the most support, all while considering historic and demographic issues.

Artificial intelligence modeling has previously supported other sections of health care, including applications for issues related to sepsis, diabetes and hospital readmission rates. AI and machine learning algorithms show promise in unlocking clinically relevant information hidden in the large volume of data, making accurate predictions and discovering valuable insights.

AI and machine learning also play an important role in making sure help is getting to those who need it most by integrating public datasets, assisting in the creation of a funds distribution formula based on overdose deaths, opioid disbursement rates, related health issues and more.

Regardless of the technology solution, state and local government organizations must embed accountability, transparency and equity throughout the process. Any framework or strategy should be flexible enough to evolve and be designed to account for and reduce structural inequalities. 

Minority populations have historically been disproportionately affected by opioid use disorders, a disparity that has widened following the COVID-19 pandemic. Without the situational awareness provided by analyzing historical data, governments will be in the dark about who to help and how to help them.

Efficiently deploying opioid settlement funds is not just a financial challenge; it’s a moral obligation. Through a data-driven approach and the establishment of a rigorous monitoring and accountability framework, state and local government teams can help address the underlying causes of the crisis and provide critical assistance to those impacted. Most important, this strategy will ensure funding reaches the people who need it most.

Danielle Chiacco is a project manager at the consulting firm RELI Group, which advises and consults on various federal, state and local health initiatives.