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Katiri Zuluaga

Manager, State Initiatives

New Report Details How Opioid Crisis Funds Are Being Used

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The Bipartisan Policy Center (BPC) has published the first comprehensive report reviewing the estimated $11 billion allocated by the federal government for 57 different federal programs to address the opioid epidemic in 2017 and 2018. Funding has been used for a wide array of state-based programs, but states have primarily focused on creating treatment networks for opioid use disorder (OUD), financing treatment for at-risk individuals, making naloxone accessible and bolstering the addiction workforce. Unsurprisingly, the report found that Medicaid and Medicaid expansion have been critical in addressing the opioid epidemic. BPC recommends the federal government focus on sustainability, transparency, improved coordination among federal offices, and increased flexibility for states to address their unique needs.

Where is the Federal Funding Going?

More than 75 percent of opioid related funding is administered by the Department of Health and Human Services (HHS). Federal funding to fight the opioid epidemic has been largely funneled into regions with the highest rates of death by overdose, with rural areas often receiving less funding than metropolitan areas. States have invested in the continuum of care for OUD, however a lack of continuous evaluation from federal agencies makes it difficult to track individual state impact on the crisis. An interactive map created by BPC shows each state’s opioid appropriations from FY17 and FY18 and their FY17 death by overdose rate. The report also looks at the largest federal opioid grants, the State Targeted Response and State Opioid Response grants, in five states: New Hampshire, Tennessee, Ohio, Louisiana and Arizona.

The report cites Medicaid as a key resource for individuals with opioid use disorder. In particular, Medicaid expansion is highlighted as an essential tool in providing individuals with opioid use disorder access to treatment. Unfortunately, Medicaid expansion continues to come under threat, most recently with the Trump Administration’s announcement that it supports the complete elimination of the Affordable Care Act (ACA) by the courts.

Recommendations for Policymakers

Through a series of interviews, BPC has identified three priorities for policymakers to enhance the federal activities meant to curb the opioid epidemic:

  • Assist states in determining sustainable funding from federal, state and private-sector sources.
  • Improve federal level coordination of grant programs, especially with White House Office of National Drug Control Policy, to improve program coordination at the state level.
  • Increase flexibility in federal grants to ensure state agencies are able to adapt to the opioid epidemic conditions on the ground and address emerging threats.

BPC calls for longer-term investment to address substance use disorders at large, criticizing one-time funding as addressing “the problem of addiction in our country as an acute condition rather than a chronic one.”  The National Council has repeatedly called on Congress to address the nation’s addiction crisis with long-term, sustainable funding, including through the expansion for Certified Community Behavioral Health Clinics (CCBHCs).

The full report and interactive map are available here. A summary of the report is available here.