Millions of dollars supposed to help fight opioid crisis — let’s not blow it | Opinion

An estimated $218 million is coming to Idaho through national legal settlements with opioid manufacturers and distributors that’s intended to help the state recover from the scourge of opioids.

A five-part series in the Idaho Statesman last week detailed the settlement, how the money is being divided and how it’s being spent. We also heard from five people on the front lines of the battle against addiction, including two Boise women addicted to fentanyl who are in jail on drug charges, a local mom who’s watched her daughter struggle with addiction for a decade and two people running a nonprofit that works with people recovering from addiction.

Here are our five takeaways from the series:

1. The money is not nearly enough. National opioid settlements total $54 billion, with such companies as Johnson & Johnson, AmerisourceBergen and McKesson.

Seems like a lot of money, right?

But the cost of opioid addiction in the United States is estimated to be $1 trillion, according to a 2021 study by the U.S. Centers for Disease Control and Prevention.

A settlement of $54 billion doesn’t even come close to offsetting the costs.

Data for Idaho was not available for this study, but per capita costs to our neighboring states were $1,701 in Wyoming, $4,096 in Nevada, $3,837 in Utah, $3,188 in Washington and $2,935 in Oregon, according to the study.

Even if Idaho were on the low end of that range, closer to Wyoming at $1,701 per person, Idaho’s combined costs of opioid use disorder and fatal opioid overdoses would total $3.2 billion.

Idaho’s payout of $218 million is a drop in the bucket.

And, frankly, the opioid manufacturers and distributors are getting off easy.

Johnson & Johnson, for example, reported sales of nearly $95 billion in the past year alone, according to an NPR article. But the company is set to pay only $5 billion — over nine years.

It’s clear the opioid settlements won’t put nearly enough of a hurt on the companies responsible in large part for unleashing this scourge on America.

Be that as it may, those are the settlement totals we’re getting, and we’ll have to live with that. But there are other problems we see with how we’re set to spend the little money we’re receiving.

2. More accountability is needed. As it stands now, all agencies receiving money self-report how they’re spending it. They are required to file a report with the Attorney General’s Office each year, and all they have to do is show that the money they’re spending falls into one of more than 100 categories on a 12-page list of eligible uses that’s part of the settlement.

Because the list is so broad and so long, agencies can spend their money on just about anything and justify it — from renovating a court building to paying for medication-assisted treatment.

But no one’s minding the store. It’s not clear who’s making sure the spending falls within one of the eligible uses or even whether the money is being wisely spent.

There needs to be more accountability and transparency in the process.

3. More coordination is needed. In Idaho, 40% of the settlement money goes to the state government; 20% is divided among the state’s seven public health districts; and 40% is divided among all 44 counties, several cities, some school districts and even a couple of fire districts.

That’s a lot of slices from a small pie, meaning no one agency is getting enough money to execute a big idea or a sustainable initiative.

We recommend an annual meeting of all the agencies receiving funds to look at what works and come up with ideas to better coordinate efforts so that Idaho gets more bang for the buck.

For example, Idaho has a dearth of sober-living houses and transitional supervised housing. Rather than spend a little money on one small program in one agency and a little bit of money on another small program in another agency, it would be a better idea to pool some money and increase the number of sober living houses.

Canyon County seems to have the right idea, with coordination among Southwest District Health, the city of Nampa, Canyon County and even Owyhee County to create a teen recovery center. The same can’t be said, however, in Ada County, where Central District Health is spending money on medication-assisted treatment and Ada County is spending it on renovating a court building.

4. The Idaho Behavioral Health Council needs to take a stronger role. “The Idaho behavioral health council shall meet as necessary and make recommendations to the governor and the joint finance-appropriations committee as to how (money) from the state-directed opioid settlement fund should be used,” according to a law passed by the Legislature in 2021.

But so far, the council has made only broad, general recommendations without specific policies or dollar amounts.

And we’ve seen the results. Gov. Brad Little this year recommended the biggest chunk of money, $500,000, go to the Idaho State Police for drug interdiction — something the council didn’t even recommend.

With so little money to go around, Idaho can’t afford to squander one penny of the opioid settlement funds on pet items of the governor that the council didn’t even want.

The council is composed of people from all three branches of state government from legislators and judges to top officials in corrections, Health and Welfare and juvenile justice. They’re the experts in their fields. Each comes from different perspectives, from the legal to the medical systems. It seems there are too many ideas going in different directions, making it difficult to come up with a cohesive, focused effort.

But council members need to do a better job of looking at what money is available each year and make more specific recommendations — with dollar amounts — on projects that will actually help fight the opioid epidemic in Idaho.

Otherwise, the money will be squandered on initiatives that may be politically popular but don’t actually help to alleviate the problem.

5. There is no quick or easy fix. The treatments for addiction are as varied as the people who suffer from the disease. One recent study showed that drug or alcohol recovery required an average of more than five recovery attempts.

There will be no magic bullet that solves the problem, and it will require a sustained and concerted effort to mitigate the problem.

What we’re doing now — throwing people with drug use disorder in jail or prison — simply isn’t working, either for those who struggle with addiction, or for the taxpayers who pay for the arrest and rearrests, or for the courts and prison system, which is already overwhelmed.

However limited and scattered the opioid settlement money is, it provides an opportunity for Idaho to come up with new and bold solutions to the opioid crisis — but only if we do it right.

Statesman editorials are the unsigned opinion of the Idaho Statesman’s editorial board. Board members are opinion editor Scott McIntosh, opinion writer Bryan Clark, editor Chadd Cripe, newsroom editors Dana Oland and Jim Keyser and community member Mary Rohlfing.