Opioid settlement funds could save lives and mitigate lifelong harms from opioid misuse if they are allocated to the most effective interventions. States and communities have one chance to get the allocation right and to avoid some of the missteps that substantially diminished the potential public health impact of the tobacco settlement.

To help address this challenge, OPTIC researchers have compiled guiding principles, recommendations, and profiles of relevant effectiveness studies.

To make the information easy to search and use, we created a reference page on the OPTIC website, organized around three major topics:

• Allocating Settlement Funds: Best Bets & Lessons Learned
• Addressing Root Causes of the Opioid Crisis
• Allocating Settlement Funds to What We Know Works

These materials have different perspectives, focus on different aspects of the crisis, and use different methods to derive their assessments. However, we offer four key takeaways:

1. The root causes of overdose death are diverse. However, they share some common socioeconomic and public health themes—e.g., lack of economic opportunity, financial and/or housing instability, persistent physical pain, feelings of despair, helplessness, and untreated mental health issues. In both the short- and long-term, address those issues directly rather than focusing only on opioid analgesic agents as the cause of harm.
2. The science demonstrates that no single policy or program can address the unique characteristics of the opioid crisis in your community. Before adopting an approach, weigh the evidence that it would work in your environment. Then clearly define how you will know if your approach is achieving its intended goals.
3. Multiple studies show that giving individuals access to evidence-based treatment for opioid use disorder and keeping them in treatment are effective ways to reduce opioid-related harms. Pursuing these goals does not necessarily require enormous spending. For example, barriers to access can be reduced by expanding insurance coverage for buprenorphine treatment, reducing cost sharing, eliminating prior authorization for treatment, and incentivizing providers to treat these patients by offering higher reimbursements.
4. In many communities, what started as an opioid crisis has quickly evolved into a polysubstance crisis. When looking for short- and long-term solutions within your community, consider how the strategies being considered influence use and treatment of other addictive substances. When appropriate, consider the multiple benefits of comprehensive strategies targeting use of various substances when appropriate rather than narrowly considering impacts only on opioid outcomes and harm.

We hope you will find these materials helpful in making critical allocation decisions.

– Rosalie Liccardo Pacula, Co-Director OPTIC

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This content compiled by RAND-USC Schaeffer Opioid Policy Tools and Information Center.