Local governments across the country are receiving thousands — if not millions of dollars — from opioid settlement payouts. But in many cases, there’s little oversight to ensure the money is being spent effectively.
A pair of research and advocacy organizations aims to change that.
This summer, the Opioid Policy Institute and Popular Democracy launched a crowdsourced database to document cases of problematic settlement spending.
“[The opioid settlement money] is spent at the state level, it’s spent by tribal governments and it's spent by municipalities, so counties and cities, across all 50 states and seven territories. So it's a lot to try to keep an eye on,” said Jonathan Stoltman, director of the Opioid Policy Institute. “We wanted to both expand our reach and also empower people to report issues if they see it in their community.”
The database asks the public to report when the money is being mismanaged — not necessarily from a legal standpoint but from an ethical one.
“For our purposes, we want all of the money to go toward all things related to reducing death and disease associated with opioids,” Stoltman said.
Already, the database contains about 200 examples, from spending on t-shirts and swag to purchases of new police cruisers. Stoltman says the items listed don’t meet criteria for best practices.
So far, four entries are from Ohio.
An Ohio example
In March, commissioners for North Central Ohio’s Ashland County approved spending about $20,000 in opioid settlement funds on a new emergency alert system.
It can quickly notify the public if the water goes out or if there’s severe weather on the horizon.
Local officials say it can also be used to inform people if the local health department has Narcan to distribute, or if there’s been an overdose nearby and they should avoid the area.
“So this is notifying everyone. It's not just designed for people who have an opioid problem to go call a hotline to get help,” said Anne Strouth, director of the county’s emergency management agency. “We're looking at the other aspect of it — of the safety and health and welfare of all community members as a result of the opioid use. So it's looking at all of us who are affected because that person uses that drug and how do we keep ourselves safe.”
Stoltman recognizes the need for emergency notifications.
“We think that's really important from a public health perspective,” he said.
But uses like this are included in the database because Stoltman says they’re not what the settlement money is intended for.
“The idea that it's not targeted for people with an opioid use disorder or active opioid addiction, it's kind of missing the point,” he said. “[Settlement money] is definitely meant to try to reduce disease and death among that population. Trying to help keep them safe is the first priority.”
Common examples of waste, fraud and abuse
Another common expenditure cited in the database, including an example from Ohio, is for Raman spectrometers. The non-contact devices can be used to detect drugs and chemicals on the scene.
“Basically, the sales pitch around them is that they can reduce accidental exposure to fentanyl, which is a myth that it would cause an overdose in first responders,” Stoltman said. “So it's really like a solution looking for a problem, as opposed to something that’s actually going to reduce any of these issues related to overdose deaths.”
"We do want to make sure every dollar is spent well, and in no case would it be excusable for government to spend more than they need to on something."Jonathan Stoltman, Opioid Policy Institute
Stoltman also says communities frequently use settlement money to purchase name brand Narcan, as opposed to cheaper Naloxone products, to reverse overdoses.
“Naloxone is super important and it's a really big part of our response to the overdose crisis,” he said. “But name brand Narcan is actually quite expensive compared to generics and alternative products. We do want to make sure every dollar is spent well, and in no case would it be excusable for government to spend more than they need to on something.”
Stoltman hopes this database can help local governments avoid these pitfalls.
When people report an entry, the Opioid Policy Institute tries to empower them to take their issues up with local lawmakers. And Stoltman wants those lawmakers to engage with the database too.
“Hopefully, decision makers will see this and then see that, ‘Hey, here are some things that maybe we spent money on in the past, or that we've heard about [or] we were considering spending money on, but it's actually probably problematic," he said.
It's meant to be a tool to help everyone consider the nuances of a complex issue.
