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Determining Best Strategies for Allocating the Pharmaceutical Settlement Dollars to Abate the Opioid Crisis: Part II

On November 12, 2024, the National Prevention Science Coalition to Improve Lives hosted the second of two briefings on best strategies for allocating the pharmaceutical settlement dollars to abate the opioid crisis. The substance use crises continue to rage—there are still thousands of deaths, many more with substance use disorders, and teenagers on the path to risky drug taking and addiction. Public health experts and agencies are working to inform the public and eliminate fentanyl and other harmful substances from the drug supply. However, misuse of addictive substances and their devastating and costly consequences will not disappear unless we implement a comprehensive, proactive, and sustained approach to substance use and addiction. There is now an unprecedented opportunity to do this right by smartly allocating the National Prescription Opiate Litigation. The substantial body of scientific knowledge and best practices generated to date offer workable solutions.

 

Investments in prevention strategies are cost-effective, reducing levels of systems involvement and need for substance use treatment, and forestalling the enormous financial, productivity, health, and social costs of untreated addiction. As Americans grow increasingly attuned to the substance use crisis the country is facing, let’s use the mounds of evidence that have been accumulated to make smart decisions and ensure that settlement funds are being heavily invested in prevention and children’s health and well-being, and not just plugging up holes in the addiction-crisis dam.

 

The first briefing featured experts in risk factors that influence pathways to substance use and addiction, authors of key recommendations for spending the settlement funds, and public health solutions that hold promise to turn this crisis around by investing in a full spectrum of responses to the crisis, rather than singularly focused approaches (e.g., only interdiction, prescription regulations, or treatment).

 

Part II of this briefing series provided additional guidance in greater detail for policymakers, agency officials, and community stakeholders, featuring the following experts:

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Phillip Graham, PhD (Center Director of RTI International's Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research) discussed proven prevention approaches to disrupt pathways to substance use and addiction and placed this information in the context of racial and social inequities and disparities that precipitate these crises.

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Phillip W. Graham, DrPH is a principal scientist in RTI’s Health Practice Area and former director of the Center on Behavioral Health Epidemiology, Implementation and Evaluation Research.  For more than 25 years, Dr. Graham has conducted community-based research and evaluation to address the impact of substance use, violence, and inequities on youth and their communities. He has led evaluations of varying size and complexity at the federal, state, and local levels.  He has investigated the effects of witnessing community violence, the development of ethnic identity among African American male adolescents, the effectiveness of science-based interventions to reduce youth substance use, and the impact of comprehensive school-based interventions and services to promote healthy child development. Dr. Graham has served as the PI for five national cross-site evaluations of SAMHSA/CSAP-funded prevention strategies developed to prevent and reduce substance misuse and related consequences. Evaluation activities included a review of the risk and protective factors related to prescription drug and opioid misuse; collaborating with federal staff, external experts, and grantees to develop cross-site measures to collect data on intervention activities, costs, and outcomes; providing evaluation-related training and technical assistance to 70 grantees and over 600 communities.

 

Currently, he serves as the PI for the NIDA-funded HEAL Prevention Coordinating Center (HPCC).  The HPCC supports 10 research projects designed to prevent opioid misuse among older adolescents and young adults and works to generate shared insights by collecting, analyzing, and reporting data across research projects.  He also serves as the PI on two CDC-funded research projects.  The first is a grant that examines the efficacy of prevention strategies to reduce community violence in Milwaukee; and second is a cooperative agreement examining  the effectiveness of a family strengthening intervention to mitigate the impact of ACES on opioid use among families in New Jersey.

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Sara Whaley, MA, MPH, MSW (Johns Hopkins Bloomberg School of Public Health) described the Johns Hopkins University Principles—adopted by various localities through the country—which provides guidance for selection and implementation of best practices.

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Sara Whaley, MSW, MPH, MA is a Senior Research Associate at the Johns Hopkins Bloomberg
School of Public Health, is a core faculty member in the Center for Mental Health and Addiction Policy, and is the Program Director of the JHSPH Bloomberg Overdose Prevention
Initiative. With expertise spanning social work practice, policy, and epidemiology, Sara now
coordinates technical assistance and evaluation aimed at addressing the nation’s overdose
crisis and is actively engaged in state policy activities leading efforts to guide effective spending of funds from opioid settlements. Sara is committed to bridging research and government to share knowledge, create strong partnerships, and inform effective policy.

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Mr. Zeke Cohen (Baltimore City Councilmember, Democratic Nominee for City Council President) talked about their work at the city level to heal trauma applying comprehensive cross-sector approaches using these dollars.

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Zeke Cohen has represented the First District on the Baltimore City Council since 2016 and is now the presumptive Democratic nominee for City Council President. He was prompted to seek this office because of his firm belief that Baltimore deserves better in terms of city services and quality of life. He is unwavering in his love of Baltimore City, its residents, and its potential. A former teacher and founder of a nonprofit teaching community organizing to young people, he ran for office with the belief that democracy only works when everyone has a voice in the process. In July 2019, Zeke introduced the Elijah Cummings Healing City Act, making Baltimore the first city in the country to comprehensively legislate trauma-responsive care. The bill, which was signed into law in February 2020, and the movement that propelled it forward were created to help Baltimore heal from our enduring legacies of trauma, racism and violence. He also sponsored the Gender-Inclusive Single-User Restroom bill and the Transparency in Lobbying Act.

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Cathy Schultz, MPH (Director of the Governor’s Overdose Task Force Rhode Island, Executive Office of Health and Human Services) provided a state-level exemplar of ways in which significant investments can and have been made in evidence-based preventive interventions.


Ms. Schultz currently serves as the Director of the Governor’s Overdose Task Force at the
Executive Office of Health and Human Services (EOHHS), which is the center of all overdose
work for the State of Rhode Island. Cathy’s role as Task Force Director includes ensuring
alignment across all strategic pillars, namely, reinforcing comprehensive prevention,
strengthening harm reduction and rescue, increasing engagement in treatment, supporting
recovery, while ensuring racial equity is embedded across all pillars, uplifting community voice,
using data to drive change, and building connections to care. Prior to Cathy’s work at EOHHS,
she managed several overdose projects at the Rhode Island Department of Health (RIDOH)
using her innate strategic thinking and ability, knowledge of resources across the state, and lived experience to develop and implement harm reduction programs aimed at saving lives. In addition, Cathy has several years of experience working as an outreach worker and a housing stabilization case manager, crisis intervention counselor, certified peer recovery specialist and statewide anti-stigma and naloxone trainer/distributer. She has also developed and implemented several local level initiatives in her former role in the West Warwick and Woonsocket Health Equity Zone.

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Rayford Etherton, J.D. (Founder, The Helios Alliance) presented their System Dynamics Simulation Modeling Technology that works in part with AI to determine which strategies are most effective and cost efficient for any given location and how it was specifically applied in Mobile, Alabama.

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Rayford Etherton is the founder of The Helios Alliance, a group of like-minded individuals and organizations with a common purpose: to effectively improve health, safety, and the quality of life using innovative, transformative technologies and methodologies. To date, members of the Helios Alliance have constructed a national Opioid Abatement simulation platform that can be used to guide policy and spending decisions, and they have built a public-private partnership to develop an Alabama-specific simulation model that will be made available to all cities and counties in Fall 2024. Additionally, Rayford is a seasoned professional who seamlessly combines his extensive legal background with cutting-edge data analytics and modeling as the principal at Janus Consultants, LLC. Using System Dynamics as the core analytic tool, Rayford established an integrated practice in 2011 that leverages a top- notch multidisciplinary team of subject matter experts to deliver innovative solutions on a wide variety of systemic issues. His work at Janus has focused on the opioid epidemic and its impacts since late 2017.

A special thank you to our interns for introducing our speakers!

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Anshuta Beeram

UG Pre-Med and Comparative

Literature, Penn State

University

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Vanessa Morales

Doctoral student,

University of Miami

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Dohyun Im

Justice, Law & Criminology, American University

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Maddy Jupina

Doctoral student in Communication Arts & Sciences, Penn State University

Presentation Slides

Watch the Replay!

Resources:

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NPSC Briefings:

  1. The Real Dangers of Equating Opioid Dependence with Addiction

  2. Harm Reduction as an Essential Part of a Comprehensive Strategy to Combat the Opioid Epidemic

  3. Determining Best Strategies for Allocating the Pharmaceutical Settlement Dollars to Abate the Opioid Crisis: Part I of 2

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Websites:

  1. www.opioidprinciples.jhsph.edu

  2. Prevent Overdose RI

  3. www.kffhealthnews.org/opioid-settlements

  4. https://drugfree.org/reports/strategies-for-abatement-of-harms-from-the-opioid-epidemic/

  5. https://opioidprinciples.jhsph.edu/

  6. https://www.theheliosalliance.com/resources  (see also one-page description)

  7. https://www.opioidsettlementtracker.com/

  8. Consortium to Advance Prevention Solutions to the Opioid Crisis

  9. Brandeis Opioid Resource Connector

  10. National Association of Counties (NACo): The Opioid Solutions Center 

  11. Bloomberg American Health Initiative at Johns Hopkins Bloomberg School of Public Health

  12. The Mental Health Literacy Collaborative

  13. Blueprints for Healthy Youth Development

  14. FrameWorks Institute

  15. Campaign for Trauma Informed Policy and Practice (CTIPP)

  16. Family Centered Treatment Recovery (FCT-R)

  17. The following websites offer high quality prevention practitioner trainings, resources, and other guidance:

    1. Prevention Technology Transfer Center Network (PTTC): https://pttcnetwork.org/

    2. Evidence-based Prevention and Intervention Support (EPIS) Center: https://epis.psu.edu/

    3. Applied Prevention Science International (APSI): https://www.apsintl.org/

    4. A Division for Advancing Prevention and Treatment (ADAPT): https://www.hidta.org/adapt/

    5. Coalition for the Promotion of Behavioral Health (CPBH): https://www.coalitionforbehavioralhealth.org/

    6. Community Anti-Drug Coalitions of America (CADCA): https://www.cadca.org

 

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Briefs & Reports:

  1. NPSC: Strategy for Preventing Opioid Use Disorders in Communities (with guidance to state and local officials)

  2. NPSC: Comprehensive National Strategy to Prevent Opioid Use Disorder

  3. A Comprehensive Report, Evidence Based Strategies for Abatement of Harms from the Opioid Epidemic

  4. NPSC Policy Brief: Combatting the Nation’s Substance Use Crises by Allocating Pharmaceutical Settlement Dollars to Proven Prevention Approaches

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Research and Other Articles:

  1. Fishbein DH, Sloboda Z. A National Strategy for Preventing Substance and Opioid Use Disorders Through Evidence-Based Prevention Programming that Fosters Healthy Outcomes in Our Youth. Clin Child Fam Psychol Rev. 2023 Mar;26(1):1-16. doi: 10.1007/s10567-022-00420-5. Epub 2022 Dec 21. PMID: 36542196; PMCID: PMC9768412.

  2. Article about the new tranquilizer Rayford mentions: https://www.npr.org/2024/05/31/nx-s1-4974959/medetomidine-overdose-fentanyl-sedative

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Op-Ed:

  1. Allocate opioid settlement dollars to real addiction-ending solutions

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Video:

  1. Interview with Virginia Guy, Drug Education Council (January 2024)

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Group Students Smilling

Want to know what others are doing and how they are making an impact in this field? Add your name to the Shared Email List

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For more information about this briefing, contact:

Dr. Diana Fishbein, President, National Prevention Science Coalition

(dfishbein@npscoalition.org)

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