Here’s who controls the $50 billion opioid settlement funds in each state

More than $50 billion from opioid settlement funds is being distributed across the United States by state councils, yet concerns are rising over the councils’ decisions on fund allocation due to questions of representation.

Decision makers: In 14 states, state councils have final say on how to use the money, while in 24 other states and Washington D.C., these councils establish budget priorities and make recommendations.
* Members of these councils vary from doctors, researchers, county health directors, law enforcement officers, business owners, to people in recovery and parents who have lost children due to addiction.

Potential bias: There are fears that overrepresentation of specific professional groups, issues with geographic representation, and lack of representation of those who have dealt with substance use disorder could affect spending decisions.
* For example, overrepresentation of law enforcement officers could lead to funds being directed towards purchases like squad cars and bulletproof vests, rather than towards harm reduction programs.

The impact: More than $3 billion of opioid settlement funds has already been landed in government coffers, meant to provide restitution for communities hard-hit by the opioid epidemic.
* Decisions on how to allocate these funds can range from immediate solutions such as buying overdose reversal medication, to longer-term investments to increase staffing and treatment beds.

Challenges on representation: The concerns extend to population representation as well, especially among states hardest hit by the opioid epidemic.
* For instance, in Louisiana, where nearly a third of the population is Black, no Black council members are present, and in Ohio, where Black residents have the highest rates of overdose death, only one of the 29 council members is Black.
* Similarly, lack of council members with first-hand experience of addiction is raised as a concern in several states.

Room for controversy: Situations have also arisen where organizations associated with council members pursued or have been awarded funding, hence prompting more calls for comprehensive conflict-of-interest policies.
* For instance, in South Carolina and New York, conflict-of-interest policies require members to disclose professional and financial connections, and prevent council members from using their positions for financial gain.

View original article on NPR

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