In 2017, more than 70,000 people in the United States died from a drug overdose, with almost 50,000 of these deaths involving an opioid. The United States is facing a devastating opioid epidemic, and the federal government has responded by investing billions of dollars into prevention, treatment, and recovery efforts over the past two years. This includes efforts to curb the supply of both illicit opioids and unnecessary prescription opioids and to improve access to evidence-based treatment for opioid use disorder. Despite these actions, addiction policy experts believe that the end of the epidemic is not yet in sight.
Considerable attention has focused on the drivers of the opioid epidemic. However, less attention has been paid to whether the federal investments to address the issue are being effectively targeted to the communities most affected and to those with the highest overdose deaths. An effective response requires policymakers to know how resources are allocated and to use that information to minimize duplication and maximize the efficiency of limited resources. The federal government has not previously produced or made available a document that provides this information to the public or policymakers.
Thus, the Bipartisan Policy Center created this first-of-its-kind, comprehensive report that tracks federally funded opioid programs in fiscal year 2017 and FY2018, and examines how these appropriated funds are being directed to address the opioid epidemic.
Over the past six months, BPC conducted a detailed analysis of federal appropriations and identified 57 federal programs that, either entirely or significantly, fund efforts to curb the epidemic. In total, the federal government included nearly $11 billion for these programs in its FY2017 and FY2018 discretionary appropriations bills. This includes a 124 percent increase between FY2017 ($3.3 billion) and FY2018 ($7.4 billion). These programs span the continuum of care, including prevention, treatment, and recovery. In addition, funds are directed to research, criminal justice, public health surveillance, and supply reduction efforts. Between FY2017 and FY2018, funding specifically targeted to opioid use disorder treatment and recovery increased by $1.5 billion (from $599 million to $2.12 billion). Over three quarters (77 percent) of the appropriations to opioid programs are administered by the Department of Health and Human Services (HHS).
The report also examines how federal opioid investments are spent across five geographically diverse states: Arizona, Louisiana, New Hampshire, Ohio, and Tennessee. The average drug overdose death rate in the five case study states was nearly one and half times (144 percent) higher than the national average in 2017. Each state case study takes an in-depth look at how these states are allocating the two largest federal opioid grants, the State Targeted Response and State Opioid Response grants. BPC’s analysis also incorporates county-level maps of federal funding and drug overdose deaths from 2015 to 2017 for each of the selected states.
OPIOID APPROPRIATIONS FY2018: $22.73 Per Capita; $7,403 million
OPIOID APPROPRIATIONS FY2017: $10.16 Per Capita; $3,311 million
DEATH RATES IN 2017: 14.9 Opioid Overdose Death Rate
- State Case Studies, Fact Sheets, and Tracking Data
- State Fact Sheets and Tracking Data