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Tracking Federal Funding to Combat the Opioid Crisis

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.


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NATIONAL RATES

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

NATIONAL FACT SHEET

  • State Case Studies, Fact Sheets, and Tracking Data
  • State Fact Sheets and Tracking Data
WA OR CA ID NV WY WV WI VT VA UT TX TN SD SC RI PA OK OH NM NY NJ NH NE ND NC MT MS MO MN MI ME MD MA LA KY KS IN IL IA HI GA FL DE CT CO AZ AR AL AK DC
Alabama

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Alaska

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Arkansas

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California

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Colorado

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Connecticut

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Delaware

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District Of Columbia

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Florida

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Georgia

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Hawaii

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Idaho

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Illinois

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Indiana

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Iowa

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Kansas

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Kentucky

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Louisiana

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Maine

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Maryland

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Massachusetts

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Michigan

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Minnesota

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Mississippi

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Missouri

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Montana

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Nebraska

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Nevada

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New Hampshire

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New Jersey

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New Mexico

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New York

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North Carolina

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North Dakota

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Oklahoma

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Oregon

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Pennsylvania

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Rhode Island

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South Carolina

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South Dakota

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Tennessee

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Texas

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Utah

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Vermont

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Virginia

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Washington

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West Virginia

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Wisconsin

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Wyoming

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Alabama

Opioid Appropriations FY2018
$14.34 Per Capita; $70 million
Opioid Appropriation FY2017 
$9.00 Per Capita; $44 million
Death Rates in 2017
9 Opioid Overdose Death Rate

Alaska

Opioid Appropriations FY2018
$71.71 Per Capita; $53 million 
Opioid Appropriation FY2017 
$28.65 Per Capita; $21 million 
Death Rates in 2017
13.9 Opioid Overdose Death Rate 

Arizona

Opioid Appropriations FY2018
$16.68 Per Capita; $117 million
Opioid Appropriation FY2017 
$10.81 Per Capita; $76 million
Death Rates in 2017
13.5 Opioid Overdose Death Rate

Arkansas

Opioid Appropriations FY2018
$13.97 Per Capita; $42 million
Opioid Appropriation FY2017 
$7.46 Per Capita; $22 million
Death Rates in 2017
6.5 Opioid Overdose Death Rate

California

Opioid Appropriations FY2018
$13.87 Per Capita; $548 million
Opioid Appropriation FY2017 
$9.22 Per Capita; $364 million
Death Rates in 2017
5.3 Opioid Overdose Death Rate

Colorado

Opioid Appropriations FY2018
$16.18 Per Capita; $91 million
Opioid Appropriation FY2017 
$8.70 Per Capita; $49 million
Death Rates in 2017
10 Opioid Overdose Death Rate

Connecticut

Opioid Appropriations FY2018
$18.77 Per Capita; $67 million
Opioid Appropriation FY2017 
$9.84 Per Capita; $35 million
Death Rates in 2017
27.7 Opioid Overdose Death Rate

Delaware

Opioid Appropriations FY2018
$36.12 Per Capita; $35 million
Opioid Appropriation FY2017 
$15.12 Per Capita; $15 million
Death Rates in 2017
27.8 Opioid Overdose Death Rate

District Of Columbia

Opioid Appropriations FY2018
$61.61 Per Capita; $43 million 
Opioid Appropriation FY2017 
$19.08 Per Capita; $13 million
Death Rates in 2017
34.7 Opioid Overdose Death Rate

Florida

Opioid Appropriations FY2018
$15.08 Per Capita; $316 million 
Opioid Appropriation FY2017 
$8.84 Per Capita; $185 million
Death Rates in 2017
16.3 Opioid Overdose Death Rate

Georgia

Opioid Appropriations FY2018
$12.75 Per Capita; $133 million
Opioid Appropriation FY2017 
$8.10 Per Capita; $84 million
Death Rates in 2017
9.7 Opioid Overdose Death Rate

Hawaii

Opioid Appropriations FY2018
$18.61 Per Capita; $26 million
Opioid Appropriation FY2017 
$11.00 Per Capita; $16 million
Death Rates in 2017
3.4 Opioid Overdose Death Rate

Idaho

Opioid Appropriations FY2018
$16.93 Per Capita; $28 million
Opioid Appropriation FY2017 
$7.22 Per Capita; $12 million
Death Rates in 2017
6.2 Opioid Overdose Death Rate

Illinois

Opioid Appropriations FY2018
$14.13 Per Capita; $178 million
Opioid Appropriation FY2017 
$8.33 Per Capita; $107 million
Death Rates in 2017
17.2 Opioid Overdose Death Rate 

Indiana

Opioid Appropriations FY2018
$16.58 Per Capita; $109 million
Opioid Appropriation FY2017 
$7.47 Per Capita; $50 million
Death Rates in 2017
18.8 Opioid Overdose Death Rate

Iowa

Opioid Appropriations FY2018
$16.75 Per Capita; $50 million
Opioid Appropriation FY2017 
$7.42 Per Capita; $23 million
Death Rates in 2017
6.9 Opioid Overdose Death Rate

Kansas

Opioid Appropriations FY2018
$14.81 Per Capita; $40 million
Opioid Appropriation FY2017 
$7.47 Per Capita; $22 million
Death Rates in 2017
5.1 Opioid Overdose Death Rate

Kentucky

Opioid Appropriations FY2018
$27.49 Per Capita; $121 million
Opioid Appropriation FY2017 
$14.88 Per Capita; $66 million 
Death Rates in 2017
27.9 Opioid Overdose Death Rate

Louisiana

Opioid Appropriations FY2018
$17.63 Per Capita; $82 million
Opioid Appropriation FY2017 
$10.30 Per Capita; $48 million
Death Rates in 2017
9.3 Opioid Overdose Death Rate

Maine

Opioid Appropriations FY2018
$27.00 Per Capita; $35 million
Opioid Appropriation FY2017 
$14.14 Per Capita; $19 million
Death Rates in 2017
29.9 Opioid Overdose Death Rate

Maryland

Opioid Appropriations FY2018
$21.30 Per Capita; $131 million 
Opioid Appropriation FY2017 
$8.78 Per Capita; $53 million
Death Rates in 2017
32.2 Opioid Overdose Death Rate

Massachusetts

Opioid Appropriations FY2018
$24.33 Per Capita; $169 million
Opioid Appropriation FY2017 
$10.64 Per Capita; $73 million
Death Rates in 2017
28.2 Opioid Overdose Death Rate 

Michigan

Opioid Appropriations FY2018
$16.27 Per Capita; $164 million
Opioid Appropriation FY2017 
$9.19 Per Capita; $92 million
Death Rates in 2017
21.2 Opioid Overdose Death Rate

Minnesota

Opioid Appropriations FY2018
$12.91 Per Capita; $71 million
Opioid Appropriation FY2017 
$8.34 Per Capita; $47 million 
Death Rates in 2017
7.8 Opioid Overdose Death Rate

Mississippi

Opioid Appropriations FY2018
$14.53 Per Capita; $44 million
Opioid Appropriation FY2017 
$7.90 Per Capita; $24 million
Death Rates in 2017
6.4 Opioid Overdose Death Rate

Missouri

Opioid Appropriations FY2018
$17.11 Per Capita; $102 million 
Opioid Appropriation FY2017 
$8.81 Per Capita; $54 million
Death Rates in 2017
16.5 Opioid Overdose Death Rate 

Montana

Opioid Appropriations FY2018
$35.67 Per Capita; $38 million
Opioid Appropriation FY2017 
$15.15 Per Capita; $16 million 
Death Rates in 2017
3.6 Opioid Overdose Death Rate 

Nebraska

Opioid Appropriations FY2018
$13.82 Per Capita; $27 million
Opioid Appropriation FY2017 
$8.09 Per Capita; $16 million
Death Rates in 2017
3.1 Opioid Overdose Death Rate

Nevada

Opioid Appropriations FY2018
$18.54 Per Capita; $56 million
Opioid Appropriation FY2017 
$11.47 Per Capita; $34 million
Death Rates in 2017
13.3 Opioid Overdose Death Rate 

New Hampshire

Opioid Appropriations FY2018
$44.31 Per Capita; $60 million
Opioid Appropriation FY2017 
$11.93 Per Capita; $16 million 
Death Rates in 2017
34 Opioid Overdose Death Rate

New Jersey

Opioid Appropriations FY2018
$12.73 Per Capita; $118 million
Opioid Appropriation FY2017 
$8.27 Per Capita; $74 million
Death Rates in 2017
22 Opioid Overdose Death Rate

New Mexico

Opioid Appropriations FY2018
$27.54 Per Capita; $58 million
Opioid Appropriation FY2017 
$15.50 Per Capita; $33 million
Death Rates in 2017
16.7 Opioid Overdose Death Rate 

New York

Opioid Appropriations FY2018
$14.98 Per Capita; $297 million 
Opioid Appropriation FY2017 
$10.02 Per Capita; $199 million 
Death Rates in 2017
16.1 Opioid Overdose Death Rate

North Carolina

Opioid Appropriations FY2018
$13.13 Per Capita; $136 million
Opioid Appropriation FY2017 
$7.05 Per Capita; $72 million
Death Rates in 2017
19.8 Opioid Overdose Death Rate 

North Dakota

Opioid Appropriations FY2018
$29.14 Per Capita; $23 million
Opioid Appropriation FY2017 
$14.75 Per Capita; $11 million 
Death Rates in 2017
4.8 Opioid Overdose Death Rate

Ohio

Opioid Appropriations FY2018
$19.23 Per Capita; $225 million 
Opioid Appropriation FY2017 
$10.21 Per Capita; $119 million
Death Rates in 2017
39.2 Opioid Overdose Death Rate

Oklahoma

Opioid Appropriations FY2018
$21.29 Per Capita; $85 million
Opioid Appropriation FY2017 
$8.81 Per Capita; $35 million
Death Rates in 2017
10.2 Opioid Overdose Death Rate 

Oregon

Opioid Appropriations FY2018
$18.57 Per Capita; $77 million
Opioid Appropriation FY2017 
$9.96 Per Capita; $41 million
Death Rates in 2017
8.1 Opioid Overdose Death Rate

Pennsylvania

Opioid Appropriations FY2018
$17.50 Per Capita; $225 million
Opioid Appropriation FY2017 
$9.36 Per Capita; $120 million
Death Rates in 2017
21.2 Opioid Overdose Death Rate

Rhode Island

Opioid Appropriations FY2018
$62.82 Per Capita; $51 million
Opioid Appropriation FY2017 
$18.07 Per Capita; $19 million
Death Rates in 2017
26.9 Opioid Overdose Death Rate

South Carolina

Opioid Appropriations FY2018
$13.21 Per Capita; $66 million 
Opioid Appropriation FY2017 
$7.25 Per Capita; $36 million 
Death Rates in 2017
15.5 Opioid Overdose Death Rate 

South Dakota

Opioid Appropriations FY2018
$31.62 Per Capita; $27 million 
Opioid Appropriation FY2017 
$12.62 Per Capita; $11 million
Death Rates in 2017
4 Opioid Overdose Death Rate

Tennessee

Opioid Appropriations FY2018
$16.88 Per Capita; $115 million
Opioid Appropriation FY2017 
$9.43 Per Capita; $63 million 
Death Rates in 2017
19.3 Opioid Overdose Death Rate 

Texas

Opioid Appropriations FY2018
$11.15 Per Capita; $316 million 
Opioid Appropriation FY2017 
$7.69 Per Capita; $218 million 
Death Rates in 2017
5.1 Opioid Overdose Death Rate

Utah

Opioid Appropriations FY2018
$17.44 Per Capita; $54 million 
Opioid Appropriation FY2017 
$10.38 Per Capita; $32 million
Death Rates in 2017
15.5 Opioid Overdose Death Rate 

Vermont

Opioid Appropriations FY2018
$44.56 Per Capita; $28 million 
Opioid Appropriation FY2017 
$22.82 Per Capita; $14 million 
Death Rates in 2017
20 Opioid Overdose Death Rate

Virginia

Opioid Appropriations FY2018
$14.69 Per Capita; $127 million
Opioid Appropriation FY2017 
$6.99 Per Capita; $59 million
Death Rates in 2017
14.8 Opioid Overdose Death Rate

Washington

Opioid Appropriations FY2018
$17.37 Per Capita; $129 million
Opioid Appropriation FY2017 
$9.59 Per Capita; $71 million 
Death Rates in 2017
9.6 Opioid Overdose Death Rate 

West Virginia

Opioid Appropriations FY2018
$39.89 Per Capita; $72 million 
Opioid Appropriation FY2017 
$13.29 Per Capita; $24 million
Death Rates in 2017
49.6 Opioid Overdose Death Rate

Wisconsin

Opioid Appropriations FY2018
$16.03 Per Capita; $95 million
Opioid Appropriation FY2017 
$9.88 Per Capita; $57 million
Death Rates in 2017
16.9 Opioid Overdose Death Rate

Wyoming

Opioid Appropriations FY2018
$27.59 Per Capita; $16 million 
Opioid Appropriation FY2017 
$16.53 Per Capita; $10 million
Death Rates in 2017
8.7 Opioid Overdose Death Rate
  • State Case Studies, Fact Sheets, and Tracking Data
  • State Fact Sheets and Tracking Data
Alabama
Opioid Appropriations FY2018
$14.34 Per Capita; $70 million
Opioid Appropriation FY2017 
$9.00 Per Capita; $44 million
Death Rates in 2017
9 Opioid Overdose Death Rate
Alaska
Opioid Appropriations FY2018
$71.71 Per Capita; $53 million 
Opioid Appropriation FY2017 
$28.65 Per Capita; $21 million 
Death Rates in 2017
13.9 Opioid Overdose Death Rate 
Arizona
Opioid Appropriations FY2018
$16.68 Per Capita; $117 million
Opioid Appropriation FY2017 
$10.81 Per Capita; $76 million
Death Rates in 2017
13.5 Opioid Overdose Death Rate
Arkansas
Opioid Appropriations FY2018
$13.97 Per Capita; $42 million
Opioid Appropriation FY2017 
$7.46 Per Capita; $22 million
Death Rates in 2017
6.5 Opioid Overdose Death Rate
California
Opioid Appropriations FY2018
$13.87 Per Capita; $548 million
Opioid Appropriation FY2017 
$9.22 Per Capita; $364 million
Death Rates in 2017
5.3 Opioid Overdose Death Rate
Colorado
Opioid Appropriations FY2018
$16.18 Per Capita; $91 million
Opioid Appropriation FY2017 
$8.70 Per Capita; $49 million
Death Rates in 2017
10 Opioid Overdose Death Rate
Connecticut
Opioid Appropriations FY2018
$18.77 Per Capita; $67 million
Opioid Appropriation FY2017 
$9.84 Per Capita; $35 million
Death Rates in 2017
27.7 Opioid Overdose Death Rate
Delaware
Opioid Appropriations FY2018
$36.12 Per Capita; $35 million
Opioid Appropriation FY2017 
$15.12 Per Capita; $15 million
Death Rates in 2017
27.8 Opioid Overdose Death Rate
District Of Columbia
Opioid Appropriations FY2018
$61.61 Per Capita; $43 million 
Opioid Appropriation FY2017 
$19.08 Per Capita; $13 million
Death Rates in 2017
34.7 Opioid Overdose Death Rate
Florida
Opioid Appropriations FY2018
$15.08 Per Capita; $316 million 
Opioid Appropriation FY2017 
$8.84 Per Capita; $185 million
Death Rates in 2017
16.3 Opioid Overdose Death Rate
Georgia
Opioid Appropriations FY2018
$12.75 Per Capita; $133 million
Opioid Appropriation FY2017 
$8.10 Per Capita; $84 million
Death Rates in 2017
9.7 Opioid Overdose Death Rate
Hawaii
Opioid Appropriations FY2018
$18.61 Per Capita; $26 million
Opioid Appropriation FY2017 
$11.00 Per Capita; $16 million
Death Rates in 2017
3.4 Opioid Overdose Death Rate
Idaho
Opioid Appropriations FY2018
$16.93 Per Capita; $28 million
Opioid Appropriation FY2017 
$7.22 Per Capita; $12 million
Death Rates in 2017
6.2 Opioid Overdose Death Rate
Illinois
Opioid Appropriations FY2018
$14.13 Per Capita; $178 million
Opioid Appropriation FY2017 
$8.33 Per Capita; $107 million
Death Rates in 2017
17.2 Opioid Overdose Death Rate 
Indiana
Opioid Appropriations FY2018
$16.58 Per Capita; $109 million
Opioid Appropriation FY2017 
$7.47 Per Capita; $50 million
Death Rates in 2017
18.8 Opioid Overdose Death Rate
Iowa
Opioid Appropriations FY2018
$16.75 Per Capita; $50 million
Opioid Appropriation FY2017 
$7.42 Per Capita; $23 million
Death Rates in 2017
6.9 Opioid Overdose Death Rate
Kansas
Opioid Appropriations FY2018
$14.81 Per Capita; $40 million
Opioid Appropriation FY2017 
$7.47 Per Capita; $22 million
Death Rates in 2017
5.1 Opioid Overdose Death Rate
Kentucky
Opioid Appropriations FY2018
$27.49 Per Capita; $121 million
Opioid Appropriation FY2017 
$14.88 Per Capita; $66 million 
Death Rates in 2017
27.9 Opioid Overdose Death Rate
Louisiana
Opioid Appropriations FY2018
$17.63 Per Capita; $82 million
Opioid Appropriation FY2017 
$10.30 Per Capita; $48 million
Death Rates in 2017
9.3 Opioid Overdose Death Rate
Maine
Opioid Appropriations FY2018
$27.00 Per Capita; $35 million
Opioid Appropriation FY2017 
$14.14 Per Capita; $19 million
Death Rates in 2017
29.9 Opioid Overdose Death Rate
Maryland
Opioid Appropriations FY2018
$21.30 Per Capita; $131 million 
Opioid Appropriation FY2017 
$8.78 Per Capita; $53 million
Death Rates in 2017
32.2 Opioid Overdose Death Rate
Massachusetts
Opioid Appropriations FY2018
$24.33 Per Capita; $169 million
Opioid Appropriation FY2017 
$10.64 Per Capita; $73 million
Death Rates in 2017
28.2 Opioid Overdose Death Rate 
Michigan
Opioid Appropriations FY2018
$16.27 Per Capita; $164 million
Opioid Appropriation FY2017 
$9.19 Per Capita; $92 million
Death Rates in 2017
21.2 Opioid Overdose Death Rate
Minnesota
Opioid Appropriations FY2018
$12.91 Per Capita; $71 million
Opioid Appropriation FY2017 
$8.34 Per Capita; $47 million 
Death Rates in 2017
7.8 Opioid Overdose Death Rate
Mississippi
Opioid Appropriations FY2018
$14.53 Per Capita; $44 million
Opioid Appropriation FY2017 
$7.90 Per Capita; $24 million
Death Rates in 2017
6.4 Opioid Overdose Death Rate
Missouri
Opioid Appropriations FY2018
$17.11 Per Capita; $102 million 
Opioid Appropriation FY2017 
$8.81 Per Capita; $54 million
Death Rates in 2017
16.5 Opioid Overdose Death Rate 
Montana
Opioid Appropriations FY2018
$35.67 Per Capita; $38 million
Opioid Appropriation FY2017 
$15.15 Per Capita; $16 million 
Death Rates in 2017
3.6 Opioid Overdose Death Rate 
Nebraska
Opioid Appropriations FY2018
$13.82 Per Capita; $27 million
Opioid Appropriation FY2017 
$8.09 Per Capita; $16 million
Death Rates in 2017
3.1 Opioid Overdose Death Rate
Nevada
Opioid Appropriations FY2018
$18.54 Per Capita; $56 million
Opioid Appropriation FY2017 
$11.47 Per Capita; $34 million
Death Rates in 2017
13.3 Opioid Overdose Death Rate 
New Hampshire
Opioid Appropriations FY2018
$44.31 Per Capita; $60 million
Opioid Appropriation FY2017 
$11.93 Per Capita; $16 million 
Death Rates in 2017
34 Opioid Overdose Death Rate
New Jersey
Opioid Appropriations FY2018
$12.73 Per Capita; $118 million
Opioid Appropriation FY2017 
$8.27 Per Capita; $74 million
Death Rates in 2017
22 Opioid Overdose Death Rate
New Mexico
Opioid Appropriations FY2018
$27.54 Per Capita; $58 million
Opioid Appropriation FY2017 
$15.50 Per Capita; $33 million
Death Rates in 2017
16.7 Opioid Overdose Death Rate 
New York
Opioid Appropriations FY2018
$14.98 Per Capita; $297 million 
Opioid Appropriation FY2017 
$10.02 Per Capita; $199 million 
Death Rates in 2017
16.1 Opioid Overdose Death Rate
North Carolina
Opioid Appropriations FY2018
$13.13 Per Capita; $136 million
Opioid Appropriation FY2017 
$7.05 Per Capita; $72 million
Death Rates in 2017
19.8 Opioid Overdose Death Rate 
North Dakota
Opioid Appropriations FY2018
$29.14 Per Capita; $23 million
Opioid Appropriation FY2017 
$14.75 Per Capita; $11 million 
Death Rates in 2017
4.8 Opioid Overdose Death Rate
Ohio
Opioid Appropriations FY2018
$19.23 Per Capita; $225 million 
Opioid Appropriation FY2017 
$10.21 Per Capita; $119 million
Death Rates in 2017
39.2 Opioid Overdose Death Rate
Oklahoma
Opioid Appropriations FY2018
$21.29 Per Capita; $85 million
Opioid Appropriation FY2017 
$8.81 Per Capita; $35 million
Death Rates in 2017
10.2 Opioid Overdose Death Rate 
Oregon
Opioid Appropriations FY2018
$18.57 Per Capita; $77 million
Opioid Appropriation FY2017 
$9.96 Per Capita; $41 million
Death Rates in 2017
8.1 Opioid Overdose Death Rate
Pennsylvania
Opioid Appropriations FY2018
$17.50 Per Capita; $225 million
Opioid Appropriation FY2017 
$9.36 Per Capita; $120 million
Death Rates in 2017
21.2 Opioid Overdose Death Rate
Rhode Island
Opioid Appropriations FY2018
$62.82 Per Capita; $51 million
Opioid Appropriation FY2017 
$18.07 Per Capita; $19 million
Death Rates in 2017
26.9 Opioid Overdose Death Rate
South Carolina
Opioid Appropriations FY2018
$13.21 Per Capita; $66 million 
Opioid Appropriation FY2017 
$7.25 Per Capita; $36 million 
Death Rates in 2017
15.5 Opioid Overdose Death Rate 
South Dakota
Opioid Appropriations FY2018
$31.62 Per Capita; $27 million 
Opioid Appropriation FY2017 
$12.62 Per Capita; $11 million
Death Rates in 2017
4 Opioid Overdose Death Rate
Tennessee
Opioid Appropriations FY2018
$16.88 Per Capita; $115 million
Opioid Appropriation FY2017 
$9.43 Per Capita; $63 million 
Death Rates in 2017
19.3 Opioid Overdose Death Rate 
Texas
Opioid Appropriations FY2018
$11.15 Per Capita; $316 million 
Opioid Appropriation FY2017 
$7.69 Per Capita; $218 million 
Death Rates in 2017
5.1 Opioid Overdose Death Rate
Utah
Opioid Appropriations FY2018
$17.44 Per Capita; $54 million 
Opioid Appropriation FY2017 
$10.38 Per Capita; $32 million
Death Rates in 2017
15.5 Opioid Overdose Death Rate 
Vermont
Opioid Appropriations FY2018
$44.56 Per Capita; $28 million 
Opioid Appropriation FY2017 
$22.82 Per Capita; $14 million 
Death Rates in 2017
20 Opioid Overdose Death Rate
Virginia
Opioid Appropriations FY2018
$14.69 Per Capita; $127 million
Opioid Appropriation FY2017 
$6.99 Per Capita; $59 million
Death Rates in 2017
14.8 Opioid Overdose Death Rate
Washington
Opioid Appropriations FY2018
$17.37 Per Capita; $129 million
Opioid Appropriation FY2017 
$9.59 Per Capita; $71 million 
Death Rates in 2017
9.6 Opioid Overdose Death Rate 
West Virginia
Opioid Appropriations FY2018
$39.89 Per Capita; $72 million 
Opioid Appropriation FY2017 
$13.29 Per Capita; $24 million
Death Rates in 2017
49.6 Opioid Overdose Death Rate
Wisconsin
Opioid Appropriations FY2018
$16.03 Per Capita; $95 million
Opioid Appropriation FY2017 
$9.88 Per Capita; $57 million
Death Rates in 2017
16.9 Opioid Overdose Death Rate
Wyoming
Opioid Appropriations FY2018
$27.59 Per Capita; $16 million 
Opioid Appropriation FY2017 
$16.53 Per Capita; $10 million
Death Rates in 2017
8.7 Opioid Overdose Death Rate

BPC’s five state case studies revealed:

  • A statewide coordinating body, typically convened by the governor, is an essential part of developing a strategic opioid epidemic response. Each of the five states BPC studied has a coordinating body to facilitate data-sharing and communication.

  • States are increasingly focused on building out treatment networks for individuals with opioid use disorder, using funds for direct payment supports for treatment in at-risk populations, providing trainings and technical assistance, distributing naloxone, and enhancing the treatment workforce.

  • Federal funding in these states is flowing to areas with the highest number of deaths. When examining the per capita federal funding in rural and metropolitan areas, many rural counties receive relatively low levels of direct funding compared with the more populated cities. It is important to note that the recipient of funds may not necessarily correspond with the geographic service area.

  • Ongoing evaluation is needed to help track all phases of progress in the state’s response to the opioid epidemic, including prevention, treatment, and recovery. Output data from these programs is only preliminary and more attention is needed to evaluate the effectiveness of this funding and its effect on longer-term outcomes.

  • Medicaid (and Medicaid expansion in four of five case-study states) has been essential to providing services to individuals with opioid use disorder.

BPC conducted interviews with various state government officials and staff and collected information from the federal and state analyses. As a result of this examination, there are three essential steps that policymakers should take to improve the federal response to the opioid epidemic:

  1. HHS, other federal departments, and non-governmental organizations involved in the response should assist states in identifying sustainable sources of federal, state, and private-sector funding to address the opioid epidemic. The Substance Abuse and Mental Health Services Administration’s Prevention and Treatment block grant is one example of a critical federal source of long-term funding that has been level-funded at approximately $1.8 billion for the past 10 years, representing a 31 percent decrease in funding when adjusted for inflation.

  2. There is substantial need for improved coordination of grant programs at the federal level, particularly with the aid of the White House Office of National Drug Control Policy. Enhanced federal coordination of opioid funding programs across federal agencies will improve program coordination at the state level. This is critical given the sheer volume of grants going to states, the need for coordination across state agencies and local governments, and the multifaceted nature of the epidemic.

  3. Congress and the administration should build flexibility into federal grants to allow state agencies to adapt to quickly changing conditions on the ground. Flexibility in funding ensures that while states are responding to today’s opioid epidemic, they are also prepared for other emerging drug threats, such as methamphetamine and cocaine.

Further research and evaluation is necessary to ensure that states are delivering quality, evidence-based services and that federal funds support not only service delivery but also sustainable infrastructure to prevent and treat opioid use disorder. The critical role of other sources of funding—specifically Medicaid and private insurance—to address the opioid epidemic also need to be tracked.

Press release

Trajectory of our opioid work since 2017

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