To spend opioid settlement funds effectively, start with needs assessments



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The two-year anniversary of the settlement between state and local governments and the opioid manufacturers and distributors — known as the multidistrict litigation, or MDL — has come and gone, and the need to responsibly distribute the opioid settlement funds remains. 

As these much-needed resources finally flow into communities, local governments and municipalities must approach this challenge with a deliberate and strategic mindset.  

One way to ensure that funds are used effectively and efficiently is to conduct a thorough needs assessment before fund distribution. This proactive step is not only fiscally responsible but also ethically sound, as each community has distinct needs and priorities in addressing the opioid crisis. 

Some early opioid settlement fund spending has received criticism, ranging from ineffective initiatives to a lack of transparency in decision-making. A needs assessment can mitigate these criticisms by clearly identifying a community’s needs and assets.  

  1. Community leaders should convene a group or coalition of diverse community members who will be directly involved in conducting a needs assessment. This group should define the scope of the needs assessment, including geography, populations and subject matter.  
  2. This group should also utilize quantitative and qualitative data, such as the number of overdose events, treatment rates, recovery supports and other community-identified priorities, to create a comprehensive picture of the community’s challenges and the existing systems in place to address them.  
  3. The parties involved should characterize evidence-based interventions to meet the needs identified. By highlighting the significant, urgent gaps between a community’s needs and its capacity to meet those needs, a needs assessment points the way to targeted spending, investment and intervention. 

Settlement funds represent a significant opportunity to bolster ongoing efforts to combat the opioid crisis. Without conducting a needs assessment, however, there is a risk of misallocation, inefficiency and squandered potential. A needs assessment is the linchpin to ensure these funds are targeted toward interventions that will save lives.   

Thankfully, many local jurisdictions already possess the resources and data necessary to conduct a needs assessment. However, to maximize the effectiveness of this critical step, it is essential to incorporate people’s experiences throughout the communities. Doing so ensures that resources target those most impacted, leverage local assets and build support for a jurisdiction’s strategy and approach to opioid settlement spending.  

As interventions are identified to fill the gaps, jurisdictions should collaborate with nearby cities and counties and other levels of government, like state agencies. For example, once a need is identified, a jurisdiction should check to see if state or federal funds (including Medicaid) are available for the intervention, or if another local jurisdiction has identified the same need. Collaboration can avoid duplication and maximize the impact of the funds.  

In addition to identifying necessities, a needs assessment can shed light on available resources, the effectiveness of current interventions, funding sources and opportunities to address service gaps and other challenges. By conducting such assessments, local governments can make informed decisions about where to allocate their opioid settlement funds for maximum impact.   

Furthermore, publishing the needs assessments improves transparency and educates the public about the jurisdiction’s approach to settlement spending. By conducting a needs assessment on a regular basis (the Substance Abuse and Mental Health Services Administration — SAMHSA — recommends every three years), local governments can understand where their investments are having an impact and identify emerging trends and needs.   

The opioid epidemic is a complex and multifaceted crisis that demands a tailored response for each community. Opioid settlement funds represent a critical lifeline in this battle, but their potential can only be realized through careful planning, including needs assessments. 

By understanding the unique needs, strengths and challenges within their communities, local governments can ensure that every dollar is used effectively to combat opioid misuse and bring about lasting change. A needs assessment is not just a proactive step; it is imperative to justify community spending and, ultimately, save lives. 

Kristen Pendergrass is the vice president of state policy at Shatterproof. Previously, she worked at the Pew Charitable Trusts leading state relations and strategy for the Substance Use Prevention and Treatment Initiative and for the Pew-MacArthur Results First Initiative helping state and local governments incorporate evidence-based policymaking into the budget and policy processes. 



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