Your article, “The big question: How to spend $600M in CT opioid settlement funds,” (Aug. 20) highlights the need to determine how and where all of this money (estimated $600 million over the next decade) will be used.
It’s a big mistake to hand out money if Connecticut doesn’t have a clearly defined strategy, measurable outcomes, and an incremental “test and learn” implementation approach across the ecosystem of opioid crisis drivers, including treatment, education, prevention, law enforcement, employment, and family and social services.
Sadly, we are already starting to see repeat mistakes of Big Tobacco settlements in the 1990s with lobbyists, contractors, state politicians, and the public — all eager to start distributing opioid settlement funds as quickly as possible.
Based on our family’s experience with this epidemic, state plans need to combat the shame and stigma of substance use disorder and provide support for not just those struggling with SUD but their families and caregivers as well.
States can learn from Big Tobacco as well as by Big Tech about how to distribute, monitor, and optimize settlement funds to achieve results—for people with SUD, their families, and communities.
The playbook below can be used by all 50 states — Connecticut included — to jumpstart action:
- Engage the community early and often. Start with listening and understanding specific needs in your state before any “solutioning” starts or funds are distributed. Talk directly to people with SUD, families, social workers, clinicians, law enforcement, educators, community organizations, and other stakeholders to understand root cause problems.
- Take a “systems thinking” approach to strategic planning. You can’t just fix just one part of the opioid crisis (e.g., law enforcement) without addressing the entire ecosystem (e.g., treatment, education and prevention, employment, etc.). Look across disciplines and problem areas to make progress across the entire problem.
- Start small and measure to “test and learn.” Ensure financial accountability for $50 billion over the next 18 years by starting with “micro-grants” and an iterative, evidence-driven approach. Measure results, and pivot based on data: Not everything is going to work–and that’s ok. Fail fast, and don’t sink good money after bad.
- Learn from other states’ success and failure, and share data as transparently as possible. It’s likely that 80% of needs are similar across all 50 states, so it’s important to understand the unique 20% of state-specific needs. Share information and build a culture of transparency so states can learn from each other, building on things that work and avoiding mistakes.
Don’t start spending money if you don’t have a plan and a way to measure results.
Kelly O’Connor lives in Washington, D.C. and has worked in both the Obama and Trump Administrations; she lost her sister to the opioid crisis in 2017, My Introduction to Narcan TEDx talk.