The Journal Gazette
Wednesday, August 28, 2019 1:00 am

Indiana shorted in war on opioids

Report questions federal formula

BRIAN FRANCISCO | The Journal Gazette

An Indianapolis foundation contends that many states – including Indiana – are not getting their fair share of federal money to combat opioid abuse.

The Richard M. Fairbanks Foundation issued a report Tuesday describing a disconnect between opioid intervention funding and drug overdose deaths.

The analysis “shows that the amount of funding flowing to states is not aligned with their share of opioid-related deaths. This creates clear winners and losers: Some states receive significantly more funding than their proportion of the nation's opioid-related deaths, while others receive far less,” the foundation said in a report summary.

The Fairbanks Foundation provides grants to tax-exempt organizations serving Indianapolis. Its focus areas are education, health and “the vitality of Indianapolis.”

The foundation said Indiana received $158.8 million in federal funds to fight opioid addiction in fiscal years 2017 and 2018, or 1.9% of the national total – but that the Hoosier State accounted for 4% of the nation's opioid deaths in calendar year 2017. By that measure, the foundation estimated the federal government underfunded Indiana by $175.6 million.

Overdose deaths are not the main factor considered in awarding opioid grants to states, according to an agency of the U.S. Department of Health and Human Services.

A spokesman for the Substance Abuse and Mental Health Services Administration said State Targeted Response to the Opioid Crisis Grants are based on a formula that assigns a 70% weight to the number of drug-dependent people who have not received treatment and a 30% weight to the number of drug poisoning deaths. The formula was established by the 21st Century Cures Act of 2016.

A second type of federal grant, from the Medication Assisted Treatment – Prescription Drug and Opioid Addiction program, goes to states with high rates of primary treatment admissions for opioids per capita. Indiana received multiyear grants totaling $2.8 million from the program in 2015.

Claire Fiddian-Green, president and chief executive officer of the Fairbanks Foundation, said her organization's analysis “focuses on opioid-involved overdose deaths because this is a widely used proxy for the severity of the opioid epidemic.”

“While uptake of treatment may provide a useful proxy, we view this as an intermediate outcome,” Fiddian-Green said in an email. “In many states, there is a dearth of evidence-based treatment, and individuals who are receiving treatment that is not evidence-based may have a higher risk of overdose. For this reason, we decided to focus on opioid-involved overdose deaths rather than uptake of treatment as a measure of the need for support.”

The Fairbanks Foundation said the federal government allocated $11 billion in fiscal 2017 and 2018 for preventing and treating the abuse of painkilling drugs. The foundation identified California, Texas, Washington and Oregon as the biggest federal funding winners; in each case, the state's share of money was roughly double its share of nationwide opioid-related deaths in 2017.

Pennsylvania, Ohio, New Jersey and Indiana were declared the largest losers by the foundation. Those states' shares of opioid deaths were double their shares of opioid funds.

The foundation said California was overfunded by $506.4 million and Texas by $254.8 million, while Pennsylvania was underfunded by $398 million and Ohio by $329.1 million.

“People suffering from opioid use disorder are worth the same across each state. The way funding is allocated now – which is not commensurate with the percentage of opioid-related overdose deaths – creates a misalignment between resources and need,” the Fairbanks Foundation said.

In all, 17 states were underfunded, the foundation said, including Michigan, Illinois and Kentucky. Louisiana was the only state where fund share and death share matched.

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