A simple heuristic for allocating opioid settlement funding to reduce overdose mortality in the United States

ABSTRACT

As resolution for opioid-related claims and litigation against pharmaceutical manufacturers and other stakeholders, state and local governments are newly eligible for millions of dollars of settlement funding to address the overdose crisis in the United States. To inform effective use of opioid settlement funds, we propose a simple framework that highlights the principal determinants of overdose mortality: the number of people at risk of overdose each year, the average annual number of overdoses per person at risk, and the average probability of death per overdose event. We assert that the annual number of overdose deaths is a function of these three determinants, all of which can be modified through public health intervention. Our proposed heuristic depicts how each of these drivers of drug-related mortality – and the corresponding interventions designed to address each term – operate both in isolation and in conjunction. We intend for this framework to be used by policymakers as a tool for identifying and evaluating public health interventions and funding priorities that will most effectively address the structural forces shaping the overdose crisis and reduce overdose deaths.

KEYWORDS:

• Overdose mortality
• opioid settlement funding
• public health intervention
• mathematical modeling

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported in part by the National Institute on Drug Abuse (R01-DA046620). Involvement in this work by JD Rich and BDL Marshall was partially funded by the National Institute on General Medical Studies (P20-GM125507). These funding sources had no involvement in the conceptualization or writing of this manuscript nor the decision to submit for publication.