Pennsylvania, Ohio, and West Virginia are facing calls for closer review of opioid settlement spending. There are questions being raised about how states measure addiction treatment results and explain those results to the public.
Government transparency group Open the Books says there is not enough detail from available records to judge whether individual programs are reducing overdoses.
Rachel O’Brien, the group’s deputy public policy editor, discussed the investigation with The National News Desk. She said Pennsylvania has received $2 billion and expects another $212 million this year from the Purdue Pharma and Sackler family settlement.
What the Audit Request Seeks
O’Brien said Pennsylvania has spent less than $84 million on the prevention, education, treatment and harm reduction categories examined by Open the Books.
The statewide administrator reported about $22 million for prevention and education, $15 million for treatment and $18.5 million for programs involving incarcerated people.
Her organization argues that those broad categories do not show which projects received money. Additionally, they argue that it doesn’t show what each project accomplished.
O’Brien said the trust that makes the decisions on how Pennsylvania spends the money is not subject to open records laws. Much of the available information was voluntarily supplied.
“Audits need to happen,” she said. “We need to see if the money is being spent well.” She pointed to annual audits of Pennsylvania tobacco settlement spending as a possible model, and she called for comparable scrutiny of opioid funds.
Open the Books compared spending and overdose deaths in 51 of Pennsylvania’s 67 counties. O’Brien said the group found no correlation. They cited figures of $714 per overdose death in Lackawanna County and more than $42,000 in Delaware County.
She said Ohio and West Virginia also did not release performance data showing whether the money was effective.
Understanding the Limits of Spending Comparisons
No correlation doesn’t necessarily mean addiction treatment or prevention programs failed. The drug supply, treatment access, population differences and local health conditions can also cause a change in overdose death statistics.
Additionally, it has to be considered that counties with more severe problems may receive more funding. Prevention or treatment programs may need years to show measurable effects.
Settlement supporters argue that sustained investment is necessary because the opioid crisis developed over decades. The agreements support treatment, recovery services, prevention, and overdose-reversal medication, and more money is scheduled to arrive over multiple years.
Those positions address different parts of the public debate. One concerns whether long-term funding is needed. The other concerns whether governments publish enough information for residents to assess particular spending decisions.
Regular reporting could include people served, treatment retention, naloxone distribution, and overdose trends, while accounting for the time and local conditions needed to interpret those measures.
How This Issue Affects Local Addiction Treatment
The practical question is whether settlement-funded services are available and whether agencies can explain their results. Public meetings, county spending reports, and state settlement dashboards can provide starting points for questions about local addiction treatment centers and prevention programs.
Opioid addiction can involve prescription opioids, heroin or fentanyl. Signs include using more than intended, unsuccessful attempts to cut back, cravings and continued use despite harm.
Naloxone, often sold as Narcan, can reverse an opioid overdose when given promptly. Fentanyl test strips can identify fentanyl in some substances, though they do not make drug use safe.
Finding Local Care in Your State
People in Pennsylvania, Ohio, and West Virginia can compare local care options by services and payment coverage.
Addictions.com lists addiction treatment centers and drug rehabs by state and city. Call
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