June 6, 2023

Washington, D.C. —The O’Neill Institute for National and Global Health Law at Georgetown University Law Center released a new report today that provides a roadmap for state and local communities seeking to transform their approach to addiction. The report includes recommendations for creating a whole-person, whole-government strategy that aligns reforms with flexible, collaborative funding to drive positive, community-driven outcomes. 

Recent funding influxes, such as proceeds from opioid litigation settlements, provide governments with an unprecedented opportunity to transform how the nation addresses substance use disorder (SUD).

“To turn the tide on the overdose crisis, we must fix America’s addiction infrastructure to make it easier for people to get the right kind of help, right when they need it,” said Shelly Weizman, associate director of O’Neill’s Addiction and Public Policy Initiative, and main author of the report. “We often still treat substance use disorder as an acute situation with a one-size-fits-all approach, as opposed to a complex condition that needs long-term support across multiple systems of care. Transforming the system starts with transforming how we pay for it.”

Money, Ego, and Turf (MET) create structural barriers to addressing SUD. Onerous regulations and disjointed funding hinder access to quality treatment and non-clinical community-based supports, impeding engagement and successful long-term recovery. Societal barriers, such as stigma, discrimination, and racial inequality limit access to necessary care and support. Additionally, a lack of coordinated infrastructure creates silos and inefficiencies in sharing data and evidence-based practices, preventing a comprehensive strategy to address addiction in the United States. 

The report provides state and local governments with a roadmap to redesign their budgets and incentivize investments in a coordinated, targeted, and holistic response to SUD that strengthens addiction care across all government agencies.

“Now is the time for state and local governments to seize the opportunity and drive systemic change in addiction care,” said Regina LaBelle, director of O’Neill’s Addiction and Public Policy Initiative. “With the infusion of opioid settlement funds and additional federal dollars, there is great potential to build more effective, compassionate, and accessible care systems. We believe this roadmap will serve as a valuable guide to initiate this critical process.”

The report outlines key components necessary to establish an aligned and integrated system of care across all levels of government.

  1. Evidence-based policies and programs: Policies and programs across all local and state government agencies should support recovery and reflect science and evidence. The system should adopt a whole-person and recovery-oriented approach and be trauma-informed and compassionate. Services, supports, and treatment should be available on demand, ensuring that individuals can access the help they need when needed. SUD initiatives must address racial equity, economic disparities, and cultural awareness.
  2. Standardized data and outcomes: SUD outcome-based data, and whole-person outcome measures should be standardized and span across government agencies. The system must consistently track and evaluate outcomes related to SUD interventions and establish an outcome-based data framework across government agencies.
  3. Aligned funding: SUD funding should be aligned across government agencies to meet a cohesive and coordinated set of outcomes. Federal programs should be leveraged to blend and braid funding across systems. Map funding models should be implemented across government agencies to align with overarching goals for efficient resource allocation.
  4. Strong governance: Governance of the SUD system of care should be designed for sharing and collecting data that supports aligned funding and transcends leadership changes.

The report underscores that with a better-integrated funding system, individuals with substance use disorder would have access to evidence-based treatment and social determinants of health, such as stable housing and transportation. This type of holistic approach would eliminate unnecessary hurdles and barriers to care.

LaBelle emphasized, “By implementing these recommendations, policymakers, government agencies, and community leaders can work together to ensure individuals and families receive effective and comprehensive care across their lifespan.”

This project was developed in collaboration with the Recovery Policy Collaborative, the McSilver Institute for Poverty Policy and Research at New York University, as well as current and former government leaders and policymakers with expertise in substance use disorder and budgeting.

Read the report.


To Interview Regina LaBelle, contact Cynthia Sun at Cynthia.Sun@georgetown.edu.