Ohio opioid settlement board: reducing overdose death not part of mission

OneOhio draft strategic plan

Embarrassing mistake results from denying voice to impacted population

On May 11, 2023, the Ohio Supreme Court ruled unanimously that the OneOhio opioid settlement board must stop acting in secret and follow Ohio public records law.

The OneOhio Recovery Foundation, a government board that controls 55% of Ohio’s $2 billion in opioid settlements, is now opening up at a snail’s pace — or a little slower. In the 26 days since the Ohio Supreme Court ruling, OneOhio has made public just one document: a two-page draft outline of OneOhio’s multi-year strategic plan. (See here or below.)

The planning document is disturbingly clueless. It puts OneOhio itself, not the impacted population, at the center of its mission.

The draft plan lists a dozen goals and measurements for success. Amazingly, none of the goals are: reduce overdose death.

OneOhio’s secrecy has created an insular and clueless process in which local government officials tell each other how awesome they are. By excluding voices of people affected by opioids, the board lives in its own private OneOhio, focused on the people who get settlement money, not the people the settlement was supposed to help.

5,000 overdose deaths a year in Ohio

OneOhio’s proposed “vision” statement is bland enough: “To alleviate and abate the impacts of addiction throughout Ohio by providing funding to regions for prevention, treatment, recovery serviced and statewide initiatives and studies.”

It measure the OneOhio money machine, not what the machine accomplishes:

Number of regional grants funded.
Dollar value on statewide studies, programs and initiatives.
Evaluation of staff.

Other than that, Mrs. Lincoln, how’d you enjoy the play?

How might a plan to spend $1 billion in opioid settlement dollars look if developed by people who’ve been harmed by opioids? Would this funeral-going population ignore the deaths of 45,000 Ohio residents, i.e., the reason the opioid settlement exists at all? Reducing overdose death should not just be a goal; it should be the No. 1 goal.

OneOhio can’t work well because it doesn’t have the right people in the room. People with direct experience need to be heard and involved in decision-making.

Today, the 29-member OneOhio board includes nobody who has lost a loved one to overdose or anyone who has struggled with opioids in the Oxycontin era. It has only one Black member (3%). That doesn’t reflect Ohio’s Black population (14%) or Black Ohioans’ share of opioid overdose deaths (21%).

The county commissioners, township trustees, small town mayor and lobbyists who control OneOhio are no more qualified to made $1 billion in opioid settlement funds than they are to run the Ohio State football team. Instead of appointing experts to direct the OneOhio “foundation”, local government officials appointed themselves, creating an ill-qualified government board rather than a qualified private foundation.

See no, hear no overdose

OneOhio Regional Board Members

The OneOhio board’s failure to comprehend that mass overdose death is our most important opioid problem can be seen everywhere, not just in OneOhio’s strategic planning process, without question, The foundation’s bylaws don’t count overdose reduction as part of OneOhio’s purpose, described as:

What’s missing is what matters most. The very first item should say: “(i) reduce overdose death.”

The deaths of tens of thousands of people who use drugs cannot be ignored. A “foundation” that will receive $1 billion as compensation for these deaths of people shouldn’t blame the victims for their death. It is not acceptable to list “stop doing that” as the only strategies that matters. This is how stigma works. Forgetting the humanity of people who use drugs and those who love them is dangerously close to being a core OneOhio value.

So far, the OneOhio board has held 12 meetings so far. A transcript of those meetings show board members have spoken more than 150,000 words. “Overdose death” has been mentioned once.

The future: Fixing OneOhio

To respect the dead and re-orient its mission, the OneOhio board should start each meeting with a moment of silence for the dead. It should welcome the impacted population and ask it to speak at every meeting. Instead, the board has refused to let the impacted population speak, not even for one minute.

This has to change. The impacted population must be substantively involved … and heard … and respected.

OneOhio’s life as a secretive, billion-dollar-club for government officials is winding down. Two court orders have put an end to a sorry period in OneOhio’s history. A county judge ruled meetings must be conducted openly and in public; the Ohio Supreme Court ruled that records on spending, no-bid contracts, decision-making, etc. must be made available to public. These courts did OneOhio a favor. They saved OneOhio from its own worst impulse.

The next thing that needs to change may be the hardest: culture. Rather than treating the impacted population as a nuisance (at best) and the enemy (at worst), OneOhio must willingly share power with a beautiful people group of true experts: Ohio residents who have suffered from opioids and those who love them.