RESUMO
The federal government provides grants to states to assist with their efforts to ameliorate the opioid epidemic. However, it is not currently understood how well these funds are targeted toward the areas with the greatest need. To address this, we constructed a database of federal grants addressing opioid and other substance use problems and investigated how closely grant dollars awarded in fiscal years 2017 and 2018 aligned with the severity of state opioid problems. Using our preferred measure, roughly one-sixth of funds, totaling $1.5 billion, would need to have been reallocated to provide equal opioid severity-adjusted funding across states; less populous states were typically the most generously funded. Grant targeting could be improved with more rigorous efforts to account for geographic differences in the severity of opioid problems. We identify problems in some frequently used targeting benchmarks, where state prevalence rates are measured with low precision.
