This Health Funder Has Joined the Fight Against Opioids. Where Is Everyone Else?

A rural town in Colorado.  Photo: Ken Hurst/shutterstock — A rural town in Colorado. Photo: Ken Hurst/shutterstock

Another regional health funder has joined the small group of foundations taking on the opioid crisis. The Colorado Health Foundation recently released a new funding strategy that incorporates addiction recovery into its work on behavioral health.

The commitment comes as the opioid epidemic worsens nationwide. In Colorado, which has a population of 5.6 million, the drug epidemic kills someone about every nine and a half hours, the Denver Post estimated in a November 2017 story. Drug overdoses killed around 900 people in the state in 2016. Opioid overdoses accounted for about 300 of those; heroin, which many opioid addicts turn to when they can no longer access or afford opioids, accounted for around 230 deaths. That compares to the 79 who died from heroin overdoses five years earlier. Both in the state and nationally, the number killed by drug overdoses exceeds the number killed in car accidents.

Nationally, the numbers are just as bad. Opioid overdoses increased 30 percent from July 2016 to September 2017, according to the National Institute on Drug Abuse. As of this month, it’s estimated that 115 die a day from opioid abuse. The U.S. Centers for Disease Control and Prevention estimate that the annual economic burden of the crisis has reached $78.5 billion. Despite those numbers, few national funders have taken on the crisis.

There are some funders that have, like the GE Foundation, which has given a $15 million to support community health and curb opioid addiction in Boston. Or the Aetna Foundation, which recently announced a new $6 million commitment to fighting the opioid crisis. The Cardinal Health Foundation also dedicated $5 million to the crisis from its Generation Rx program, which handles prescription drug use and misuse. And, as we've reported, the Conrad N. Hilton Foundation has also given to reduce opioid addiction as part of its substance abuse grantmaking.

For the most part, though, national funders are missing in action when it comes to responding to the opioid epidemic. Most philanthropic work on the crisis is happening locally, led by foundations embedded in those communities, like the Colorado Health Foundation.

We've written about CHF before. With some $2.5 billion in assets and annual giving of nearly $100 million, it's one of the biggest health legacy foundations in the nation, and can often be found on the cutting edge of public health grantmaking.

As part of its strategy revamp, the foundation will turn its attention to supporting adults with substance abuse problems through their recovery. The work is part of a broader focus on nurturing healthy minds, which also includes promoting the kids’ social and emotional development, and helping teens learn resiliency.

The strategy shift followed a listening tour through Colorado communities back in 2015 and early 2016, said Erica Snow, the foundation’s portfolio director leading the work on behavioral health.

“We learned and heard from communities statewide that mental health and substance use... were the number one issues in their communities, certainly related to, in many cases, the opioid crisis, but it was much bigger than that,” Snow said. From there, the foundation worked with communities to get a plan together for behavioral health.

The strategy balances the immediate need left by the opioid crisis with upstream interventions that are aimed at giving kids the skills they need to avoid becoming the epidemic’s next generation of victims.

“That’s where we landed with our priorities, which are certainly addressing the current crisis, but also going upstream and looking at early childhood and social emotional learning, and teen and young adult resiliency,” Snow said.

The foundation also keeps a pot of money that goes toward immediate response community needs, she said. Substance abuse officially became part of the foundation’s strategy with the newly released plan, but the philanthropy gave to addiction recovery as early as 2016 through this fund.

Public health funders have had a difficult time lately balancing long-term and short-term needs. At a time when many are looking upstream at social and environmental factors that determine health, few funders have responded to the immediate need for direct services prompted by the opioid crisis.

The biggest public health funder in the states and a leader of the upstream movement among health funders, the Robert Wood Johnson Foundation was at one time a big giver to substance abuse issues. The foundation gave $700 million over 20 years to support recovery. The funder stepped away from this work a little more than a decade ago, around the same time it shifted focus upstream to social and environmental determinants of health.

It’s hard to pinpoint a specific reason health funders have been slow to respond to the crisis, but a few possibilities jump out. For starters, foundations tend to be slow-moving. Budgets and strategies are hammered out ahead of time, and funders may be reluctant to pull money away from other work to respond to a crisis.

Changing priorities is a process, one that can take years. In the case of the Colorado Health Foundation, the process to change its strategy started a little more than two years ago with a listening campaign.

Another theory to explain the tepid response is that most foundations are based in urban areas and don’t see firsthand the destruction caused by the crisis in rural areas, where the epidemic has hit hardest. It fits with broader trends within philanthropy, which tends to favor urban work at the expense of rural issues.

This may be one reason that most of the funders responding to the crisis are regional foundations, like the Colorado Health Foundation, based in areas deeply affected by opioid addiction. Also in this group: the Community Foundation of New Jersey, which funded a recovery hotline managed by the Mental Health Association of New Jersey. In Ohio, the Columbus Foundation took up this work, issuing a critical need alert to donors to raise money for the cause. The Independent Blue Cross Foundation leads the charge in southeastern Pennsylvania, where the number of deaths caused by opioids increased 36 percent in 2017. The Florida Blue Foundation is also putting some serious money behind initiatives on opioids and addiction.

Regional foundations make up the backbone of the philanthropic work to fight opioid addiction, but another good predictor of whether a funder will get involved is whether they have previous contact with addiction, either personally or through past work. There’s still a lot of stigma around drug abuse. Exposure to addiction either professionally or personally may break down some of those barriers for some funders.

John Graykin, the founder of the private equity firm Lone Star, and his wife Eilene are examples of this type of giver. The couple became some of the biggest donors to addiction medicine with a $25 million gift to the Boston Medical Center to create a center for addiction. The Graykins did not give a specific reason for the gift, but said that drug addiction is “something that our immediate and extended family have had experience of.”

The Smithers Foundation, which supported alcoholism treatment and recovery for 60 years, is another funder that fits this bill. The donor increased funding to the Long Island Council on Alcoholism and Drug Dependence to allow the organization to expand its work related to heroin and opioid addiction.

The foundation also ran a full-page ad in the New York Times, comparing the seriousness and severity of the crisis to terrorism. When it comes to philanthropy, it would seem the plea fell mostly on deaf ears.

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