It's Now the Worst Drug Crisis in U.S. History. So Where Are All the Funders?

Here's a stunning statistic: Opioid overdoses now kill around as many people annually as guns in the United States. Around 33,000 people died of such overdoses in 2015. Such deaths have skyrocketed in recent years, and it's estimated that over a half-million people have a substance abuse disorder related to heroin in the U.S., while another 2 million people are embroiled with prescription pain relievers.

Increasingly, prescription drug misuse and illegal drug abuse in the United States go hand in hand. A 2014 survey indicated that 75 percent of heroin addicted participants were “introduced to opioids through prescription drugs.”

That connection helps explain why private funders in this space tend to tackle opioid abuse writ large. Yet even as this problem has exploded, the number of funders working the opioid problem is not nearly as great as one would expect.

Maybe the best known and deepest-pocketed funder on the case is the Conrad N. Hilton Foundation, which has given heavily to combat opioid addiction as part of its larger substance addiction grantmaking. Two other big foundations that have lately been paying attention are the Laura and John Arnold Foundation, which awarded $1 million in grants in 2016 to combat what is now the worst drug crisis in the country’s history; and the GE Foundation, which has made curbing opioid addiction a priority as part of a $15 million commitment to community health in Boston.

The Cardinal Health Foundation is another funder on the short list, here, and has awarded over $5 million in grants out of its Generation Rx program. The program zeroes in on combating prescription drug abuse and misuse.

Meanwhile, among community foundations, it's worth spotlighting a recent effort by the Columbus Foundation in Ohio to address the opioid epidemic in that city. In December, the foundation issued a "Critical Need Alert" to donors in its community to fund a program that aims at addressing the problem. It succeeded in reaching its goal of raising $475,000. The New Jersey Foundation has also been active on this issue, as have other community foundations.

Another notable funder in this space is the Smithers Foundation. What’s interesting here is that for the past 60 years, Smithers has focused its attentions and grantmaking on the prevention and treatment of alcoholism as well as reducing stigmas associated with the disease. In recent years, however, the foundation began recognizing the growing heroin and opioid epidemic. As a result, Smithers increased its funding to the Long Island Council on Alcoholism and Drug Dependence (LICADD). This increased funding allowed LICADD not only to expand its alcohol-related work, but also ramp up its work related to the heroin and opioid epidemic.

Over the past couple of years, Smithers seemed content in quietly backing groups working on the front lines in the war against heroin and opioids. That may be changing, starting with the foundation's dramatic full-page ad in the New York Times last month.

The ad, which states, “we must confront this epidemic with the same resolve we confront terrorism,” draws increased attention to the national crisis. It also issues a call to arms about what can be done to combat the rising tide of heroin and opioid abuse, beginning with increased engagement of law enforcement at the local, state and federal levels.

Law enforcement is a first line of defense in cutting off the supply of heroin and opioids flowing into the United States. The foundation also noted that increased resources need to be allocated to law enforcement agencies, drug education programs, treatment services, and alternatives to incarceration.

Smithers is, without doubt, doing what it can in terms of funding. But this is a small family foundation awarding modest grants that typically fall in the $5,000 to $20,000 range. It doesn’t have millions of dollars to throw around.

The mystery, here, is why more funders haven't yet come to the table as opioid addiction has become a full-blown national health crisis. In particular, we haven't seen as much activity from top health funders as you might expect.

The Robert Wood Johnson Foundation was once a leading funder of substance abuse work, pouring some $700 million into this area over 20 years, before pulling back from this field a decade ago. Meanwhile, we haven't seen significant grantmaking on the opioid crisis from such big state health funders as the Colorado Health Foundation and the Episcopal Health Foundation. Others like the California Health Care Foundation and the New York State Health Foundation are doing some work in this area. But the overall response by health funders to skyrocketing opioid deaths is still pretty limited.

No doubt we're missing some important funding in this quick scan of the field. Still, we've been watching for major new grants and initiatives on the opioid front for several years now, and the action has been limited, even as the problem has worsened. This is an urgent niche that could really benefit from major reinforcements right now.

Smart new money could potentially make a big difference right now and save young lives.

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