This eight-page document lists what Ohio governments can spend opioid settlement funds paid from legal settlements with wholesales distributors and opioid manufacturers.
OHIO ABATEMENT STRATEGIES
Funds from any settlement dollars should be used to prevent, treat and support recovery
from addiction including opioids and/or any other co-occurring substance use and/or mental
health conditions which are all long-lasting (chronic) diseases that can cause major health,
social, and economic problems at the individual, family and/or community level.
Ohio Abatement Strategy Overview
Similar to and including many national settlement strategies, to abate addiction in Ohio, we
have created an abatement plan that includes three main components that will work
collaboratively to address Ohio’s needs and also serve as a complement to and should be
integrated with all other state and local government plans:
- Strategies for Community Recovery: Included but not limited to prevention,
treatment, recovery support and community recovery projects (examples include
child welfare, law enforcement strategies and other infrastructure supports). These
strategies have a hyper-local focus that allows communities to collaborate and
expand necessary services to their community.
- Strategies for Statewide Innovation & Recovery: Included but are not limited to
strategies included in Community Recovery Component but also projects that
promote statewide change and regional development for prevention, treatment,
recovery supports and community recovery (examples include regional treatment
hubs, drug tasks forces, data collection and dissemination). This component also
includes research and development to understand how to better serve individuals
and families in Ohio.
- Strategies for Sustainability: Ohio’s addiction and mental health epidemic was not
created overnight, and it will not go away immediately. By collaborating to share
resources and knowledge, Ohio’s state and local communities can a build
sustainable financing strategy and infrastructure to reverse the damage that has
been done and prevent future epidemics and crises.
PART ONE: Community Recovery
Expanding availability of treatment, including Medication-Assisted Treatment (MAT), for OUD
and any co-occurring substance use or mental health condition.
Trauma-informed treatment services and support for individuals, their children and family
members who have experienced trauma during their lives including trauma as a result of
addiction in the family.
Expand access and support infrastructure developments for telemedicine / telehealth
services to increase access to OUD treatment, including MAT, as well as counseling,
psychiatric support, and other treatment and recovery support services.
Improve oversight and quality assurance of Opioid Treatment Programs (OTPs) to assure
evidence-informed practices such as adequate methadone dosing.
Engage non-profits and faith community to uncover and leverage current community faith-
based prevention, treatment and recovery support in partnership with medical and social
Expand culturally appropriate services and programs that address health disparities in
treatment for persons with mental health and substance use disorders, including for
programs for vulnerable populations (i.e. homeless, youth in foster care, etc.); citizens of
racial, ethnic, geographic and socio-economic differences, and new Americans to ensure
that all Ohioans have access and treatment and recovery support services that meet their
Development of National Treatment Availability Clearinghouse – Fund development of a
multistate/nationally accessible database whereby healthcare providers can list locations
for currently available in-patient and out-patient OUD treatment services that are both timely
and accessible to all persons who seek treatment.
Ensure that each patient’s needs and treatment recommendations are determined by a
qualified clinical professional. Offer training and practice support to clinicians on the
American Society of Addiction Medicine (ASAM) levels of care (or other models) and the
most effective methods of treatment continuation between levels of care for people with
addiction including opioids and any other co-occurring substance use or mental health
conditions and make all levels of care available to all Ohioans.
Early Intervention and Crisis Support
Fund the expansion, training and integration of Screening, Brief Intervention and Referral to
Treatment (SBIRT) and Screening, Treatment Initiation and Referral (STIR) programs and
ensure that healthcare providers are screening for addiction and other risk factors and know
how to appropriately counsel and treat (or refer if necessary) a patient for mental health and
substance use disorders.
Support work of Emergency Medical Systems, including peer support specialists, to
effectively connect individuals to treatment or other appropriate services following an opioid
overdose or other opioid-related adverse event.
Create an intake and call center to facilitate education and access to treatment, prevention
and recovery services for persons with addiction including opioids and any co-occurring
substance use or mental health conditions.
Create a plan to meet the distinct needs of families of children and youths who experience
severe emotional disorders and provide respite and support for these caregivers to reduce
family crisis and promote treatment.
Create community-based intervention services for families, youth, and adolescents at-risk
for addiction including opioids and any co-occurring substance use or mental health
Create school-based contacts who parents can engage with to seek immediate treatment
services for their child.
Develop best practices on addressing individuals with addiction in the workplace, including
opioids and any other co-occurring substance use or mental health conditions.
Implement and support assistance programs for healthcare providers with OUD and any co-
occurring substance use disorders or mental health (SUD/MH) conditions.
Address the Needs of Criminal-Justice Involved Persons
Address the needs of persons involved in the criminal justice system who have opioid use
disorder (OUD) and any co-occurring substance use disorders or mental health (SUD/MH)
Support pre-arrest diversion and deflection strategies for persons with addiction including
opioids and any other co-occurring substance use or mental health conditions, including
established strategies such as sequential intercept mapping and other active outreach
strategies such as the Drug Abuse Response Team (DART) or Quick Response Team (QRT)
models or other co-responder models that engage people not actively engaged in treatment.
Support pre-trial services that connect individuals with addiction including opioids and any
other co-occurring substance use or mental health conditions to evidence-informed
treatment, including MAT, and related services.
Support treatment and recovery courts for persons with addiction including opioids and any
other co-occurring substance use or mental health conditions, but only if these problem-
solving courts provide referrals to evidence-informed treatment, including MAT.
Provide evidence-informed treatment, including MAT, evidence-based psychotherapies,
recovery support, harm reduction, or other appropriate services to individuals with addiction
including opioids and any other co-occurring substance use or mental health conditions who
are incarcerated, on probation, or on parole.
Provide evidence-informed treatment, including MAT, evidence-based psychotherapies,
recovery support, harm reduction, or other appropriate re-entry services to individuals with
addiction including opioids and any other co-occurring substance use or mental health
conditions who are leaving jail or prison or who have recently left jail or prison.
Support critical time interventions (CTI), particularly for individuals living with dual-diagnosis
substance use disorder/serious mental illness, and services for individuals who face
immediate risks and service needs and risks upon release from correctional settings.
Mother-Centered Treatment and Support
Finance and promote evidence-informed treatment, including MAT, recovery, and prevention
services for pregnant women, post-partum mothers, as well as those who could become
pregnant and have addiction including opioids and any other co-occurring substance use or
mental health conditions.
Training for obstetricians and other healthcare personnel who work with pregnant women or
post-partum women and their families regarding treatment for addiction including opioids
and any other co-occurring substance use or mental health conditions.
Invest in measures to address Neonatal Abstinence Syndrome, including prevention, care for
addiction and education programs.
Fund child and family supports for parenting women with addiction including opioids and
any co-occurring substance use or mental health conditions.
Enhanced family supports and childcare services for parents receiving treatment for
addiction including opioids and any co-occurring substance use or mental health conditions.
Identify and support successful recovery models including but not limited to: college
recovery programs, peer support agencies, recovery high schools, sober events and
community programs, etc.
Provide technical assistance to increase the quantity and capacity of high-quality programs
that model and support successful recovery.
Training and development of procedures for government staff to appropriately interact and
provide social and other services to current and recovering opioid users. To reduce stigma
and to normalize a culture of recovery, government staff will be provided with onboarding
and training that generates a cultural shift and provides all government employees with tool
and resources to feel supported and to support colleagues who may be struggling with
substance use disorder.
Convene community conversations and trainings that engage non-profits, civic clubs, the
faith-based community, and other stakeholders in training and techniques for providing
referrals and supports to those persons to family and friends struggling with substance use
Identify and address transportation barriers to permit consistent participation in treatment
and recovery support.
Support the development of recovery-friendly environments in all sectors, schools,
communities and workplaces to promote and sustain health and wellness goals. Put
- Supportive and recovery housing;
- Supportive employment/jobs;
- Certification of peer coaches, peer-run recovery organizations, recovery community
- Crisis intervention and relapse prevention; and
- Services and structures that support young people living a life in recovery including,
recovery high schools and collegiate recovery communities.
Invest in school-based programs that have demonstrated effectiveness in preventing drug
misuse and that appear promising to prevent the uptake and use of opioids. Investment in
school and community-based prevention efforts and curriculum that has demonstrated
effectiveness in reducing Adverse Childhood Events (ACEs) and their impact by increasing
resiliency, and preventing risk-taking, unhealthy or dangerous behaviors such as: drug use,
misuse, early alcohol use, and suicide attempts.
Assist coalitions and community stakeholders in aligning state, federal, and local resources
to maximize procurement of school and community education curricula, programs and
campaigns for students, families, school employees, school athletic programs, parent-
teacher and student associations, aging and elderly community members and others in an
effort to build a comprehensive prevention and education response that addresses
prevention across the lifespan.
Invest in environmental scans and school surveys to identify effective prevention efforts and
realign prevention and treatment responses with those emerging risk factors and changing
patterns of substance misuse.
Fund community anti-drug coalitions that engage in drug prevention efforts and education.
Prevent Over-Prescribing of Opioids and Other Drugs of Potential Misuse
Training for healthcare providers regarding safe and responsible opioid prescribing, dosing,
and tapering patients off opioids.
Continuing Medical Education (CME) on prescribing of opioids and other drugs of concern.
Support for non-opioid pain treatment alternatives, including training providers to offer or
refer patients to multi-modal, evidence-informed treatment of pain.
Development and implementation of a National Prescription Drug Monitoring Program
(PDMP) – Fund development of a multistate/national PDMP that permits information
sharing while providing appropriate safeguards on sharing of private health information,
including but not limited to: a. Integration of PDMP data with electronic health records,
overdose episodes, and decision support tools for healthcare providers relating to opioid use
disorder (OUD) and other drugs of concern.
Prevent Overdose Deaths and Other Harms (Harm Reduction)
Increase availability and distribution of naloxone and other drugs that treat overdoses for
use by first responders, persons who have experienced an overdose event, patients who are
currently prescribed opioids, families, schools, community-based service providers, social
workers, and other members of the general public.
Promote and expand naloxone strategies, which work to ensure that individuals who have
received naloxone to reverse the effects of an overdose are then engaged and retained in
evidence-based treatment programs.
Provide training and education regarding naloxone and other drugs that treat overdoses for
first responders, persons who have experienced an overdose event, patients who are
currently prescribed opioids, families, schools, and other members of the general public.
Develop data tracking software and applications for overdoses/naloxone revivals.
Invest in evidence-based and promising comprehensive harm reduction services and
centers, including mobile units, to include; syringe services, supplies, naloxone, staffing,
space, peer-support services, and access to medical and behavioral health referrals.
Expand access to testing and treatment for infectious diseases such as HIV and Hepatitis C
resulting from intravenous opioid use.
Services for Children
Review the continuum of services available to Ohio’s youths, young adults, and families to
identify gaps and to ensure timely access to appropriate care for Ohio’s youngest citizens
and their parents.
Fund additional positions and services, including supportive housing and other residential
services to serve children living apart from custodial parents and/or placed in foster care
due to custodial opioid use.
Expand collaboration among organizations meeting the prevention, treatment, and recovery
needs of Ohio’s young people and organizations serving youths, such as Boys & Girls Clubs,
YMCAs and others. Support the growth of recovery high schools, collegiate recovery
communities, and alternative peer groups for youths recovering from mental illness and
substance use disorders.
First Responders (EMS, Firefighters, Law Enforcement and other criminal
Provide funds for first responders and criminal justice professionals and participating
subdivisions for cross agency/department collaboration and other public safety
expenditures relating to the opioid epidemic that address both community and statewide
supply and demand reduction strategies including criminal interdiction efforts.
Training public safety officials and responders safe-handling practices and precautions when
dealing with fentanyl or other drugs.
Provide trauma-informed resiliency training and support that address compassion fatigue
and increased suicide risk of public safety responders.
Fellowships for addiction medicine specialists for direct patient care, instructors, and clinical
research for treatments.
Scholarships/loan forgiveness for persons to become certified addiction counselors,
licensed alcohol and drug counselors, licensed clinical social workers, and licensed mental
health counselors practicing in the SUD/MH field, and scholarships for certified addiction
counselors, licensed alcohol and drug counselors, licensed clinical social workers, and
licensed mental health counselors practicing in the SUD/MH field for continuing educations
Funding for clinicians to obtain training and a waiver under the federal Drug Addiction
Treatment Act to prescribe MAT for opioid use disorders.
Training for healthcare providers, students, and other supporting professionals, such as
peer recovery coaches/recovery outreach specialists to support treatment and harm
Dissemination of accredited web-based training curricula, such as the American Academy of
Addiction Psychiatry’s Provider Clinical Support Service-Opioids web-based training
curriculum and motivational interviewing.
PART TWO: Statewide Innovation & Recovery
Leadership, Planning and Coordination
Provide resources to fund the oversight, management, and evaluation of abatement
programs and inform future approaches.
Community regional planning to identify goals for opioid reduction and support efforts or to
identify areas and populations with the greatest needs for prevention, treatment, and/or
A government dashboard to track key opioid/and addiction-related indicators and supports
as identified through collaborative community processes.
Provide funding for grant writing to assist already established community coalitions in
securing state and federal grant dollars for capacity building and sustainability.
Stigma Reduction, Training and Education
Commission statewide campaigns to address stigma against people with mental illness and
substance use disorders. Stigma and misinformation deeply embed the deadly
consequences of Ohio’s public health crisis. These prevent families from seeking help, fuel
harmful misperceptions and stereotypes in Ohio communities, and can discourage medical
professionals from providing evidence-informed consultation and care. Ohio’s campaign to
end stigma should include chronic disease education; evidence-based prevention,
treatment, and harm reduction strategies; stories of recovery; and a constant reframing of
mental illness and addiction from a personal moral failing to a treatable chronic illness.
Coordinate public and professional training opportunities that expand the understanding
and awareness of adverse childhood experiences (ACEs) and psychological trauma, effective
treatment models, and the use of medications that aid in the acute care and chronic
disease management of both mental illness and addiction.
Strengthen the citizen workforce by providing community-based trainings, such as Mental
Health First Aid, Crisis Intervention Training, naloxone administration, and suicide
prevention. These best practice trainings should be allowable as Continuing Education Units
for professional development and when offered in an educational setting, provide academic
Development and dissemination of new accredited curricula, such as the American Academy
of Addiction Psychiatry’s Provider Clinical Support Service Medication-Assisted Treatment.
Training for emergency room personnel treating opioid overdose patients on post-discharge
planning. Such training includes community referrals for MAT, recovery case management
and/or support services.
Public education relating to drug disposal.
Drug take-back disposal or destruction programs.
Public education relating to emergency responses to overdoses.
Public education relating to immunity and Good Samaritan laws.
Educating first responders regarding the existence and operation of immunity and Good
Invest in public health education campaigns that inform audiences about the ease of
contraction of hepatitis C, and that engage persons at-risk to receive testing and treatment.
Convene and host community conversations and events that engage local non-profits, civic
clubs, and the faith-based community as a system to support prevention.
Fund programs and services regarding staff training, networking, and practice to improve
staff capability to abate the opioid crisis.
Support infrastructure and staffing for collaborative cross-systems coordination to prevent
opioid misuse, prevent overdoses, and treat those with addiction including opioids and/or
any other co-occurring substance use and/or mental health conditions (e.g. behavioral
health prevention, treatment, and recovery services providers, healthcare, primary care,
Support community-wide stigma reduction regarding accessing treatment and support for
persons with substance use disorders.
Ensuring that funding is flexible to invest in short and long-term research and innovation
projects that embrace new advances, technology and other strategies that meet the needs
of Ohioans today and in the future.