Silenced Voices: The Troubling Exclusion of the Public from Opioid Settlement Discussions

The opioid crisis has devastated communities across the nation, leaving countless families in its wake. As states and municipalities receive billions of dollars in settlement funds, one would expect the public - those directly impacted by this crisis - to have a prominent voice in determining how these resources are spent. However, a recent investigation has revealed a troubling trend of councils and boards systematically shutting out the very people they aim to serve.

Accountability and Transparency Elusive as Councils Restrict Public Participation

The Kensington Conundrum: A Community Silenced

The city of Philadelphia had planned to use $7.5 million in opioid settlement funds to improve the quality of life in the hard-hit Kensington neighborhood, a critical center of the nation's opioid crisis. However, a Pennsylvania oversight board was poised to reject this plan, setting a precedent that could shape spending decisions for years to come. Yet, the board barred members of the public from speaking at its meetings, shutting out the very voices of those most affected by the crisis."It's another moment where folks not connected to this community are making decisions for this community, and I think that's inappropriate," lamented Bill McKinney, a Kensington resident and executive director of a local nonprofit. This sentiment echoes across the nation, as communities grapple with the reality that their input is often dismissed when it comes to the allocation of these crucial settlement dollars.

A Nationwide Trend: Councils Limiting Public Engagement

The exclusion of the public is not limited to Pennsylvania. A first-of-its-kind survey conducted by KFF Health News and Spotlight PA found that in at least 39 states and Washington, D.C., councils responsible for guiding decisions about opioid settlement spending routinely block members of the public from speaking at their meetings. Furthermore, four of these councils typically conduct their meetings in secret, barring the public from even attending or observing.The lack of transparency extends beyond public comment, with the majority of councils failing to make video recordings of their meetings readily available online. In some cases, such as Minnesota's Opioid Epidemic Response Advisory Council, recordings are even deleted after being used to create meeting minutes.This systemic shutting out of the public's voice is, in the words of Tennessee's Opioid Abatement Council chair Stephen Loyd, "unconscionable." Loyd believes that the people directly affected by the crisis are the ones who know best what needs to be improved, and their feedback is "invaluable" in shaping effective solutions.

Compounding Challenges for Marginalized Communities

The exclusion of the public from opioid settlement discussions is particularly problematic for communities of color, who have endured the devastating impact of both the current opioid crisis and the earlier crack cocaine epidemic. Many feel that the government's response to the crack cocaine crisis was ineffective and even harmful, and they fear that the same pattern may be repeating itself."If settlement money is used only to 'build on what's already in place, you've already failed,'" said Philip Rutherford, an expert on substance use disorder at the National Council for Mental Wellbeing. Fanya Burford-Berry, director of the West Side Heroin/Opioid Task Force in Chicago, hopes that by allowing more diverse voices to be heard, the council can develop solutions tailored to the unique needs of women of color struggling with substance use disorder.

The Importance of Transparency and Accountability

The lack of public involvement in opioid settlement discussions not only denies affected communities a say in how the money is spent but also undermines accountability and transparency. In Pennsylvania, the state's opioid settlement board has the power to withhold future funding if it deems local governments' spending decisions inappropriate. Yet, the board's closed-door work groups and lack of public comment have been criticized by victims, advocates, and even one member of the council as obscuring the reasoning behind the board's actions.In contrast, councils in states like Illinois, Kentucky, and Oregon routinely allow public comment at both full council and smaller committee meetings. This open process has enabled members of the public to provide valuable insights, such as the fierce debate in Kentucky over funding research into ibogaine, a psychedelic drug that has shown potential to treat addiction.

A Call for Inclusive and Responsive Policymaking

As the opioid crisis continues to devastate communities across the nation, the need for inclusive and responsive policymaking has never been more urgent. By shutting out the voices of those most affected, councils and boards risk making decisions that fail to address the true needs of the people they serve.Tennessee's Opioid Abatement Council chair Stephen Loyd has a clear message for his counterparts in other states: "You'll make better decisions as a result. I can't be convinced otherwise." Loyd's commitment to increasing public participation, including the creation of an advisory panel composed primarily of those with personal experience of addiction, is a model that other councils would do well to emulate.The time has come to tear down the barriers that have silenced the public and to embrace the valuable insights and solutions that can only come from those who have lived through the devastation of the opioid crisis. Only then can the settlement funds truly be leveraged to heal the wounds inflicted upon our communities.