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Harm Reduction Coalition Applauds the Launch of the Opioid Crisis Response Fund (OCRF)

New start-up non-profit fund is already financing life-saving interventions in Ohio, Indiana, Wisconsin, Iowa, Louisiana, and Connecticut

A vital new effort to combat opiate-related fatalities at the national level is now in operation. Harm Reduction Coalition applauds the launch of the Opioid Crisis Response Fund (OCRF).

OCRF is a start-up non-profit fund with the mission to save as many lives as possible, as quickly as possible, from opiate-related overdose. It is an evergreen fund that raises money and grants it out to the un(der)-funded programs, nationwide, that can save the most lives with incremental funding. OCRF has won backing from major funders and partner organizations active in the national response to the opioid epidemic. It is supported in part by grants and donations from the Open Society Foundations, Addiction Policy Forum, the Yagan Family Foundation, a board member of the Kaiser Family Foundation, and individual contributors. Harm Reduction Coalition is OCRF’s fiscal sponsor. OCRF’s advisors include: Jacob Harold (CEO of Guidestar), Kathryn Hawk, M.D., M.H.S (Yale School of Medicine; emergency department of Yale-New Haven Hospital), and Clayton Collins, J.D., LL.M (PwC; United States Tax Court).

OCRF raises money for overdose interventions with the promise to prioritize its funding decisions according to a model of rational decision-making. That model is to estimate the net present value of overdose interventions’ unmet life-saving potential, and then force-rank funding for these interventions purely on the basis of that unmet life-saving potential. OCRF does not begin with preferences for any particular geography, target population, or “philosophy of change.” It prioritizes funding solely on the basis of size of impact, probability of impact, and how soon that impact will be felt.

Colin Dwyer, OCRF’s founder, explains, “Our approach may sound overly numbers-driven, andwonky—but it’s actually the only way to launch a response to the opioid epidemic that is founded on justice. We act on the beliefs that all lives are equally valuable, and that our only priority is to save asmany lives as possible, as quickly as possible. That is not how existing stakeholders are currentlymaking funding decisions for opioid response. Each has incentives to provide funding on the basis ofpriorities other than an intervention’s unmet life-saving potential.”

The private sector is incentivized to invest in the health services that make the most money (oncology,dermatology, sports medicine), which leads to chronic underfunding of services related to overdose. The public sector is incentivized to advance policies that are popular (PharmaCo litigation, stronger law enforcement), not necessarily policies with the greatest unmet life-saving potential—which leaves out policies that help people most vulnerable to stigma and structural violence, such as people highly at risk of overdose. Finally, most philanthropic funders observe institutional priorities (target geographies, “systems change,” policy advocacy) that are worthy in themselves, but which draw resources away from opioid responses with the highest “net present value” on a strictly lives-saved basis.

“The net result of all these misaligned incentives,” Colin Dwyer says, “is that, over a decade into anAmerican public health crisis that is killing more people every year than the AIDS epidemic ever did, the lowest-hanging fruit is still hanging.”

The astonishing lack of nationwide funding for syringe access program (SAP)-facilitated naloxone distribution illustrates how large and immediate opportunities to save lives are falling through the cracks. The cost to save a life through SAP-facilitated naloxone distribution is about $250, an unbelievably low figure outside of the developing world. Nevertheless, US funding for naloxone overwhelmingly goes to law enforcement and other public agencies that are more culturally acceptable than SAPs, but which save far fewer lives (San Francisco, 2017—participants trained by the D.O.P.E. Project, primarily people who use drugs, reported reversing 1,267 overdoses, and SF Police Department reported 27 naloxone uses in the same time period). Due to this lack of public funding, right now SAPs in some of the most opioid-impacted regions of the US are self-funding their naloxone distribution through yard sales hosted by mothers whose children died of overdose.

Harm Reduction Coalition is proud to act as OCRF’s fiscal sponsor, and agrees with Colin’s assessment.“OCRF plays a critical role in our vision to end opioid overdose in the US,” said Monique Tula, Harm Reduction Coalition’s Executive Director. For nearly 20 years, Harm Reduction Coalition has helpedlead the effort to distribute naloxone to people in the community who need it most: people who usedrugs. Harm Reduction programs with extremely limited resources are often ill-equipped to supportthe growing demand for naloxone as the opioid crisis rages on. OCRF is a lifeline for manyorganizations, helping to fill a gap that can be life or death for people most vulnerable to overdose.”

As its first priority, OCRF has made grants to SAPs in Ohio, Indiana, Wisconsin, Iowa, Louisiana, and Connecticut funding an incremental 30,000 doses of naloxone in the field. This funding will enable thousands of reversals of otherwise fatal overdoses in several extremely under-resourced regions, including Native American tribal communities of Northern Wisconsin, majority African-American communities in the Mississippi Delta, and Appalachian Ohio. Further—given that in the range of 95% of overdose survivors are still alive 1-year post-overdose, and SAPs regularly refer 20–30% of their clients to treatment annually—OCRF’s funding could ultimately lead to hundreds of new patients entering treatment who otherwise would have died of overdose.

Funding for naloxone distribution is only the first stage of OCRF’s efforts. Depending on its fundraising success, OCRF will go on to identify the 2nd, 3rd, and nth, fastest ways to save as many lives as possible from fatal overdose, and assess how it can support their implementation.

OCRF is not a program within a larger philanthropic foundation, and is not financed by an internal endowment. As such it is always in need of grants, donations, and partnerships to support its work.

If you would like to support OCRF’s work, individual donations can be made at www.ocrfund.org/take-action. To discuss grants, larger gifts, or partnerships, please email info [@] ocrfund.org. For press and general questions about OCRF, please also contact info [@] ocrfund.org.

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