Skip to content
Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?
Payback: Tracking Opioid Cash

Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?

At an event in downtown Mobile, Alabama, on Jan. 24, the Poarch Band of Creek Indians presented a check for $500,000 from the tribe鈥檚 opioid settlement funds to the Helios Alliance, a group of statistical modelers, media strategists, consultants, and artificial intelligence experts. The alliance plans to use the money to build a model it says can help Alabama leaders decide how to spend the rest of their opioid settlement funds. (Aneri Pattani/素人色情片Health News)

MOBILE, Ala. 鈥 In this Gulf Coast city, addiction medicine doctor Stephen Loyd announced at a January event what he called 鈥渁 game-changer鈥 for state and local governments spending billions of dollars in opioid settlement funds.

The money, which comes from companies accused of aggressively marketing and distributing prescription painkillers, is meant to tackle the addiction crisis.

But 鈥渉ow do you know that the money you鈥檙e spending is going to get you the result that you need?鈥 asked Loyd, who was once hooked on prescription opioids himself and has become a nationally known figure since Michael Keaton played a character partially based on him in the Hulu series 鈥淒opesick.鈥

Loyd provided an answer: Use statistical modeling and artificial intelligence to simulate the opioid crisis, predict which programs will save the most lives, and help local officials decide the best use of settlement dollars.

Loyd serves as the unpaid co-chair of the , a group that hosted the event and is seeking $1.5 million to create such a simulation for Alabama.

The state is set to receive from opioid settlements over nearly two decades. It in grants to various community groups in early February.

Loyd鈥檚 audience that gray January morning included big players in Mobile, many of whom have known one another since their school days: the speaker pro tempore of Alabama鈥檚 legislature, representatives from the city and the local sheriff鈥檚 office, leaders from the nearby Poarch Band of Creek Indians, and dozens of addiction treatment providers and advocates for preventing youth addiction.

Many of them were excited by the proposal, saying this type of data and statistics-driven approach could reduce personal and political biases and ensure settlement dollars are directed efficiently over the next decade.

But some advocates and treatment providers say they don鈥檛 need a simulation to tell them where the needs are. They see it daily, when they try 鈥 and often fail 鈥 to get people medications, housing, and other basic services. They worry allocating $1.5 million for Helios prioritizes Big Tech promises for future success while shortchanging the urgent needs of people on the front lines today.

鈥淒ata does not save lives. Numbers on a computer do not save lives,鈥 said Lisa Teggart, who is in recovery and runs two sober living homes in Mobile. 鈥淚’m a person in the trenches,鈥 she said after attending the Helios event. 鈥淲e don鈥檛 have a clean-needle program. We don鈥檛 have enough treatment. 鈥 And it鈥檚 like, when is the money going to get to them?鈥

The debate over whether to invest in technology or boots on the ground is likely to reverberate widely, as the Helios Alliance is in discussions to build similar models for other states, including West Virginia and Tennessee, where Loyd lives and leads the .

Stephen Loyd stands at a podium as he speaks at a convention. Behind him is a large, pink neon sign that reads, "Make it happen!"
Stephen Loyd is an addiction medicine doctor who was once hooked on prescription opioids himself. He serves as the unpaid co-chair of the Helios Alliance, which is asking Alabama leaders to invest $1.5 million in a model that the group says can help officials decide how to spend their opioid settlement funds most effectively.(Aneri Pattani/素人色情片Health News)

New Predictive Promise?

The Helios Alliance comprises nine nonprofit and for-profit organizations, with missions ranging from addiction treatment and mathematical modeling to artificial intelligence and marketing. As of mid-February, the alliance had received $750,000 to build its model for Alabama.

The largest chunk 鈥 $500,000 鈥 came from the Poarch Band of Creek Indians, whose tribal council voted unanimously to spend most of its opioid settlement dollars to date on the Helios initiative. A state agency chipped in an additional $250,000. Ten Alabama cities and some private foundations are considering investing as well.

Stephen McNair, director of external affairs for Mobile, said the city has an obligation to use its settlement funds 鈥渋n a way that is going to do the most good.鈥 He hopes Helios will indicate how to do that, 鈥渋nstead of simply guessing.鈥

Rayford Etherton, a former attorney and consultant from Mobile who created the Helios Alliance, said he is confident his team can 鈥減redict the likely success or failure of programs before a dollar is spent.鈥

The Helios website features a similarly bold tagline: 鈥淕oing Beyond Results to Predict Them.鈥

Robert McGhee stands at a podium as he speaks at a conference to a crowd. Beside him is a large screen with various logos.
Robert McGhee is vice chairman of the Poarch Band of Creek Indians tribal council. The small, southern Alabama tribe has allocated $500,000 of its opioid settlement funds to the Helios Alliance, which says it鈥檚 building a model that can help Alabama leaders decide how to spend the rest of their opioid settlement funds. (Aneri Pattani/素人色情片Health News)
A crowd of about 30 people sit on plastic chairs in rows. They are in a building with a cement floor, exposed brick walls, and crisp, modern lighting overhead.
The Helios Alliance is a group of statistical modelers, media strategists, consultants, and artificial intelligence experts. At an event in downtown Mobile on Jan. 24, the alliance announced it is building a model to help state officials decide how to spend their opioid settlement funds most effectively. The group is asking for $1.5 million to finish the model. (Aneri Pattani/素人色情片Health News)

To do this, the alliance uses system dynamics, a mathematical modeling technique developed at the Massachusetts Institute of Technology in the 1950s. The Helios model takes in local and national data about addiction services and the drug supply. Then it simulates the effects different policies or spending decisions can have on overdose deaths and addiction rates. New data can be added regularly and new simulations run anytime. The alliance uses that information to produce reports and recommendations.

Etherton said it can help officials compare the impact of various approaches and identify unintended consequences. For example, would it save more lives to invest in housing or treatment? Will increasing police seizures of fentanyl decrease the number of people using it or will people switch to different substances?

And yet, Etherton cautioned, the model is 鈥渘ot a crystal ball.鈥 Data is often incomplete, and the real world can throw curveballs.

Another limitation is that while Helios can suggest general strategies that might be most fruitful, it typically can鈥檛 predict, for instance, which of two rehab centers will be more effective. That decision would ultimately come down to individuals in charge of awarding contracts.

Mathematical Models vs. On-the-Ground Experts

To some people, what Helios is proposing sounds similar to a cheaper approach that 39 states 鈥 including Alabama 鈥 already have in place: opioid settlement councils that provide insights on how to best use the money. These are groups of people with expertise ranging from addiction medicine and law enforcement to social services and personal experience using drugs.

Even in places without formal councils, treatment providers and recovery advocates say they can perform a similar function. Half a dozen advocates in Mobile told 素人色情片Health News the city鈥檚 top need is low-cost housing for people who want to stop using drugs.

鈥淚 wonder how much the results鈥 from the Helios model 鈥渁re going to look like what people on the ground doing this work have been saying for years,鈥 said , director of prevention for AIDS Alabama South and a person in recovery from opioid use disorder.

(From left): Devin Burton, Lisa Teggart, Chance Shaw, and Larry Vahle stand side by side in an office room. Above them in a purple neon sign which reads, "#showmeyourrecovery" in script.
(From left): Devin Burton, Lisa Teggart, Chance Shaw, and Larry Vahle are recovery advocates in Mobile who say they want opioid settlement dollars to support direct services like treatment and housing that can help people in crisis today.(Aneri Pattani/素人色情片Health News)

But Loyd, the co-chair of the Helios board, sees the simulation platform as augmenting the work of opioid settlement councils, like the one he leads in Tennessee.

Members of his council have been trying to decide how much money to invest in prevention efforts versus treatment, 鈥渂ut we just kind of look at it, and we guessed,鈥 he said 鈥 the way it鈥檚 been done for decades. 鈥淚 want to know specifically where to put the money and what I can expect from outcomes.鈥

, an expert in mathematical modeling who directs the Institute for Technology Assessment at Massachusetts General Hospital, said models can reduce the risk of individual biases and blind spots shaping decisions.

If the inputs and assumptions used to build the model are transparent, there鈥檚 an opportunity to instill greater trust in the distribution of this money, said Chhatwal, who is not affiliated with Helios. Yet if the model is proprietary 鈥 as Helios鈥 marketing materials suggest its product will be 鈥 that could erode public trust, he said.

Etherton, of the Helios Alliance, told 素人色情片Health News, 鈥淓verything we do will be available publicly for anyone who wants to look at it.鈥

Lisa Teggart sits on the porch of a small house. Behind her is a red door and a vertical sign that reads, "WELCOME"
Lisa Teggart, executive director of the Door to Serenity sober living homes, sits outside the women鈥檚 home she runs in Mobile. The house has only nine beds. Teggart says she must regularly turn people away until she can afford to expand.(Aneri Pattani/素人色情片Health News)

Urgent Needs vs. Long-Term Goals

Helios鈥 pitch sounds simple: a small upfront cost to ensure sound future decision-making. 鈥淪pend 5% so you get the biggest impact with the other 95%,鈥 Etherton said.

To some people working in treatment and recovery, however, the upfront cost represents not just dollars, but opportunities lost for immediate help, be it someone who couldn鈥檛 find an open bed or get a ride to the pharmacy.

鈥淭he urgency of being able to address those individual needs is vital,鈥 said Pamela Sagness, executive director of the North Dakota Behavioral Health Division.

Her department recently in opioid settlement funds to programs that provide mental health and addiction treatment, housing, and syringe service programs because that鈥檚 what residents have been demanding, she said. An additional $52 million in grant requests 鈥 including an application from the Helios Alliance 鈥 went unfunded.

Lisa Teggart proudly points to her certification from the Alabama Alliance for Recovery Residences. The certificate hangs on a gray wall beside a staircase.
Lisa Teggart, executive director of the Door to Serenity sober living homes in Mobile, proudly points to her certification from the Alabama Alliance for Recovery Residences. The certification indicates her homes meet national criteria for being safe spaces for people in recovery to live in a drug-free environment. (Aneri Pattani/素人色情片Health News)
A picture of a white board which reads, "Buy Laundry Detergent / I love you / I believe in you.鈥
The Door to Serenity men鈥檚 house in Mobile allows people to stay in a drug-free space at a low cost. Executive director Lisa Teggart left one of the residents a message on his white board: 鈥淚 love you. I believe in you.鈥 (Aneri Pattani/素人色情片Health News)

Back in Mobile, advocates say they see the need for investment in direct services daily. More than 1,000 people visit the office of the nonprofit each month for recovery meetings, social events, and help connecting to social services. Yet the facility can鈥檛 afford to stock naloxone, a medication that can rapidly reverse overdoses.

At the that Mobile resident Teggart runs, people can live in a drug-free space at a low cost. She manages 18 beds but said there鈥檚 enough demand to fill 100.

Hannah Seale felt lucky to land one of those spots after leaving Mobile County jail last November.

鈥淎ll I had with me was one bag of clothes and some laundry detergent and one pair of shoes,鈥 Seale said.

Since arriving, she鈥檚 gotten her driver鈥檚 license, applied for food stamps, and attended intensive treatment. In late January, she was working two jobs and reconnecting with her 4- and 7-year-old daughters.

After 17 years of drug use, the recovery home 鈥渋s the one that鈥檚 worked for me,鈥 she said.

A painting of a silver tree is on a wall. Leaves blow off the tree and are accompanied by flying birds. A quote is to the left of the tree, and it reads, "You can't go back and change the beginning, but you can start where you are and change the ending. 鈥揅.S. Lewis"
People Engaged in Recovery, a nonprofit in Mobile, provides recovery meetings, social events, and connections to social services for more than 1,000 people a month. The wall decoration in the group鈥檚 yoga room reminds people that change is possible. (Aneri Pattani/素人色情片Health News)