The United States is spending more money than ever on addiction treatment. However, the federal response is hindered by one-time grants and limitations on the programs that they can fund, according to a new report by the Bipartisan Policy Center. The report found that federal spending on addiction interventions more than doubled between 2017 and 2018, rising from $3.3 billion to $7.4 billion. However, more federal coordination is needed to streamline how these funds are delivered to states and help determine how they can best be used. “The sheer volume of grants going to the states has made it challenging for state officials to track and coordinate these funding streams and monitor the quality of treatment that is being provided,” Dr. Anand Parekh, the Bipartisan Policy Center’s chief medical advisor, said in a news release. “Congress and the administration must provide greater oversight to ensure these federal resources are better coordinated and well spent, so states can respond effectively to this crisis.”Looking at how funds were utilized in Arizona, Louisiana, New Hampshire, Ohio and Tennessee, researchers found that the money was making it to areas with the highest overdose rates, but that rural areas received less funding. One way to avoid this is by having a state system, often directed by the governor, to coordinate an opioid response. “A statewide coordinating body, typically convened by the governor, is an essential part of developing a strategic opioid epidemic response,” the report authors wrote. “Governors are on the front lines of the opioid epidemic and keenly aware that the crisis is multifaceted and demands the same response,” said Hemi Tewarson, health division director for the National Governors Association.These state agencies can also help coordinate more in-depth tracking of outcomes for intervention programs. In addition, the report pointed out problems with the current funding model. With states only getting grants, it’s difficult to plan for a long-term response to the drug crisis. “With one-time funding, we are treating the problem of addiction in our country as an acute condition rather than a chronic condition,” said Regina LaBelle, a consultant for the policy center and former chief of staff of the White House Office of National Drug Control Policy. “Substance use disorders are not going away. Federal funding must be provided over the long-term instead of in annual budget cycles.”In addition, the terms of funding need to allow for flexibility in how states handle substance use disorder, she said. “Flexibility in funding ensures that while states are responding to today’s opioid epidemic, they are also prepared for other emerging drug threats, such as methamphetamine and cocaine,” the report reads.