Idaho’s Behavioral Health Council has pinpointed eight counties where opioid-related challenges pose the greatest public health threat, creating a roadmap for how the state allocates millions in settlement funding recovered from pharmaceutical manufacturers.
The council, which draws members from the state legislature, judiciary, and executive branch, finalized its recommendations Friday to focus opioid settlement resources on the most vulnerable populations and geographic areas. The findings will now go to state lawmakers and the governor for final decisions on how to deploy the $6.8 million in settlement funds approved by the Legislature last year.
Eight Counties Flagged as High Priority
Kootenai, Benewah, Nez Perce, Bannock, Bear Lake, Clearwater, Boise, and Ada counties emerged as the highest-risk jurisdictions based on epidemiological analysis and demographic data. The council identified these areas through comparison of opioid prescription rates, educational attainment levels, and other vulnerability factors tracked across Idaho.
Sara Omundson, administrative director of state courts and co-chair of the Behavioral Health Council, explained the council’s approach: “This handout identifies risk factors for opioid use disorder and puts them in the context of Idaho, where those places are, where we may have more vulnerable folks,” she told East Idaho News.
The council agreed to distribute a one-page summary of risk factors and at-risk counties to stakeholders statewide, making the data publicly available for community organizations, health providers, and local officials considering their own opioid response strategies.
Data Reveals Education, Age, and Gender Patterns
The analysis underlying the council’s work drew from multiple sources, including the American Community Survey, Idaho’s Prescription Drug Monitoring Program, and data from the Idaho State Police Statistical Analysis Center. The resulting assessment, titled “Opioid-Related Overdose Vulnerability in Idaho: An Epidemiological Assessment,” was completed in 2024, as first reported by the EastIdahoNews.com.
The research identified distinct demographic patterns in opioid risk. Men die from opioid overdoses at rates 50 percent higher than women. Adults between 26 and 49 face the greatest risk for opioid misuse and overdose. Educational status also correlates strongly with vulnerability: people without college experience are nearly twice as likely to struggle with opioid misuse compared to those holding a college degree.
When examining educational attainment across counties, the council flagged Shoshone, Lincoln, Minidoka, Owyhee, Adams, Benewah, Payette, Gooding, Jerome, and Clark counties as areas where lower college completion rates may contribute to elevated opioid risk. Prescription patterns tell a different geographic story: Nez Perce, Bannock, Bear Lake, Butte, Lewis, Shoshone, Benewah, Caribou, Gem, and Lemhi counties show among the highest opioid prescription rates in the state.
Three Core Spending Priorities Identified
During a June meeting, the council voted on three overarching priorities to guide settlement fund expenditures. The board committed to emphasizing prevention programs designed for high-risk populations, behavioral health support services tailored to first responders who face occupational stress and substance use exposure, and initiatives to build Idaho’s behavioral health workforce in areas facing shortages.
State representative Brooke Green, a Boise Democrat, underscored the significance of the council’s work. The findings, she said, “(really) highlight some of our vulnerabilities throughout the state,” according to remarks provided to East Idaho News.
The council specifically urged Governor Brad Little and state legislative budget writers to prioritize projects serving rural communities as they make final decisions on opioid settlement spending. Rural areas often face compounded challenges: limited access to behavioral health providers, higher geographic isolation, and economies that may offer fewer economic opportunities for residents vulnerable to substance misuse.
What Comes Next
The recommendations now move into the legislative and executive budget process. State lawmakers and the governor will weigh the council’s findings alongside other competing priorities as they determine how to deploy the settlement funds over coming fiscal years. The council’s detailed county-level analysis provides policymakers with data-driven guidance while leaving room for local input on which specific programs and interventions would best serve each region’s unique circumstances.