Bloomberg Puts $150 Million Into Treatment in Jails and Emergency Rooms

Michael R. Bloomberg committed another $150 million to Bloomberg Philanthropies' Overdose Prevention Initiative, lifting the foundation's spending on the U.S. overdose crisis to $335 million since 2018 and attaching a concrete promise to the money: everyone incarcerated in six states will soon have access to opioid use disorder medication, and so will every patient who walks into a hospital emergency department in those states.

The announcement came at the ninth annual Bloomberg American Health Summit in Baltimore. Washington state joins the program's existing roster of Kentucky, New Jersey, New Mexico, North Carolina and Wisconsin. At the same time, the initiative is winding down in Pennsylvania and Michigan, the two states where it started eight years ago — a decision the foundation frames as graduation rather than retreat.

Two settings where overdose risk concentrates

The design reflects a body of research the initiative has cited since its launch. In the opening paragraph of its own announcement, the foundation notes that overdoses are the leading cause of death for adult Americans under 45, and it directs the new money at the two places where the risk spikes hardest: the hours after release from custody and the hours after an emergency room visit.

A 2007 study of formerly incarcerated people in Washington state found they were 129 times more likely to die of an overdose in the first two weeks after release than the general public, a pattern the foundation says more recent research confirms. A 2018 study of overdose survivors found that those who received medication treatment in a hospital emergency department were far less likely to die of a later overdose than those who did not start treatment there.

Neither finding is new, and neither is the intervention. What is new is the scale at which the money is being aimed at them, with medication-assisted treatment written into correctional and emergency medicine rather than offered as a referral afterward.

Pennsylvania and Michigan leave the program

The two original states exit with a list the foundation can point to. In Pennsylvania, all 24 state prisons now provide buprenorphine for opioid use disorder. In Michigan, the initiative helped launch an online naloxone-by-mail portal with the state health department and cleared the way for community organizations to distribute naloxone without individual prescriptions.

"Michigan continues to support lifesaving programs by investing in harm reduction, expanding treatment options, and increasing availability of community-based supports," Gov. Gretchen Whitmer said in the announcement. She credited the state's community naloxone ordering portal with preventing "thousands of families from having to deal with the tragedy of an overdose death."

Pennsylvania Gov. Josh Shapiro, whose state has drawn national attention for treating prison-based medication as standard care, said the results were measurable: "overdose deaths are down, thousands of Pennsylvanians are alive today, and more families have hope."

The track record the foundation is selling

Bloomberg Philanthropies says overdose deaths in its focus states fell nearly 15% more than the national average in 2024. It also reports that its work helped remove policy barriers to buprenorphine prescribing, that all prisons in New Jersey and Wisconsin now provide medication for opioid use disorder, and that more than 75% of emergency departments in New Jersey, Michigan and Pennsylvania have begun offering it.

The initiative also pays for work that is harder to photograph: naloxone distribution, technical help for counties trying to spend opioid settlement dollars, and data and evaluation contracts.

"Even one death from an overdose is too many," Bloomberg said. "The overdose epidemic continues to be one of the hardest public health crises our nation faces. Now is the time to accelerate this hard-fought progress, expand access to treatment, and save more lives."

What the announcement leaves out

The release does not break the $150 million down by state, does not give a timeline for when treatment will actually be available in every prison and emergency department, and does not name benchmarks that would let an outside observer judge success or failure. It also does not say which states might be added next, or what "concluding" work in Pennsylvania and Michigan means in dollars and staff.

Those are the questions that will decide whether this is a philanthropic expansion or a philanthropic headline. The model has already been tested once: the initiative began in 2018 with two states and now covers six, and the operating assumption — that treatment offered at the moment of highest risk sticks — has survived a decade of scrutiny better than most ideas in addiction policy.

For people leaving jail or sitting in an emergency room tonight, the practical version of the question is simpler. Anyone looking for opioid addiction treatment in the meantime can reach the SAMHSA National Helpline at 1-800-662-4357, free and confidential, around the clock.