Bannock County is among eight Idaho counties flagged as highest-risk for opioid use disorder under a new recommendation from the Idaho Behavioral Health Council, which finalized a plan to guide how the state directs millions in opioid settlement dollars toward the communities most in need.
The council — a body that brings together all three branches of state government, including legislative, judicial, and executive representation — voted in June on its top priorities before finalizing its formal recommendation last Friday. Those priorities center on prevention programs for high-risk populations, behavioral health support for first responders, and expanding the state’s behavioral health workforce, which remains thin across much of rural Idaho.
Eight Counties Identified as Highest Risk
The eight counties identified as carrying the greatest overall risk for opioid use disorder are Kootenai, Benewah, Nez Perce, Bannock, Bear Lake, Clearwater, Boise, and Ada. The designation draws from a 2024 epidemiological report titled Opioid-Related Overdose Vulnerability in Idaho: An Epidemiological Assessment, which examined a range of social, economic, and public health factors across the state.
The council agreed to send a one-page summary of those risk factors and the identified counties to both the governor and legislative budget writers, with a specific request that future spending projects prioritize rural communities.
Sara Omundson, administrative director of state courts and co-chair of the Behavioral Health Council, explained the intent behind the outreach. As first reported by East Idaho News, Omundson said the summary “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.”
The Idaho Legislature approved $6.8 million in opioid settlement funds for spending last year. That money flows from a nationwide legal settlement with opioid manufacturers, and the council’s role is to advise on how those funds are deployed across the state.
Education and Prescription Rates Also Factor Into Risk Assessment
Beyond the eight high-risk counties for opioid use disorder broadly, the council’s assessment broke down vulnerability along additional lines. Ten counties ranked highest for risk tied to low educational attainment: Shoshone, Lincoln, Minidoka, Owyhee, Adams, Benewah, Payette, Gooding, Jerome, and Clark. Educational attainment matters because those without any college experience are nearly twice as likely to misuse opioids compared to those who have attended college.
A separate list of ten counties showed the highest opioid prescription rates: Nez Perce, Bannock, Bear Lake, Butte, Lewis, Shoshone, Benewah, Caribou, Gem, and Lemhi. Bannock County’s appearance on both the overall high-risk list and the high-prescription-rate list underscores the depth of the challenge facing southeast Idaho communities, including Pocatello and Chubbuck.
The data also revealed stark demographic patterns. Men die from opioid overdose at a rate nearly 50 percent higher than women, and adults between the ages of 26 and 49 face the greatest risk of misuse and fatal overdose.
Boise Democratic state Rep. Brooke Green, as quoted by East Idaho News, said she appreciated the visual format the council assembled: “It really highlights some of our vulnerabilities throughout the state.”
What Comes Next
The Behavioral Health Council’s finalized recommendation now moves to the governor’s office and legislative budget writers, who will weigh the council’s guidance as they consider how remaining settlement funds are allocated in future budget cycles. The council’s emphasis on rural communities and workforce development reflects the challenge of building sustainable behavioral health infrastructure in counties that have long struggled to attract and retain licensed providers.
For Bannock County residents, the designation carries both urgency and an opportunity: federal settlement dollars may be steered toward local prevention programs, first-responder mental health support, and workforce pipeline efforts that could help address an opioid crisis that has touched families across southeast Idaho. Local law enforcement and coroner offices have dealt firsthand with the consequences — including Bannock County’s coroner implementing new identity verification protocols before cremations, a policy shift that reflects the growing strain on county services.
Further details on how the settlement funds will be formally appropriated are expected as the next Idaho legislative session approaches.