Payback

Since Colorado created a pool of money to pay for naloxone in 2019, it has distributed more than half a million doses of the opioid reversal drug to hundreds of organizations throughout the state. Now, its main funding stream is drying up.

In many places, victims of the opioid epidemic are silenced in decision-making about how to use opioid settlement money, a first-of-its-kind survey conducted by KFF Health News and Spotlight PA found.

Millions of dollars from national opioid settlements are pouring into Mississippi. The state and localities haven’t spent much yet. In many cases, how the money will be used is up in the air.

California is in line for more than $4 billion in opioid settlement funds, and local governments are most often spending the first tranche of money on lifesaving drugs. An exclusive KFF Health News analysis also found projects to help police deter youths’ drug use and counsel officers who witness overdoses.

The court struck down a $6 billion bankruptcy plan from Purdue Pharma, the maker of OxyContin. What does this mean? We’ll explain.

Hundreds of Native American tribes are getting money from settlements with companies that made or sold prescription painkillers. Some are investing it in sweat lodges, statistical models, and insurance-billing staffers.

The national opioid settlements don’t prohibit using money for initiatives already supported by other means, but doing so could dilute the impact.

Want to know how much opioid settlement money your city, county, or state has received so far? Or how much it’s expecting in the future? Use our new searchable database to find out.

A mathematical model designed to direct spending of opioid settlement funds is at the center of a debate over whether to invest in technology to guide long-term decisions or focus on the immediate needs of people in addiction.

The four-page bill lists how states should spend settlement money, but it doesn’t specify consequences for flouting the rules or name who is in charge of monitoring compliance.

As opioid settlement dollars land in government coffers, a swarm of businesses are positioning themselves to profit from the windfall. But will their potential gains come at the expense of the settlements’ intended purpose — to remediate the effects of the opioid epidemic?

Some states haven’t begun using opioid settlement funds intended to help curb the opioid epidemic. Meanwhile, more than 100,000 Americans died of an overdose last year.

The Supreme Court heard arguments over whether the Sacklers, the family behind Purdue Pharma — which marketed OxyContin — could claim immunity from future lawsuits without claiming bankruptcy.

Some gubernatorial candidates are sparring over bragging rights for their state’s share of $50 billion in opioid settlement funds. Many of the candidates are attorneys general who pursued the lawsuits that produced the payouts.

State and local governments will receive a windfall of more than $50 billion over 18 years from settlements with companies that made, sold, or distributed opioid painkillers. Using the funds for law enforcement has triggered important questions about what the money was meant for.

State attorneys general vowed that opioid settlement funds — unlike the tobacco settlement of the 1990s — would go toward tackling the underlying crisis. But in Mendocino County, officials have found a way to use some of its share to help fill a budget shortfall — a throwback to what agreement architects hoped to avoid.

As settlement dollars land at the state level, state councils wield significant power in determining how the windfall gets spent. And, though they will likely include the most knowledgeable voices on addiction, these panels also face concerns about conflicts of interest and other issues.

KFF Health News obtained documents showing the exact dollar amounts — down to the cent — that local governments have been allocated in 2022 and 2023 to battle the ongoing opioid crisis.

Greene County, Tennessee, so far has received more than $2.7 million from regional and national settlements with opioid manufacturers and distributors. But most of the money is not going to help people and families harmed by addiction.

Billions of dollars are headed to state and local governments to address the opioid crisis. Policy experts and advocates expect the federal government to play a role in overseeing the use of the money. Failure to do so, they say, could lead to wasted opportunities. And, since Medicaid helps pay health care costs, the feds could have a claim to portions of states’ opioid settlements.

Some people say it’s reasonable for densely populated areas to receive more settlement funds, since they serve more of those affected. But others worry this overlooks rural communities disproportionately harmed by opioid addiction.

The cash represents an unprecedented opportunity to derail the opioid epidemic, but with countless groups advocating for their share of the pie, the impact could depend heavily on geography and politics.

States, tribes, and local governments are figuring out how best to spend billions of dollars from an opioid lawsuit settlement. One option they’re considering is funding peer support specialists, who guide people recovering from addiction as they do it themselves.