The opioid epidemic has been one of the deadliest public health crises in modern history, causing thousands of overdose deaths each year. In response, governments have pursued legal actions against pharmaceutical companies for their role in the crisis. Under pressure, several drug manufacturers, including McKesson, AmerisourceBergen, Johnson & Johnson, and Walmart, have agreed to pay over $50 billion for opioid settlement funds to state and local governments, spread out annually over the next 15 years. The first wave of payments began to process in May 2022, but only $3 billion has been paid so far. Terva, CVS, Allergan, and Kroger (among others) began a second wave of payments in June 2023.

How Are the Settlement Funds Being Used?

While the settlements specify that at least 85% of these funds must be used for addiction treatment and prevention by states,  there is no set definition of “addiction treatment and prevention,” leading to very different initiatives from state to state. While states are required to report how they spend the other 15%, few have done so. Some states have committed to transparent reporting of fund usage, but since it’s not mandatory, tracking how the money will be used might prove difficult.

Fund allocation is enforced by the companies that pay the settlement, making this even murkier. There are guidelines, but states don’t have to follow them. This is causing some controversy; while some states are focusing on community outreach, prevention, or evidence-based programs (like Florida), others are choosing to use these funds for law enforcement as a continuation of the war on drugs.

Some experts are concerned that funding is not being allocated where it’s needed the most, leading to more health disparity. The usual barriers to access also block much-needed funding, as organizations and programs that have been starved of resources and money fight tooth and nail to inject much-needed cash into their programs.

There are additional concerns from experts that mistakes from the tobacco industry’s settlement funding are being repeated, which could lead to funds being misused or allocated to other programs.

Does My Organization Qualify for Opioid Settlement Money?

It might! Here are the steps you can take to receive funding for your programs:

• Check your state or county’s settlement agreement. This is one of the websites you can use to do so. You can also go directly through your state.
• Find out which entity controls how funds will be spent.
• Apply for funding with the relevant controlling entity. Some states have yet to publish an application process, so you may need to check frequently.

Tips For Your Opioid Settlement Fund Application:

If this isn’t your first funding rodeo, you know the drill: include as much information as you can, backed up by numbers to bolster your application.

• Include community statistics. This can include things like the number of overdoses in your community, how many people your organization treats, referrals and partnerships, and more.
• Add a budget. How will your agency use these funds? How much will be allocated for each program?
• Showcase your impact on the community. How is your organization helping people? How has it impacted the number of overdoses, or how many people did you refer to other providers? By showcasing your results, you can prove that funding your organization will lead to better outcomes.
• Letters of support can help: if you partner with healthcare organizations, you should ask for letters to support your funding application.
• Don’t forget citations: Your state’s controlling document should include PAARI and deflection programs, which you should cite in your application.

Although the opioid settlement funds should be significantly larger, they have the potential to infuse much-needed cash into a system that is desperately lacking resources. However, the current lack of transparency and enforcement, coupled with the ability of responsible companies to dictate the distribution of funds, raises concerns about repeating the mistakes made in tobacco settlements. It is evident that we are already facing challenges in ensuring that settlements reach those who need them the most, perpetuating health inequity and allocating money to programs that may not effectively support opioid victims. Substance use recovery providers must strive to secure the necessary funding to assist their community, while also ensuring transparency in the utilization of these funds. It is vital that we closely monitor the allocation of funding to prevent this settlement from going to waste.