The Health 202

Gubernatorial Candidates Tout Opioid Settlements

Tuesday’s election served as a testing ground for themes that could resonate with voters in 2024. Abortion is obviously among the biggest. One that’s not getting as much attention as it deserves: opioid settlement money.

In Kentucky, both the newly reelected Democratic governor, Andy Beshear, and his Republican challenger, Attorney General Daniel Cameron, were involved in lawsuits against companies that made, sold or distributed opioid painkillers. 

They sparred for months in news conferences and on social media over who deserved credit for bringing hundreds of millions of dollars to their state to address the opioid epidemic. Beshear filed several of the lawsuits when he was attorney general, but Cameron finalized the deals during his tenure.

More than 100,000 Americans died of drug overdoses last year. The billions in opioid settlement dollars arriving nationwide could make a dent in the epidemic. But there are widely differing opinions on how to spend it. Some people favor investing in law-and-order efforts to stop the trafficking of fentanyl and other illicit drugs, while others prefer to focus on treatment and social support to help people achieve long-term recovery. While politicians talk about the amount of cash they’ve brought in, many people directly affected by the crisis are more concerned with how the money will help them and their loved ones. 

It’s hard to tell how much of a role opioid money played in Beshear’s victory. But this playbook could be instructive to gubernatorial candidates next year, some of whom have a more decisive claim to the settlements.

North Carolina Attorney General Josh Stein, a Democrat, and West Virginia Attorney General Patrick Morrisey, a Republican, are among the most prominent voices on the opioid settlements across the country — and they’re both running for governor in 2024. (“AG,” the joke goes, stands for “aspiring governor.”)

Stein, a Democrat seeking to succeed Gov. Roy Cooper, has made his name as one of the lead negotiators in the national deals. He has emphasized his office’s role in ensuring opioid settlement money is spent on addiction treatment and prevention — unlike the tobacco settlement of 1998, from which less than 3 percent of annual payouts go to antismoking efforts. 

He has toured his state discussing the use of settlement funds and has won an award for the state’s transparency in reporting how dollars are spent. Securing opioid settlement funds is listed at the top of the “accomplishments” section of his 2024 gubernatorial campaign website

Morrisey’s claim to fame is a bit different. He chose not to participate in many national deals, instead striking out on his own to win larger settlements just for West Virginia. The state is set to receive more than $500 million over nearly two decades. Morrisey has repeatedly boasted about his record of securing the “highest per capita settlements in the nation.” The claim appears on his campaign website, too. Morrisey’s looking to succeed Democrat-turned-Republican Gov. Jim Justice, who is term-limited.

KFF polling suggests that even beyond the death toll, the impact of the epidemic is broad: 3 in 10 Americans say they or a loved one have been addicted to opioids. Throw in alcohol and other drugs, and the burden of addiction rises to two-thirds of the country. It’s not clear whether politicians can break through to voters by touting their records on the settlements, but regardless, we’re going to hear a lot more about the money on the campaign trail next year. 

Stephen Voss, an associate professor of political science at the University of Kentucky, said it’s a smart talking point for politicians.

Scoring money for your constituency almost always plays well,” he said. It “is a lot more compelling and unifying a political argument than taking a position on something like abortion,” where you risk alienating someone no matter what you say.


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