Payback

Tracking the Opioid Settlement Cash

Opioid manufacturers, distributors, and retailers are paying tens of billions of dollars in restitution to settle lawsuits about their role in the overdose epidemic, with little oversight on how the money is spent. We’re tracking how state and local governments use — or misuse — the cash.

A man with a bushy gray beard in a jacked and cap stands outside a building and smokes a cigarette while looking at the camera.

How Are States Spending Opioid Settlement Cash? We Built a Database of Answers

From addiction treatment to toy robot ambulances, we uncovered how billions in opioid settlement funds were used by state and local governments in 2022 and 2023. Find out where the money went.

By Aneri Pattani

Dec. 16, 2024

A police officer holding a rifle stands outside.

From Narcan to Gun Silencers, Opioid Settlement Cash Pays Law Enforcement Tabs

Local governments have received hundreds of millions of dollars from the opioid settlements to support addiction treatment, recovery, and prevention efforts. Their spending decisions in 2024 were sometimes surprising and even controversial. Our new database offers more than 10,500 examples.

By Aneri Pattani

Nov. 3, 2025

Two people dancing with their arms in the air at an outdoor concert.

Sock Hops and Concerts: How Some Places Spent Opioid Settlement Cash

States, counties, and cities are receiving millions in opioid settlement money to address the addiction crisis. The ways they spent the dollars in 2024 sometimes drew criticism from advocates and at least one state official, who alleged misuse.

By Aneri Pattani

Nov. 3, 2025

Localize the Data

If you are a journalist who wants to investigate opioid settlement transparency data for your area, here’s how you can do that.

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Do you have concerns about how your state or locality is using the opioid settlement funds? Are they doing something effective that other places should replicate? Tell us here.

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Data From the Project

More Stories from the Project

Maker of Device To Treat Addiction Withdrawal Seeks Counties’ Opioid Settlement Cash

Some researchers and recovery advocates see the NET device as the latest in a series of products pitched as the solution to the addiction crisis that have been overhyped to capitalize on money from the opioid settlements.

By Aneri Pattani

March 18, 2026
How Is Your County Spending Opioid Settlement Cash? Our New Tool Follows the Money.

Lifesaving or wasteful? Opinion is divided on the ways local communities are using opioid settlement funds. Survivors of the overdose crisis and families who’ve lost loved ones to it are raising alarms about what some perceive as wasteful spending.

By Aneri Pattani

Jan. 16, 2026
Optum Rx Invokes Open Meetings Law To Fight Kentucky Counties on Opioid Suits

In a Goliath-versus-David fight, UnitedHealth Group’s pharmacy benefit manager, Optum Rx, has filed lawsuits in five counties to stop them from including the company in national opioid litigation.

By Aneri Pattani

Aug. 20, 2025
Who’s Policing Opioid Settlement Spending? A Crowdsourced Database Might Help

Billions in opioid settlement money was meant to be spent on treating and preventing addiction — but what happens if it’s misspent? Some advocates say attorneys general need to pay closer attention. If they don’t, a new tool might empower the public.

By Aneri Pattani

July 11, 2025
Opioid Settlement Windfall: Where the Billions Are Going

Opioid manufacturers, distributors, and retailers have been paying billions of dollars to settle lawsuits over their role in the overdose epidemic. How to spend the money remains an open question.

By Aneri Pattani

May 30, 2025
For Opioid Victims, Payouts Fall Short While Governments Reap Millions

Pharmaceutical companies accused of fueling the nation’s opioid crisis are paying state and local governments billions of dollars in legal settlements. But how much are victims who suffered addiction and overdoses getting?

By Aneri Pattani

April 8, 2025
Opioid Cash Grab: As Federal Funding Dries Up, States Turn to Settlement Money

Nevada’s budget debate highlights how uncertainty over funding for federal safety net programs may lead some officials to turn to opioid settlement dollars to make up the difference.

By Aneri Pattani

Feb. 25, 2025
An Ice Rink To Fight Opioid Crisis: Drug-Free Fun vs. Misuse of Settlement Cash

A decision about how to spend settlement funds in Carter County, Kentucky, which was hit hard by the opioid epidemic, offers a window into the choices that surround this windfall.

By Aneri Pattani

Feb. 20, 2025
12 States Promised To Open the Books on Their Opioid Settlement Funds. We Checked Up on Them.

Victims of the opioid crisis, health advocates, and public policy experts have repeatedly called on state and local governments to transparently report how they’re using the funds they are receiving from settlements with opioid makers and distributors.

By Aneri Pattani

Nov. 7, 2024
Colorado’s Naloxone Fund Is Drying Up, Even as Opioid Settlement Money Rolls In

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.

By Claire Cleveland

Oct. 11, 2024
Public Voices Often Ignored in States’ Opioid Settlement Money Decisions

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.

By Aneri Pattani, Henry Larweh, and Ed Mahon, Spotlight PA

Aug. 27, 2024
Opioid Settlements Promise Mississippi a Windfall. What Happens Next?

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.

By Violet Jira, Mississippi Today and Henry Larweh

Aug. 14, 2024
Lifesaving Drugs and Police Projects Mark First Use of Opioid Settlement Cash in California

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.

By Aneri Pattani and Don Thompson

July 12, 2024
Supreme Court Upends Purdue Pharma Opioid Settlement

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

By Aneri Pattani

June 27, 2024
Tribal Nations Invest Opioid Settlement Funds in Traditional Healing To Treat Addiction

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.

By Aneri Pattani and Jazmin Orozco Rodriguez

May 15, 2024
Swap Funds or Add Services? Use of Opioid Settlement Cash Sparks Strong Disagreements

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

By Aneri Pattani

April 15, 2024
Track Opioid Settlement Payouts — To the Cent — In Your Community

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.

By Aneri Pattani, Lydia Zuraw, and Holly K. Hacker

April 2, 2024
Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?

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.

By Aneri Pattani

March 5, 2024
Federal Lawmakers Take First Steps Toward Oversight of $50 Billion in Opioid Settlements

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.

By Aneri Pattani

Jan. 22, 2024
The Year in Opioid Settlements: 5 Things You Need to Know

In the past year, opioid settlement money has gone from an emerging funding stream for which people had lofty but uncertain aspirations to a coveted pot of billions being invested in remediation efforts. Here are some important and evolving factors to watch going forward.

By Aneri Pattani

Dec. 21, 2023
‘They See a Cash Cow’: Corporations Could Consume $50 Billion of Opioid Settlements

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?

By Aneri Pattani

Dec. 18, 2023
Millions in Opioid Settlement Funds Sit Untouched as Overdose Deaths Rise

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.

By Katheryn Houghton and Aneri Pattani

Dec. 13, 2023
Watch and Listen: Opioid Settlement Case Triggers Protests Outside the High Court

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.

By Aneri Pattani

Dec. 5, 2023
Gubernatorial Candidates Quarrel Over Glory for Winning Opioid Settlements

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.

By Aneri Pattani

Nov. 1, 2023
Using Opioid Settlement Cash for Police Gear Like Squad Cars and Scanners Sparks Debate

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.

By Aneri Pattani

Oct. 23, 2023
Officials Agree: Use Settlement Funds to Curb Youth Addiction. But the ‘How’ Gets Hairy.

Parents, educators, and elected officials agree that investing in school-based prevention efforts could help curb the rising rate of youth drug overdoses. The well-known D.A.R.E. program is one likely choice, but its effectiveness is in question.

By Aneri Pattani and Emily Featherston, InvestigateTV

Sept. 25, 2023
Repeating History: California County Plugs Budget Gap With Opioid Settlement Cash

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.

By Aneri Pattani

Aug. 2, 2023
Meet the People Deciding How to Spend $50 Billion in Opioid Settlement Cash

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.

By Aneri Pattani

July 10, 2023
Opioid Settlement Payouts to Localities Made Public for First Time

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.

By Aneri Pattani

June 16, 2023
A Rural County’s Choice: Use Opioid Funds to Pay Off Debt, or Pay Them Forward to Curb 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.

By Aneri Pattani

May 16, 2023
The Biden Administration Vowed to Be a Leading Voice on Opioid Settlements But Has Gone Quiet

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.

By Aneri Pattani

April 21, 2023
$50 Billion in Opioid Settlement Cash Is on the Way. We’re Tracking How It’s Spent.

Spending the money effectively and equitably is a tall order for state and local governments, and a lack of transparency in the process is already leading to fears of misuse.

By Aneri Pattani

March 30, 2023
In Rural America, Deadly Costs of Opioids Outweigh the Dollars Tagged to Address Them

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.

By Aneri Pattani and Rae Ellen Bichell

Dec. 12, 2022
Schools, Sheriffs, and Syringes: State Plans Vary for Spending $26B in Opioid Settlement Funds

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.

By Aneri Pattani

Nov. 22, 2022
The Player-Coaches of Addiction Recovery Work Without Boundaries

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.

By Rae Ellen Bichell

Nov. 16, 2022

Discussions of the Project

The May 12, 2024 broadcast of “Last Week Tonight With John Oliver” frequently cited KFF Health News in its examination of how billions of dollars from the opioid settlements are being spent: