Dubious buys raise alarm over local control of opioid cash
Summary
State and local governments spent about $3.7 billion in opioid settlement funds in 2025, but an investigation found thousands of expenditures with uncertain links to addiction prevention or treatment. The funds are expected to total about $60 billion over nearly two decades, while local governments control nearly half and often have limited expertise and oversight.Key Facts
- Opioid settlement funds come from companies sued over their role in aggressively promoting painkillers and fueling the opioid crisis.
- Many governments used the money for addiction treatment, recovery housing, and other initiatives related to the crisis.
- The investigation identified spending including $150,000 for street lighting in Camden, New Jersey, and $36,200 for a pickleball court in Gilmer County, West Virginia.
- KFF Health News, Johns Hopkins Bloomberg School of Public Health, and Shatterproof gathered records and analyzed nearly 17,500 expenditures.
- The resulting database tracks how settlement funds were spent or left unspent in 2025.
- Settlement agreements include some spending guidelines, but officials have considerable flexibility and the public has limited ways to track many expenditures.
- Local decision-makers control nearly half of the settlement money, according to OpioidSettlementTracker.com.
- Recovery advocates have questioned whether local officials have the expertise and support needed to decide how best to use the funds.
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