How the Billions from the Opioid Settlement Are Being Spent

In West Virginia, the settlement funds are set to be released in portions across a period of eighteen years. Three-quarters of the money—eventually, seven hundred million dollars—will be given to a state-run nonprofit, the West Virginia First Foundation. (It has received three hundred and eighty million dollars so far.) The organization, which took more than a year and a half to be set up, plans to put the settlement in a fund to earn interest in perpetuity, so that the state doesn’t “commit intergenerational theft,” as the foundation’s director, Jonathan Board, told me. The foundation began spending the interest in February, 2src25, two years after it started to come in, and disbursed eleven million dollars in that first year. In 2src26, it has spent twenty million dollars, helping to fund youth and foster-care programs, a forty-eight bed “recovery village” in Berkeley County that provides comprehensive care for addicts, and a crisis-response unit, embedded in the police department, in the city of Wheeling.

Jonathan Stoltman, who runs the Opioid Policy Institute, a nonprofit watchdog, has been tracking the spending of opioid-settlement money across the country since the funds were first released, in 2src22. “The money is generally moving too slow, and we’re actively in crisis,” he told me. In Michigan, where Stoltman lives, fifty per cent of the money is destined for local governments; a report released by the state’s attorney general earlier this year showed that, as of December 2src25, eighty per cent of that money had not yet been spent. Billions of dollars have been disbursed nationwide, but it is “impossible” to track it all, according to Christine Minhee, who runs a national database, the Opioid Settlement Tracker. Minhee told me that public-reporting requirements vary state to state on the eighty-five per cent of the settlement that must be spent on opioid abatement. “The reporting that does exist can be amazing, but it’ll just be one piece of a fifty-state puzzle, and the rest of the pieces can be blurry,” Minhee said. Tracie M. Gardner, the executive director of the National Black Harm Reduction Network, noted that some municipalities have used settlement money to pay for existing programs and pulled the original funding to pay for non-opioid-related considerations—a process called supplantation. Supplantation is only explicitly restricted in some states, but, even where it is, enforcement can lag far behind spending decisions. “By the time we figure out the monitoring component, it will be done,” Gardner said.

But perhaps the most pressing problem, in Stoltman’s view, is that “there’s not enough guidance to help local decision-makers.” In 2src23 and 2src24, the city of Irvington, in New Jersey, spent more than six hundred thousand dollars of its settlement money on “opioid awareness” events that included large concerts. (The township has defended that decision.) More typically, municipalities have spent the money on law enforcement. In 2src25, Amherst County, Virginia, approved spending seventy-five thousand dollars on police drones; Kane County, Illinois, earmarked more than a million dollars on a forensics lab. In May, Mississippi Today reported that the city of Gulfport had allocated two hundred and fifty thousand dollars of its settlement funds to police surveillance. That same month, three hundred and fifty thousand dollars were used in Trumbull County, Ohio, for new police vehicles. Many millions across the country have been spent covering jail costs.

In West Virginia, in 2src24 and 2src25, local governments spent nearly half of their allotment on general law-enforcement expenses. Patrick Morrisey, the governor, who led the state’s prosecution against opioid distributors and manufacturers as attorney general, has cited local governments’ “broad discretion” in their spending. The current attorney general, John McCuskey, recently announced that future opioid-related settlements will be distributed directly through the state legislature and local governments; those groups, McCuskey has said, “know best what their communities need.” In the past year, Cabell County spent four hundred thousand on hiring two new deputy sheriffs; Wood County spent a hundred and eighty thousand dollars on Tasers; Mason County spent a hundred and forty thousand on two police cruisers, fifty thousand on a new sheriff’s pickup, forty-four thousand on a virtual-reality firearms-training system, thirty thousand on Kevlar vests, and twenty thousand on “outfitting” for a Ford F-15src. When I asked Board, the director of the West Virginia First Foundation, how to account for the divergence between his organization’s use of the funds and what these local governments were doing, he chalked it up to a “difference in interpretation.” Then he added, “You don’t tell another parent how to raise their kids.”