Some $26 billion in settlement dollars are coming to cities, counties and states over the next 18 years to help satisfy the damages caused by the opioid epidemic.

More dollars will be coming from ongoing lawsuits, but this $26 billion represents the largest single settlement with Opioid manufacturer Johnson & Johnson and distributors, AmerisourceBergen, Cardinal Health, and McKesson. It was finalized in early 2022 by state attorneys general and required 90% of cities and counties in each of the 46 participating states to give up individual lawsuits. 

That’s a huge amount of cash, and questions are emerging about how and where the money will be most effectively used. Today, February 27, 2024, a joint release by the National League of Cities and the National Association of Counties is providing some of the answers.

In total, the settlement is being divided with $2 billion for cities, $7.3 billion for counties, and $9.7 billion for states. But while individual cities, counties and states will be receiving specific allotments, the emphasis in the report is on the ways that entities have been working together to plan for the use of the money in the most effective ways – avoiding duplication and sharing expertise to fight opiate addiction and reduce overdose deaths, which quadrupled between 2010 and 2021.  

One example comes from Clinton County and the City of Frankfurt, Indiana, where a joint Opioid Settlement Funding Committee launched a needs assessment to identify gaps in services. According to the committee chair, Lorra Archibald, the effort has led to pooling allocations and sharing resources. “It made no sense to work in silos and risk duplicating effort,” said Archibald, who is also executive director of Healthy Communities of Clinton County.

The NLC-NACo analysis also points to the way New Hanover County and the City of Wilmington in North Carolina are pooling resources with the aim of developing a comprehensive and holistic approach to the problem. Meanwhile, in Arkansas, the Municipal League and the Association of Counties created an Opioid Recovery Partnership to increase the effectiveness of opiate use disorder response. 

As was recently discussed at length at the NACo Opiate Settlement Summit, an important and often repeated message is that settlement dollars should not replace other funds but should supplement them. As the brief states, “Incoming settlement payments pale” next to “opiate related costs” with every three overdose deaths increasing public safety spending by $130,000 to $140,000. In 2021, annual overdose deaths topped 100,000.

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