A new database tracking how jurisdictions across the country are allocating opioid settlement funds shows that while treatment and prevention were heavily prioritized, most states gave no funding whatsoever to syringe service programs (SSP). Meanwhile, scores of payments went toward “purposes that do not qualify as Opioid Remediation.”
The database, unveiled earlier in December, was born out of a collaboration between KFF Health News, Johns Hopkins Bloomberg School of Public Health and the nonprofit Shatterproof. The team of journalists and researchers analyzed more than 7,000 opioid settlement expenditures in 2022 and 2023. The resulting database is the largest of its kind to date.
The team found that just 2 percent of funds went to expanding SSP. The state that gave SSP the largest share of its funding was Maine, with a little over 31 percent. The data show that around 11 percent of funds went toward naloxone and other overdose-reversal medications. California allocated the largest percentage of its funding to that category, followed closely by Oregon, Missouri and Texas.
Kentucky committed the biggest share, 55.96 percent, to medications for opioid use disorder. Maryland allocated the biggest share of its funding to treatment for people currently incarcerated—22.63 percent.
One-third of the payouts had actually been spent; another third was not traceable.
Overall, the team found that about one-third of payouts disbursed had actually been spent; another third had been set aside for future projects; and the remaining third was not traceable. However, this still doesn’t represent the sum total of all payouts disbursed for 2022 and 2023. Much of that information has been kept shrouded by state and local governments.
Settlement terms allow state and local governments to allocate up to 15 percent of the funds for purposes unrelated to opioid remediation. But there’s no oversight whatsoever to hold them to that percentage. Montana, New Mexico and West Virginia, for example, appear to so have so far committed 100 percent of their opioid settlement payouts to unrelated expenditures. The team behind the database found that only 29 states published reports on such expenditures.
“You can’t manage what you can’t measure,” Tonja Myles, cofounder of Baton Rouge-based Set Free recovery services, told Filter. Louisiana was one of four states, in addition to the District of Columbia, which didn’t publish any state-level reports on settlement spending. “We can’t afford to mess this up. There needs to be more accountability and oversight so we can make sure the money that is being allocated to states and municipalities is being used the right way.”
Her organization has received grants funded with opioid settlement payouts, and she participated in the recent analysis by speaking with interviewers. Set Free team members are all part-time independent contractors, but opioid settlement-funded grants allowed the organization to scale up their services by over 35 percent.
“That helped us to add more peers,” Myles said. “There’s a funding source for … getting Narcan and [fentanyl test strips], doing harm reduction, and just giving people options for whatever they want their treatment to look like.”
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