Within the coronary heart of Appalachia, regulation enforcement is usually seen as being on the entrance line of the dependancy disaster.
Bre Dolan, a 35-year-old resident of Hardy County, West Virginia, understands why. All through her childhood, when her dad had dependancy and psychological well being crises, cops had been usually the primary ones to reply. Dolan calls them “good men and women” who “care about seeing their community recover.”
However she’s skeptical that they will mitigate the basis causes of an dependancy epidemic that has racked her house state for many years.
“Most of the busts that go down are addicts,” she stated — individuals who want therapy, not jail.
Dolan’s father was one in every of them. And so was she.
Now 14 years into restoration, she’s been stunned to see many native officers spending opioid settlement cash — an inflow of money from firms accused of fueling the overdose disaster — on police Tasers, cruisers, evening imaginative and prescient gear, and extra.
“How is that really tackling an issue?” Dolan stated. “How will it help families battling addiction?”
Nationwide, greater than $61 million in opioid settlement funds had been spent on regulation enforcement-related efforts in 2024, in response to a yearlong investigation by KFF Well being Information and researchers on the Johns Hopkins Bloomberg College of Public Well being and Shatterproof, a nationwide nonprofit targeted on dependancy. That included initiatives that public well being consultants largely assist, equivalent to hiring social staff to accompany officers on overdose calls, in addition to actions they’re extra skeptical of, equivalent to beefing up police arsenals.
Over practically 20 years, state and native governments are set to obtain greater than $50 billion in opioid settlement cash, which is meant for use to combat dependancy. The settlement agreements even outlined instructed makes use of and established different guardrails to restrict unrelated makes use of of the funds — as occurred with the Tobacco Grasp Settlement Settlement of the Nineties.
However there’s nonetheless vital flexibility with these {dollars}, and what constitutes a great use to 1 particular person could be deemed waste by one other.
To Stephen Loyd, an dependancy medication physician who was as soon as hooked on opioids and has served as an skilled in a number of opioid lawsuits, some regulation enforcement bills fall into that second class.
Drones and police officer salaries usually are not “in the spirit of what we wanted to use the money for when we were fighting for it,” Loyd stated.
“People died for this money. Families were torn apart for this money. And to not spend it to try to make our system better, so that people don’t have to experience those losses going forward, to me, is unconscionable,” he stated.
As a part of this investigation, KFF Well being Information and its companions compiled essentially the most complete nationwide database of opioid settlement spending to this point, that includes greater than 10,500 examples of how the cash was used (or not) final yr. The staff filed public information requests, scoured authorities web sites, and extracted expenditures, which had been then sorted into classes, equivalent to therapy or prevention. The findings embrace:
- Practically $2.7 billion — that’s the quantity states and localities spent or dedicated in 2024, in response to public information. The lion’s share went to investments dependancy consultants think about essential, together with about $615 million to therapy, $279 million to overdose reversal medicines and associated coaching, and $227 million to housing-related packages for folks with substance use problems.
- Smaller, although notable, quantities funded regulation enforcement initiatives — equivalent to making a taking pictures vary and tinting patrol automobile home windows — and prevention packages that consultants referred to as questionable, equivalent to placing on a fishing event.
- Some jurisdictions paid for fundamental authorities providers, equivalent to firefighter salaries.
- The cash is managed by completely different entities in every state, and about 20% of it’s untrackable via public information.
This yr’s database, together with the expenditures and untrackable percentages, shouldn’t be in contrast with the one KFF Well being Information and its companions compiled final yr, attributable to methodology adjustments and state funds quirks. The database can not current a full image as a result of some jurisdictions don’t publish experiences or delineate spending by yr. What’s proven is a snapshot of 2024 and doesn’t account for selections in 2025.
Nonetheless, the database helps counteract the secrecy amongst a few of these in cost of settlement cash and confusion amongst these monitoring it.
‘How My Population Would Like Me To Vote’
Dolan has seen intergenerational dependancy up shut. When her father was excessive, he typically kicked teenage Dolan out of the home together with her toddler siblings. She began consuming early and progressed to different medicine, ultimately touchdown in jail.
Though she managed to seek out restoration on her personal, even touchdown a job as an EMT, she needs to make the trail simpler for others.
If settlement cash had been used to rent social staff or construct household restoration packages, it might change the course of a child’s life, she stated.
“Maybe people could have helped my dad get into recovery and gave him therapy,” she stated. “Anything could have happened.”
However many native officers say regulation enforcement is among the few instruments they’ve, particularly in rural areas. And their constituents imagine it’s efficient.
“If the goal was treatment and prevention, it would have been better to throw [the money] into a big grant system and give it to treatment centers,” stated Cris Meadows, metropolis supervisor of Oak Hill, West Virginia, which paid greater than $67,000 for a drone and surveillance cameras for its police division. “Unfortunately, local governments are really not set up to do that.”
Clarkdale, Arizona, City Supervisor Susan Guthrie stated her city purchased practically $15,000 value of drones as a result of they assist with enforcement — equivalent to recording crime scenes and conducting search-and-rescue operations — in addition to training, when officers work together with youngsters at neighborhood occasions.
Comparable views nationwide have led to spending that features:
- About $12,000 for rifle suppressors (often known as silencers) in Alexandria, Indiana.
- About $21,000 for Tasers in Mooresville, Indiana.
- About $49,000 to switch outdated physique cameras and Tasers in Hardy County, West Virginia.
- Practically $70,000 in Lewisburg, West Virginia, so as to add a police officer to the county’s drug activity pressure, exchange that officer regionally, purchase weapons and automobiles, and tint automobile home windows.
A number of elected officers stated their decisions mirror native politics.
That’s “how my population would like me to vote,” Hardy County Commissioner Steven Schetrom stated of his fee’s objective to spend a couple of quarter of its settlement cash on regulation enforcement.
Mooresville City Council President Tom Warthen instructed KFF Well being Information, “People have petitioned our government for less taxes but have never petitioned for less services” from the native police pressure. With federal and state funds cuts looming, the city should be resourceful, he stated, including that the Tasers had been purchased with a portion of settlement funds that haven’t any restrictions.
After these purchases, an Indiana fee issued a listing of regulation enforcement tools that it cautioned in opposition to shopping for with restricted settlement {dollars}. California, Kansas, and Virginia have launched related lists.
Analysis backs these restrictions. Research have proven that drug busts and arrests can exacerbate the overdose disaster. Officers responding to overdoses usually arrest folks, making individuals who use medicine afraid of calling 911 or searching for therapy via police.
In distinction, equipping cops with overdose reversal medicines has been proven to avoid wasting lives. That’s a key element of an $18 million effort in Texas, the state with the very best proportion of reported regulation enforcement spending.
Police and Firefighter Salaries
Some locations used settlement funds to keep up fundamental first responder providers.
For instance, Mantua Township, New Jersey, used about $79,000 to “offset police salary and wages” and, in response to its public spending report, plans to take action yearly. Township officers didn’t reply to requests for remark.
Los Angeles County allotted $1 million to cowl a portion of firefighter salaries and advantages final yr and estimates it can use one other $1 million this yr.
County fireplace division spokesperson Heidi Oliva stated opioid funds had been used to fill a funds hole till income kicked in from a new tax voters authorized final November.
The usage of funds was “appropriate,” she stated in an e-mail, as a result of “the opioid crisis presents a significant burden to EMS response, from dispatch through arrival at hospitals, clinician mental health/burnout, and a variety of other factors.”
Utilizing opioid cash to switch different income is authorized in most locations. But it surely’s thought-about dangerous follow.
“I don’t want to see this money used to make up for stuff that would be paid for anyway,” stated Daniel Busch, chair of the FED UP! Coalition, a nationwide advocacy group representing many mother and father who’ve misplaced kids to dependancy.
Settlement {dollars} are “the only financial representation from the governments and from the drug companies” of households’ losses, Busch stated. To see that cash used to keep up the established order is “painful” and “distressing.”
Busch fears this follow will develop into extra frequent as states grapple with federal funds cuts.
Already in New Jersey, lawmakers allotted $45 million in settlement funds to well being techniques to cushion in opposition to anticipated Medicaid losses — a transfer opposed by the state’s legal professional basic, opioid settlement advisory council, and advocates.
Nonetheless, some states are taking proactive steps.
Colorado launched steering this yr in opposition to such actions.
“These dollars can’t be part of budget games where we simply backfill existing programs,” state Legal professional Common Phil Weiser instructed KFF Well being Information. “We have to build on whatever we’re doing because it hasn’t been enough.”
Different states, equivalent to Maine, Maryland, and Kentucky, are newly requiring native governments to report how they spend the cash, which can make it simpler to identify disputed practices. Officers in Delaware, Hawaii, Massachusetts, and Missouri stated they count on to revamp their public reporting techniques to extend transparency by early 2026.
In Mississippi, which produced no substantive public experiences final yr, the legal professional basic’s workplace has arrange an internet site that can host spending data after Dec. 1.
Jennifer Twyman is anxious to see some optimistic adjustments.
“We have people literally dying on our sidewalks,” stated the Louisville, Kentucky, advocate.
Twyman struggled with opioid misuse for 20 years and now works with Vocal-KY to finish homelessness and the conflict on medicine. To her, any spending that doesn’t straight assist folks with dependancy betrays the settlement’s function.
“It is the blood from many of my friends, people that I care deeply about,” she stated. “That money could have been me, could have been my life.”
Learn the methodology behind this mission.
KFF Well being Information’ Henry Larweh; Shatterproof’s Kristen Pendergrass and Lillian Williams; and the Johns Hopkins Bloomberg College of Public Well being’s Abigail Winiker, Samantha Harris, Isha Desai, Katibeth Blalock, Erin Wang, Olivia Allran, Connor Gunn, Justin Xu, Ruhao Pang, Jirka Taylor, and Valerie Ganetsky contributed to the database featured on this article.
The Johns Hopkins Bloomberg College of Public Well being has taken a number one position in offering steering to state and native governments on the usage of opioid settlement funds. School from the varsity collaborated with different consultants within the area to create rules for utilizing the cash, which have been endorsed by over 60 organizations.
Shatterproof is a nationwide nonprofit that addresses substance use dysfunction via distinct initiatives, together with advocating for state and federal insurance policies, ending dependancy stigma, and educating communities concerning the therapy system.
Shatterproof is partnering with some states on tasks funded by opioid settlements. KFF Well being Information, the Johns Hopkins Bloomberg College of Public Well being, and the Shatterproof staff that labored on this report usually are not concerned in these efforts.
