Officers in Irvington, New Jersey, had an concept. To boost consciousness concerning the risks of opioid use and habit, the township might host live shows with fashionable R&B artists like Q Parker and Musiq Soulchild. It spent greater than $600,000 in 2023 and 2024 to pay for the reveals, even footing the invoice for VIP trailers for the performers. It purchased cotton sweet and popcorn machines.
In lots of instances, one of these neighborhood occasion can be unremarkable. However Irvington’s live shows stood out for his or her funding supply: settlement cash from corporations accused of fueling the opioid overdose disaster.
As a part of nationwide settlements, greater than a dozen corporations that offered prescription painkillers are anticipated to pay state and native governments upward of $50 billion over almost 20 years. Governments are imagined to spend a lot of the windfall combating habit. Officers who negotiated the settlements even outlined prompt makes use of and established different guardrails to keep away from a repeat of the Tobacco Grasp Settlement Settlement of the Nineteen Nineties, from which paltry quantities went to anti-smoking applications.
However there’s nonetheless vital flexibility with these {dollars}, and what constitutes use to at least one individual could be deemed waste by one other.
In Irvington, township officers stated they used the cash appropriately as a result of the live shows decreased stigma round habit and related individuals to remedy. However performing state Comptroller Kevin Walsh known as the live shows a “waste” and “misuse” of the settlements, which resulted from the overdose deaths of tons of of 1000’s of People.
Comparable disputes are intensifying nationwide as officers start spending settlement cash in earnest — all whereas grappling with slashed federal grants and looming cuts to Medicaid, the state-federal public insurance coverage program that’s the biggest payer for habit remedy.
To make clear these discussions, KFF Well being Information and researchers on the Johns Hopkins Bloomberg Faculty of Public Well being and Shatterproof, a nationwide nonprofit targeted on habit, carried out a yearlong effort to doc settlement spending in 2024. The group filed public information requests, scoured authorities web sites, and extracted expenditures, which had been then sorted into classes resembling remedy or prevention.
The result’s a database of greater than 10,500 methods settlement money was used (or not) final 12 months — essentially the most complete nationwide useful resource of its form. Some highlights embrace:
- States and localities spent or dedicated almost $2.7 billion in 2024, based on public information. The majority went to investments habit consultants take into account essential, together with about $615 million to remedy, $279 million to overdose reversal medicines and associated coaching, and $227 million to housing-related applications for individuals with substance use problems.
- Smaller, although notable, quantities funded legislation enforcement gear, resembling night time imaginative and prescient tools, and prevention efforts that consultants known as questionable, resembling hiring a drug consciousness magician.
- Some jurisdictions paid for fundamental authorities providers, resembling firefighter salaries.
- The cash is managed by totally different entities in every state, and about 20% of it’s untrackable by public information.
This 12 months’s database, together with expenditures and untrackable percentages, shouldn’t be in contrast with the one KFF Well being Information and its companions compiled final 12 months, as a consequence of methodology modifications and state price range quirks. The database can’t current a full image as a result of some jurisdictions don’t publish reviews or delineate spending by 12 months. What’s proven is a snapshot of 2024 and doesn’t account for selections in 2025.
Nonetheless, the database helps counteract a bent towards secrecy amongst a few of these answerable for settlement cash and confusion amongst individuals making an attempt to observe it.
Greater than $237 million — about 9% of all trackable spending in 2024 — went to efforts broadly aimed toward stopping habit, based on public information. These ranged from placing on neighborhood consciousness occasions, just like the live shows in Irvington, to hiring psychological well being counselors in colleges.
Lots of the examples raised purple flags for researchers, together with:
- Suffield, Connecticut, held a Fifties-style sock hop, at which youngsters and seniors wore poodle skirts, posed with inflatable guitars, and pledged to stay drug-free.
- Vernon, Connecticut, hosted a combined martial arts demonstration, at which a fighter spoke about his expertise with habit.
- Hardy County, West Virginia, spent $60,000 to restore a faculty observe.
“There is no evidence” to again these efforts, stated Linda Richter, who leads prevention-oriented analysis on the nonprofit Partnership to Finish Dependancy.
Elected officers just like the occasions as a result of “you can announce to the community that you did something,” she stated. However except they’re a part of bigger initiatives that incorporate different approaches, resembling screening college students for psychological well being considerations or supporting mother and father combating habit, they’re unlikely to have lasting affect.
And when settlement funds pay for these one-offs, there’s much less left for methods “that we do know work,” Richter added.
Faculty meeting audio system had been additionally fashionable, with three Connecticut cities spending greater than $30,000 whole for former Boston Celtic Chris Herren to share his habit story with college students.
“You get 1,200 kids in the gym and you can hear a pin drop when he talks,” stated Joe Kobza, superintendent of colleges in Monroe. He described Herren’s talks to college students and oldsters as “pretty impactful.”
However emotional affect isn’t essentially efficient, Richter stated. Audio system usually discuss medication messing up their lives despite the fact that they’ve develop into rich celebrities. “The messages are so mixed,” she stated.
Many native officers admitted their spending selections weren’t evidence-based. However they meant nicely, they stated. They usually acquired little to no steering on learn how to use the cash.
Kelly Giannuzzi, Suffield’s former director of youth providers, who organized the sock hop, stated the objective was to lift consciousness and fight loneliness.
Hardy County Commissioner Steven Schetrom stated spending cash on observe repairs made sense, since he’d seen the constructive affect the game had on his son’s life. He wished different youngsters to have the identical alternative.
David Owens, a spokesperson for Vernon, stated the city’s combined martial arts occasion was the kickoff to an ongoing marketing campaign, meant to point out those who athletics might help them construct connections and keep away from medication. The occasion introduced out younger males, who are sometimes troublesome to achieve, he stated.
However the city has no means of figuring out if the occasion had lasting traction.
In New Jersey, performing Comptroller Walsh launched a report this summer time calling on Irvington township officers to repay the settlement cash spent on the live shows.
“If they’re going to hold big parties, that’s up to them and the taxpayers,” Walsh informed KFF Well being Information. “But they can’t use opioid money for that.”
He additionally prompt the live shows had been political rallies for the mayor, Tony Vauss.
Irvington officers strongly objected to the report and unsuccessfully sued Walsh to attempt to block its launch. Vauss informed KFF Well being Information it was “misleading and flat-out wrong.”
Vauss stated the township distributed overdose reversal medicines on the live shows and unfold messages about searching for assist. At the very least 4 individuals sought remedy on-site, the township stated in its lawsuit.
“We felt as though we did everything correctly,” Vauss stated.
Nonetheless, a few of the analysis Irvington cited within the lawsuit to help its case appeared irrelevant, resembling a research in rural Ghana and a graduate thesis.
Irvington officers didn’t reply to questions on these citations.
As this dispute — and others prefer it nationwide — proceed, individuals affected by the disaster say it’s essential to recollect the ethical weight of those settlements.
It’s “blood money,” stated Stephen Loyd, an habit drugs physician who was as soon as hooked on opioids and has served as an knowledgeable in a number of opioid lawsuits.
He’s seen many members of the family lose mother and father, kids, and siblings.
“I don’t know how I would look a family in the face” if this cash isn’t used to stop extra losses, he stated.
Learn the methodology behind this undertaking.
KFF Well being Information’ Henry Larweh; Shatterproof’s Kristen Pendergrass and Lillian Williams; and the Johns Hopkins Bloomberg Faculty 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 Faculty of Public Well being has taken a number one function in offering steering to state and native governments on using opioid settlement funds. School from the college 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 by distinct initiatives, together with advocating for state and federal insurance policies, ending habit stigma, and educating communities concerning the remedy system.
Shatterproof is partnering with some states on initiatives funded by opioid settlements. KFF Well being Information, the Johns Hopkins Bloomberg Faculty of Public Well being, and the Shatterproof group that labored on this report are usually not concerned in these efforts.
