After years of authorized battles, state attorneys normal received billions of {dollars} in opioid settlements from drug corporations accused of fueling the habit disaster. They declared victory at press conferences, and a few touted the offers throughout their gubernatorial campaigns.
However now that the windfall is being spent, are attorneys normal doing sufficient to make sure it’s used for the meant functions?
No, say many households affected by the overdose disaster, restoration and hurt discount advocates, coverage specialists, and researchers following the money.
“This is blood money,” stated Toni Torsch, a Maryland resident whose son Dan died of an overdose at age 24. It may possibly’t make up for the lives misplaced, however “we do want to make sure that it’s going to count.”
Torsch and others affected by the disaster are more and more fearful that nobody appears to be guarding the opioid settlement money whereas elected officers eye it hungrily. With the Trump administration slashing federal funding for habit and Congress approving huge reductions to Medicaid — the largest payer for habit care nationwide — folks concern state legislators will use the settlements as a seize bag to fill price range shortfalls.
Within the face of those issues, two analysis and advocacy organizations are proposing an answer: a crowdsourced database to determine potential examples of misuse and immediate attorneys normal to analyze.
The Opioid Coverage Institute and Standard Democracy launched an internet site that enables members of the general public to submit alleged circumstances of waste, fraud, abuse, and mismanagement of opioid settlement funds. Submissions are reviewed by Jonathan Stoltman, director of the Opioid Coverage Institute, after which posted with particulars equivalent to how a lot cash was spent, what was bought, who made the choice, and hyperlinks to related information articles or price range paperwork.
The database, shared first with KFF Well being Information, consists of about 150 examples to start out, together with $2,362 awarded by a Missouri county to its roads and bridge division and $375,600 spent on a physique scanner for a Michigan county jail. The preliminary examples had been sourced from folks in restoration, advocates, and others Stoltman and his group requested to check the challenge. Stoltman acknowledged he’ll face criticism as the first arbiter of what qualifies as misuse for the database, however stated he’ll use analysis research to defend his choices.
The web site additionally reveals folks learn how to file complaints with their state legal professional normal and ask the workplace to develop a proper course of for receiving and investigating such complaints.
“I hope this is a wake-up call for state AGs that their work on this project is not done,” stated Frank Kearl, who co-led the hassle with Stoltman and is working as an legal professional at Standard Democracy till July 14. “We still have time” to make modifications to make sure we “spend this money in a way that actually responds to the harm that was caused.”
The web site’s launch comes simply over every week after New Jersey lawmakers handed a price range that gave well being programs $45 million in settlement funds regardless of the state legal professional normal’s opposition. Legislators stated it could protect hospitals from the blow of federal Medicaid cuts, however harm-reduction advocates stated it offers quick shrift to folks with substance use problems, whom the cash was meant to serve.
Lawmakers in North Carolina and Washington, D.C., are additionally contemplating utilizing settlement funds to plug gaps, and Connecticut and Nevada have mentioned it too.
“That’s not what it’s there for,” stated Torsch, who runs a nonprofit devoted to habit restoration in her son’s honor. “We want to make sure that money is being spent in the most responsible and effective way to help people that are still struggling.”

Final yr, when Torsch heard {that a} western Maryland county spent a few of its settlement cash on weapons, she reached out to her state legal professional normal to complain. The workplace stated it wasn’t its accountability, Torsch stated, and instructed her to contact the well being division.
She was confused.
The legal professional normal’s workplace is meant to signify “the top cops,” Torsch instructed KFF Well being Information.
The Maryland legal professional normal’s workplace declined to reply KFF Well being Information’ questions on the way it handles opioid settlement complaints.
A couple of dozen corporations are anticipated to pay state and native governments greater than $50 billion in opioid settlements over practically 20 years. Purdue Pharma’s case, essentially the most well-known, remains to be wending its method by way of courtroom. However different corporations, together with Johnson & Johnson, CVS Well being, and Walgreens, have begun paying.
Though the specifics of every settlement deal range, most require states to make use of not less than 85% of the cash on efforts associated to the opioid disaster. However enforcement is left to the businesses that paid out the cash. And authorized specialists are skeptical that the businesses are monitoring state spending.
Attorneys normal ought to be implementing that normal too, stated Stoltman, of the Opioid Coverage Institute. “If you’re going to bang your chest about how much money you got for your state for opioids,” he stated, “what are you doing to make sure that it’s actually being spent well?”
Stoltman’s and Kearl’s groups surveyed attorneys normal workplaces in 56 states and territories to see if every workplace had a grievance kind particular to this pot of cash, defined the main points wanted to report misuse, and allowed submitters to trace their complaints. Additionally they searched web sites of state auditors, comptrollers, and comparable entities for grievance types or procedures.

Their findings? Solely three states talked about particular processes for reporting misuse of opioid settlement cash.
South Carolina and New Jersey had hyperlinks on settlement-related web sites that directed folks to normal grievance types. Oklahoma was the one state to have an opioid settlement-specific kind.
Jill Nichols, opioid response and grant coordinator within the Oklahoma Workplace of Legal professional Common, stated it was created in April in response to the researchers’ inquiry. As of late June, she’d obtained one grievance, which was discovered to be with out benefit.
Stoltman and Kearl stated they hope the crowdsourced database will encourage extra attorneys normal to take an lively oversight position by illustrating how a lot potential misuse is happening.
The Michigan legal professional normal’s workplace stated it plans to publish a settlement-specific grievance kind this yr.
However some attorneys normal instructed KFF Well being Information it wasn’t their job to trace how the cash is spent.
Brett Hambright, a spokesperson for Pennsylvania Legal professional Common David Sunday, stated the state created an opioid settlement council to tackle that accountability.
In North Carolina, Legal professional Common Jeff Jackson’s workplace stated, settlement funds are managed by the state legislature and native governments. “Our office does not administer the funds nor do we have the power to withhold them,” spokesperson Ben Conroy stated.
Even when attorneys normal watch the cash carefully, their energy could also be restricted. For instance, Arizona Legal professional Common Kris Mayes went to courtroom final yr to cease the state legislature from giving $115 million in settlement funds to the Division of Corrections. However a decide dominated in opposition to her.
Maryland Legal professional Common Anthony Brown’s workplace directed KFF Well being Information’ inquiries to different state companies.
Michael Coury, a spokesperson for Maryland’s Workplace of Overdose Response, stated members of the general public can e mail the workplace with complaints. If the workplace agrees misuse has occurred, it should deliver the grievance to the legal professional normal, who — per the state’s settlement with native governments — “may” take motion.
As of this yr, the legal professional normal’s workplace will obtain $1.5 million of Maryland’s opioid settlement funds yearly to cowl personnel and administration prices associated to opioid-related lawsuits. This may increasingly contain suing extra corporations for future settlement offers.
Torsch, the Maryland mother, stated she needs the main target wasn’t simply on successful more cash but additionally making certain that present settlement {dollars} are spent properly.
“We owe it to all the families that have been destroyed and suffered great losses,” she stated.