Good afternoon,

As opioid settlement funding continues to flow to states and localities, questions about transparency, equity, and effectiveness are coming into sharper focus. This week, national headlines point to two growing concerns: the spread of fentanyl misinformation and the limited compensation reaching victims of the crisis.

Despite overwhelming scientific consensus, myths about accidental overdose from simply touching fentanyl are driving public safety policy and, in some cases, influencing how settlement dollars are spent. At the same time, individuals who were directly harmed by prescription opioids are receiving small (or no)payouts, even as governments collect billions in restitution.

These stories remind us why community voices, harm reduction principles, and evidence-based strategies must remain at the center of this work.

Thanks for continuing to stay engaged, and for everything you do to build a healthier, more just response.

— The CEG Team

White House Releases Drug Policy Priorities

The Office of National Drug Control Policy (ONDCP) has released the Trump Administration’s 2025 Drug Policy Priorities, laying out a coordinated, federal approach to reduce overdose deaths and disrupt drug trafficking. The plan focuses on six key areas:

1. Reducing overdose fatalities (with a focus on fentanyl)
2. Securing the global drug supply chain
3. Blocking drug flows at U.S. borders
4. Preventing drug use before it starts
5. Expanding access to treatment and recovery
6. Investing in data and innovation.

The Administration emphasizes collaboration across government, public health, and public safety sectors as essential to addressing the complex nature of addiction and substance use disorder.

Viatris and Mylan to Pay $335M in Opioid Settlement with 15 States

Pharmaceutical company Viatris and its subsidiary Mylan Inc. have agreed to a $335 million, nine-year multistate settlement over allegations they deceptively marketed opioid products—particularly generic fentanyl patches—as less prone to abuse. Attorneys general from 15 states and the District of Columbia claim the company’s practices contributed to widespread overprescribing and diversion into the illegal drug market.

States involved in the settlement include: California, Colorado, Delaware, Georgia, Idaho, Illinois, Iowa, Massachusetts, New York, North Carolina, Oregon, Tennessee, Utah, Vermont, and Virginia.

Alabama

Huntsville Faces Rising Homelessness Linked to Substance Use

First Stop, a Huntsville-based nonprofit, reports over 600 new clients in just four months (AL.com).

The organization receives support from:

• $1.8M in city funding (over four years)
• Federal Community Development Block Grant funds
• Opioid settlement dollars

Local partners include:

• R.O.S.S. – substance use support & naloxone distribution
• Huntsville Hospital Foundation – medical care and prescriptions

Opioid Impact & Statewide Budget Actions

Alabama reported 1,221 overdose deaths in 2022, most involving fentanyl (State Opioid Dashboard).

The House Ways and Means General Fund Committee passed HB460, allocating:

Opioid Treatment and Abatement Fund dollars

Based on recommendations from the Oversight Commission on Opioid Settlement Funds

Other budget highlights (Alabama Political Reporter):

• Some decreases for Medicaid and Mental Health (due to expiring pandemic-era funds)
• Continued investment in opioid response and early childhood programs

Kentucky

The Kentucky Opioid Abatement Advisory Commission recently awarded $19.8 million to 75 organizations to expand treatment, prevention, and recovery services statewide, including housing and peer support programs. Additional state-led investments have targeted high-need areas, with new grants going toward medication access and workforce development. Recipients include:

• Goodwill Industries of Kentucky: $397,539
• Hazard Community & Technical College: $500,000
• Unlawful Narcotics Investigations, Treatment & Education (Operation UNITE): $859,000

A qualitative study of Kentucky treatment organizations identified ongoing barriers to scaling medications for opioid use disorder (MOUD), including staffing shortages, stigma, and structural limitations in rural areas.

At the local level, counties like Spencer have approved the purchase of drug incinerators to support safe disposal of illicit substances, while Rowan County’s fiscal court passed its 2025–26 budget approved opioid abatement funding to renovate a DOVES of Gateway shelter.

Attorney General Coleman is working to close a legal loophole related to fentanyl analogs, and legislators are reviewing additional bills tied to behavioral health, housing, and justice system coordination. This includes HB 537, which ensures that all opioid settlement funds go directly into the Opioid Abatement Trust Fund and gives the attorney general the authority to set rules on spending.

Maryland

Maryland is seeing significant progress in reducing overdose deaths, with a reported 34.4% decline in fatal overdoses from 2023 to 2024, according to the Maryland Overdose Data Dashboard. This progress was a central focus of the state’s first Substance Use Awareness Advocacy Day held in Annapolis, where Lt. Governor Aruna Miller, Special Secretary of Overdose Response Emily Keller, and a broad coalition of community members and officials gathered to share strategies, stories, and solutions.

The state’s newly released strategic plan for overdose reduction centers around five priority areas:

1. Prevention
2. Harm Reduction
3. Treatment
4. Recovery
5. Public Safety

To support this work, Maryland recently awarded $12.4 million in competitive grants from its Opioid Restitution Fund, part of the $650+ million the state expects from national opioid settlements over the next 15–18 years.

In Baltimore City, where overdose rates remain among the highest in the state, city officials are juggling overlapping fiscal and public health priorities. Mayor Brandon Scott’s proposed FY 2026 budget aims to close an $85 million deficit without cutting services by increasing fines and fees on quality-of-life violations, ambulance rides, and landfill tipping. This strategy is intended to preserve investments in public health and safety while navigating financial uncertainty.

New York

New York’s opioid response is facing significant stress and scrutiny as federal funding cuts collide with the urgent need to sustain and expand addiction services. Local and state leaders are leveraging opioid settlement funds to fill critical gaps, while advocates push for greater transparency and accountability.

Crisis Response in Monroe County

• Delphi Rise, Monroe County’s only 24/7 open access substance use treatment center, lost federal funding after the Trump administration rescinded $12 billion in public health grants nationwide.
• County Executive Adam Bello has proposed using $405,000 in opioid settlement funds to keep Delphi’s services operational through 2025, noting that more than 2,000 people relied on the center last year.
• Congressman Joe Morelle joined Bello in condemning the cuts and urging immediate local action: “Delphi is a lifeline in the dark — we cannot let it close.”
• The crisis spotlights broader vulnerabilities, as New York State’s substance use services face $40 million in losses due to federal cuts.

Statewide Funding & Accountability

• Attorney General Letitia James announced a new settlement with Mylan, securing up to $335 million nationally as part of her office’s ongoing efforts to hold pharmaceutical companies accountable. New York has now secured over $3 billion in total opioid-related settlements.
• Broome County has seen a 40% decrease in fatal overdoses over two years, with funds used for jail-based treatment, recovery services, and community outreach. However, drug-related crime remains high, especially involving methamphetamine and fentanyl.
• Seneca County will allocate $84,417 in settlement funds to the United Way for prevention and harm reduction work. Local leaders are also exploring creative revenue-sharing solutions like jail space rental to NYC.

Legislators and advocates in Nassau County are demanding accountability for nearly $100 million in settlement funds, of which less than $5 million has been spent.

• Critics like Legislator Delia DeRiggi-Whitton call the county’s failure to act a “shocking” breach of duty, urging the hiring of outside experts to fix a broken distribution process.
• Only after intense questioning did county officials acknowledge delays and inefficiencies in the Department of Human Services’ management of funds.

North Carolina

North Carolina continues to lead in opioid settlement recovery efforts, but disparities, implementation delays, and federal funding shortfalls are testing the system’s ability to respond equitably and effectively across the state.

New Settlement Expands Statewide Resources

• North Carolina will receive up to $9 million from a new national settlement with Mylan Pharmaceuticals over deceptive opioid marketing.
• This brings the state’s total opioid settlement funds to $1.6 billion, with $1.3 billion allocated directly to counties and municipalities.
• Spending is tracked through the CORE-NC platform for transparency.

Implementation Gaps: Progress vs. Paralysis

• Only 12 of 100 counties have completed strategic spending plans required by the state. Wilkes County stands out for its swift progress:
• Has already implemented 15 strategies.
• Invested $3 million in services including jail-based addiction treatment and recovery support.
• Success attributed to partnerships with The Health Foundation and maintaining project leadership continuity.

Community-Based Innovation in Rural Areas

• Edgecombe County created a post-overdose response team, offering in-home care, fentanyl testing, and harm reduction services.
• The team designed services based on feedback from residents with lived experience, emphasizing equity and relevance.
• Rural counties like Nash and Beaufort are also mapping long-term strategies with a community-first approach.

Black North Carolinians now experience overdose deaths at more than double the rate recorded in 2019. In 2021, overdose deaths among Black residents reached 38.5 per 100,000. Groups like Hajee House Harm Reduction in Charlotte are leading culturally responsive outreach and services:

• Naloxone distribution, fentanyl test strips, safe-use kits.
• Community events that feel like block parties, helping normalize harm reduction in Black neighborhoods.
• Advocates note systemic barriers: lower treatment access, insurance hurdles, and criminal justice fears that limit service engagement.

Ohio

Ohio’s total opioid settlement pool now exceeds $2 billion, stemming from lawsuits with opioid distributors and manufacturers. Funds are distributed via a three-tier model:

• 15% retained by the state
• 55% managed by the OneOhio Recovery Foundation
• 30% allocated directly to local governments

Attorney General Dave Yost launched the Opioid Remediation Grant Program, directing $60 million over several years to Ohio jails for addiction services. In the first $1.2 million round of grants, eight counties received funding to support inmate addiction care:

• Richland & Trumbull Counties: $250,000 each
• Summit: $187,200
• Erie: $177,516
• Washington: $144,470
• Ashland: $114,788
• Wyandot: $95,252
• Medina: $50,000 — used to provide long-acting injectable Sublocade to reduce relapse risk upon release

Lima City Council approved opioid settlement spending to:

• Fund a juvenile intervention specialist
• Expand peer support through Lighthouse Behavioral Health

Allen County and Lima collaborated to match OneOhio grant funds, emphasizing non-duplicative services across systems.

Scioto County, long considered the epicenter of Ohio’s opioid crisis, continues to raise concerns about underfunding. Despite having Ohio’s highest per capita overdose death rate, the county received just $800,000 so far.

• HopeSource, a local nonprofit, has been denied funding for a recovery clubhouse and is urging greater access to direct, community-focused investments.
• The OneOhio Region 9 board has awarded $2.75 million in grants, but few have targeted Scioto County directly.

Pennsylvania

Bucks County is receiving approximately $70 million over 18 years from national opioid settlements. To manage this investment, the county created a full-time Opioid Settlement Program Manager position. The role provides:

• Fiscal and programmatic oversight
• Contract management and compliance
• Cross-departmental coordination
• Monitoring and technical support for community providers

$13,500 in settlement funds was awarded to Planned Parenthood Keystone’s Rainbow Room, an LGBTQ+ youth program, to fund transportation to their new site in Langhorne.

The program offers a safe space, homework help, and behavioral health engagement for youth ages 14–21. Funding aims to address substance use disparities among LGBTQ+ youth, who face higher rates of opioid misuse and access barriers to affirming care.

Bucks County also hosted an in-person forum April 8 and will host a virtual forum later this spring to solicit public input on opioid settlement spending.

Luzerne County earmarked $260,000 in opioid funds to prevent cuts to outpatient substance use services, including MAT. County leaders emphasized that without this funding, they would have had to reduce service frequency for residents.

South Carolina

South Carolina is set to receive up to $600 million over 15 years from national opioid settlements with companies including Johnson & Johnson, CVS, Walgreens, Teva, and Allergan. At least 92% of settlement funds must be used for opioid abatement, including treatment, prevention, education, harm reduction, and recovery support.

Hampton County Detention Center is now home to one of three Narcan vending machines in South Carolina, funded by opioid settlement dollars. A ribbon cutting ceremony was held on April 3 to mark the installation. The vending machine provides free, 24/7 access to naloxone (Narcan) for the public and recently released inmates.

• Holds 180 boxes, each with two doses of Narcan.
• Accompanied by educational materials and local treatment resources.
• Individuals can buzz detention center staff after hours to receive Narcan and instructions.
• All released individuals are now automatically provided Narcan and referral information.

Hampton County 2024 Statistics (via New Life Center):

• 38 overdoses, including 1 fatality
• 28 Narcan administrations by EMS
• 398 Narcan kits distributed
• 108 clients admitted to treatment, with 18 reporting opioids as their primary substance

In 2023, South Carolina saw a 6.1% decrease in overdose deaths, the first drop since 2014. Largest reductions were in:

• Greenville County: -25%
• Greenwood County: -40.5%
• Union County: -30.3%

However, 15 counties still exceeded the statewide average of 41 overdose deaths per 100,000 residents.

• Jasper County had the highest rate: 118 per 100,000.
• Chesterfield County experienced back-to-back overdose spikes in 2023 and 2024, with multiple fatalities occurring within 48-hour windows.
• Overdoses linked to fentanyl-xylazine mixtures and other synthetic “gray death” drug cocktails.
• Alpha Behavioral Health, the county’s treatment provider, is ramping up distribution of Narcan and testing strips ahead of expected summer spikes.

Tennessee

Tennessee will receive over $1 billion in settlement funds are being disbursed over 18 years through the Tennessee Opioid Abatement Council, with funds reaching all 95 counties. Tennessee’s Opioid Abatement Council (OAC) ensures county funds are used for evidence-based strategies as outlined in Exhibit E (Remediation List). Key focus areas include naloxone distribution, MAT expansion, sober housing, youth prevention, community outreach, and data collection.

ReVIDA Recovery Centers Expanding in East Tennessee

• New clinics in Fountain City and Oak Ridge will expand access to MAT and behavioral health services.
• Part of the “Treatment for All” initiative, funded by the Opioid Abatement Council, offering free care to uninsured Tennesseans.
• ReVIDA now operates 16 outpatient centers across the state.

HOPE Family Health – Narcan & Fentanyl Strip Vending Machines

• Public Health Vending Machines installed in Westmoreland, Lafayette, and Hartsville.
• Free NARCAN and fentanyl test strips available 24/7 to reduce fatal overdoses.

Anderson County awarded $427,000 in grants to 12 organizations, including:

• Free Medical Clinic ($81K)
• Recovery Court ($65K)
• ASAP ($39K)
• Churches
• Housing programs
• Drug disposal initiatives

Anderson County commission created a public application portal and hosted multiple town halls. Implementation is supported by the UT SMART Initiative for data collection and evaluation.

Sumner County – Recovery Infrastructure Planning

Total received: $901K (2023), $892K (2024), $710K (2025).

Dual strategy: Fund immediate services + invest in long-term infrastructure.

Highlights:

• Highpoint Health and partners created an emergency response & treatment linkage program.
• Planning underway for:
• Permanent Recovery Court facilities ($500K proposal)
• A women’s recovery housing project led by Sumner Prevention Coalition
• Potential property transfer of former youth facility to local prevention groups

Lawrence County created Lawrence County Opioid Board to manage funds and oversee a competitive annual grant process.

• Up to 20% of funds held for urgent needs.
• Grant applicants must align with the state remediation strategy and provide detailed data on outcomes and population served.

Hawkins County approved $289,000 for an EMS-led overdose follow-up program:

• EMS teams will deliver Narcan, offer referrals, and provide harm reduction education at overdose scenes.
• Funds will support vehicles, outreach materials, and medical response supplies.

Future plans:

• Judge Todd Ross proposed a Recovery Court residential facility to serve individuals who lack housing or family support.
• Officials committed to exploring this use for future settlement funding.

Virginia

Virginia will receive $6.6 million as part of a $335 million multistate settlement with pharmaceutical company Mylan Inc. (now Viatris). Attorney General Jason Miyares emphasized that funds will support “treatment, prevention, and recovery” initiatives, reinforcing Virginia’s commitment to accountability and healing.

The Virginia Opioid Abatement Authority recently hosted the Opioid Abatement Academy on March 27 to help municipalities build capacity for effective fund management. The academy focused on:

• Allowable uses of funds (aligned with Exhibit E)
• Grant application strategies
• Reporting and evaluation standards
• Peer learning from other localities

This marks a shift toward institutionalizing best practices and ensuring that rural and urban communities alike can leverage resources effectively. Watch the full recording here.

The Martinsville City Council is considering the creation of a Kinship Navigator Family Services Specialist. This position, jointly funded with Henry County, will support kinship caregivers, such as grandparents raising grandchildren, and strengthen permanency for children in foster or informal care. The specialist will be skilled in prevention, substance use identification, and recovery support—all aimed at mitigating youth risk of opioid misuse.

• Cost: $254,932 over 3 years; Martinsville’s portion of $84,892 would come entirely from opioid settlement funds, with no local match required.

The Council is also preparing an application for Individual Distribution and Gold Standard Funds through the OAA. The proposed projects emphasize cross-sector collaboration, with the Department of Social Services playing a leadership role.

Martinsville FY 2025–2026 Budget Context:

• City Manager Aretha Ferrell-Benavides presented a $87.2 million proposed budget, which includes opioid settlement-related allocations.
• Community priorities include:
• $2.4 million in outside agency funding, much of it related to health and social services.
• A continued focus on public safety and EMS, with a combined proposed budget of over $3.2 million.
• Council is actively exploring ways to streamline tax relief, particularly for seniors, veterans, and low-income households—some of whom may also benefit from opioid prevention and recovery services.

In 2023, Southside Virginia received $8.7 million of the state’s $23 million in opioid settlement funding. Localities like Martinsville and Henry County are aligning efforts to share staffing and coordinate impact, a model that the OAA has encouraged.

West Virginia

Facing rising jail costs and debt from expanding its Day Report Center, Berkeley County voted to transfer $1.16 million from its opioid settlement fund into the general operating budget. The funds will cover roughly half of the county’s FY2025 debt service and nearly $800,000 in regional jail overages. While the move was approved unanimously, commissioners flagged concerns about the sustainability of using one-time settlement dollars for recurring expenses, stressing the need for strategic planning before funds begin to diminish in future years.

The City of Lewisburg allocated $357,008 to add a new Opioid Task Force officer, enhancing the city’s ability to respond to drug-related emergencies and community harm. The position was highlighted during the city’s annual review, which also included updates on major infrastructure projects and revitalization efforts. City Manager Misty Hill emphasized the importance of fiscal responsibility and bringing every expenditure to council with transparency.

Weirton is deploying its opioid funds directly into emergency services:

• The Police Department received $211,655 to purchase K-9 vehicles, license plate readers, and video surveillance systems.
• The Fire Department was awarded $277,555 for AEDs, a LUCAS CPR device, and associated medical training.

City Manager Mike Adams noted more applications are under review. The city’s process requires applicants to demonstrate alignment with one of five priority areas: education, prevention, emergency services, intervention, or rehabilitation.

Morgantown earmarked $121,000 from its opioid settlement funding in its FY25–26 budget. The funds are part of a multi-pronged approach that includes investments in public health, arts and culture, and parks. Finance Director Jonathan Furgison emphasized the city’s commitment to fiscal stewardship and strategic community investments.

The West Virginia First Foundation (WVFF), which manages a significant share of the state’s opioid settlement dollars, awarded $6.21 million in its most recent supplemental grant round. Funds are now at work in all 55 counties, supporting efforts ranging from school-based prevention programs to mobile harm reduction units. The WVFF has stressed the importance of quarterly reporting, outcome tracking, and transparency in all funded projects.

Weirton, West Virginia — application info. (“[f]unding decisions are made by the Weirton City Council”) (courtesy of OpioidSettlementTracker.com)

West Virginia First Foundation (RFP) Needs Assessment— application info.. (DUE 4/18)

Lawrence County, TN Round 2: Opioid Abatement Settlement Grant— application info. (DUE 5/4)

Cumberland County, NC (RFP) to Address Opioid Crisis— application info. (DUE 5/30)

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