Narcan, Drones, and Concerts: How Governments Spent Opioid Settlement Windfalls

Twenty-two million dollars to repay loans made to people working in the addiction field. About $12,000 for gun silencers. Sixteen dollars for a children’s book about Spookley the Square Pumpkin.

The purchases varied widely, but they all came from the same source: opioid settlement money.

The money, which comes from companies accused of fueling the overdose crisis, was used in more than 10,500 ways last year, according to an investigation by KFF Health News and researchers from the Johns Hopkins Bloomberg School of Public Health and Shatterproof, a national nonprofit focused on drug abuse.

That money is expected to exceed $50 billion over nearly two decades, paid by companies selling prescription painkillers. State and local governments are expected to spend most of their budgets on fighting addiction. The settlement agreements even described suggested uses and established other guardrails to limit unrelated uses – as happened with the Tobacco Master Settlement Agreement of the 1990s.

But there is still significant flexibility, and what is a good use for one person may be considered wasteful for another.

“People have died for this money. Families have been torn apart over this money. And to not spend it to try to improve our system, so that people don’t have to suffer these losses in the future, to me, is unconscionable,” said Stephen Loyd, an addiction doctor who was once addicted to opioids and has been an expert in several opioid-related trials.

To build the most comprehensive national database of settlement-related spending, KFF Health News and its partners filed public records requests, scoured government websites and extracted spending, which was then categorized into categories, such as treatment or prevention. Results include:

• States and localities spent or obligated nearly $2.7 billion in 2024, according to public records. Most of it went to investments that addiction experts say are crucial, including about $615 million for treatment, $279 million for overdose medications and $227 million for housing-related programs.

• The money is controlled by different entities in each state, and about 20% is not traceable in public records.

Explore the database here.