The settlements with opioid companies outlined specific uses for the funds to ensure they are used for their intended purpose. But there have still been several examples of states and localities using them for projects that will not be effective in addressing the opioid crisis.

• Plus, with federal funding for addiction now being slashed and Congress approving massive reductions to Medicaid, there is concern the funds will be used to fill budget shortfalls.

Recent examples:

• At least 9 counties in West Virginia have used a total of more than $3.5 million in opioid settlement funds to pay off at least a portion of their regional jail bill. The memorandum of understanding that guides how the funds can be spent acknowledges regional jail fees as an approved use, saying it provides “restitution for monies that were previously expended on opioid abatement activities.” But experts argue this will not help people with addiction.
• New Jersey’s recently enacted budget sends $45 million in opioid settlement funds to four health care systems, ignoring the recommendations of the Opioid Recovery and Remediation Advisory Board. Gov. Murphy defended the provision, promising that there would soon be another round of funding for opioid prevention, that the hospitals will meet with the advisory board, and that his administration will track the funds to ensure they are used for evidence-based programming in compliance with the settlements.
• The New Jersey comptroller found that Irvington, New Jersey, wasted and misspent over $632,000 on two “Opioid Awareness Day” concerts that did little to promote opioid awareness or provide services to people with opioid use disorder. A substantial portion was paid to an employee who was hired to secure musical performers for the event. Over $200,000 was spent on promotional materials advertising the events, but none included information about obtaining treatment or avoiding opioid misuse. Tens of thousands of dollars went toward luxury trailers for the performers and food supplies like popcorn machines, cotton candy machines, and shaved ice.

The big picture:

• Only 3 states have specific processes for reporting misuse of opioid settlement money.
• State attorneys general (AGs) secured the settlement agreements, but some argue it isn’t their job to track how the money is spent. They are largely not responsible for distributing funds, and the settlements detail that the companies are responsible for tracking the spending. Even when AGs watch the money closely, their power may be limited to control how the money is spent.

BUT: Opioid Policy Institute and Popular Democracy launched a crowdsourced database to identify potential examples of misuse and prompt state AGs to investigate.

• The website allows members of the public to submit alleged cases of waste, fraud, abuse, and mismanagement of opioid settlement funds.
• Submissions are reviewed and then posted with details such as how much money was spent, what was purchased, who made the decision, and links to relevant news articles or budget documents.
• The website shows people how to file complaints with their state AGs and ask the offices to develop a formal process for receiving and investigating such complaints.