A pot of alleged “blood money” settlements for opioid addiction survivors is reportedly getting passed around by government agencies across the nation and spent in a questionable manner, a new report alleges.
Through a yearlong investigation, KFF Health News uncovered a number of expenditures with “tenuous ties to addiction,” among about 17,500 expenses, a Thursday report from the outlet shows.
Thirty-three percent of opioid settlement spending — totaling $1.2 billion — was used for “other” purposes, per the report. This was the largest such category of spending, ahead of “warm handoff programs and recovery services” (21%) and “medicaid-assisted treatment and other treatment” (14%).
This “other” spending includes $150,000 for street lighting in Camden, New Jersey, $130,000 for Flock Safety cameras in Carmel, Indiana, $36,200 for a pickleball court in Gilmer County, West Virginia and at least $84,000 for city insurance, building utilities, vehicle repairs, and other standard city expenses in Mullens, West Virginia, according to the report.
Meanwhile, Syringe Service Programs and Initiatives for Babies Exposed to Drugs in the Womb each received less than 1 percent of opioid settlement spending — despite being two out of nine core strategies recommended in most settlement agreements, the public records cited by KFF Health News show.
In New York, local governments directly control 46 percent of the opioid settlement money. They spent tens of thousands of dollars on surveillance cameras, technology to help police access data on locked cellphones and goggles that simulate being drunk, according to public records obtained by the nonprofit advocacy group Legal Action Center and shared exclusively with KFF Health News, the outlet reported in July.
KFF Health News conducted the investigation alongside the Johns Hopkins Bloomberg School of Public Health and Shatterproof, a national nonprofit dedicated to ending the addiction crisis. The piece is the latest in the outlet’s “Payback” investigation series, in it has scrutinized the use of opioid settlement money across state and local governments since 2022.
Advocacy organizations and groups argue that these governments lack sufficient oversight to track what these settlement funds are going towards, the report said.
Jasmine Budnella, director of drug policy at VOCAL-NY, an advocacy organization that is tracking settlement money as part of its mission to serve people affected by the war on drugs told KFF Health News that county governments have the chance “to go rogue” with the money and often punt responsibility to other agencies when people raise concerns about accountability.
“It feels like the Spider-Man meme, where it’s like everybody’s pointing at each other,” Budnella told KFF Health News, referring to a viral image from a 1960s cartoon featuring the superhero. “Somebody needs to be able to have the stick and slam their hand on the table and be like, ‘You’re doing this wrong and this is the consequence.’”
Democratic New York Attorney General Letitia James has issued dozens of press releases from her office about prosecuting pharmaceutical companies that fueled the overdose crisis and secured billions of opioid settlement dollars for the state. However, she passed the buck to other agencies when asked how to ensure the windfall is spent appropriately, the outlet said.
“While our partners in state and local governments distribute and oversee these funds, we will continue our work to hold accountable the companies responsible for fueling the spread of addictions and overdoses,” James spokesperson Grant Fox wrote in a statement to KFF Health News.
“The money is here because of their efforts,” Democratic New York state Sen. Nathalia Fernandez, who chairs the committee on alcoholism and substance use disorders told the outlet. “I believe it is under the Office of the Attorney General to enforce.”
State and local governments spent about $3.7 billion in opioid settlement funds in 2024 — more than the median annual income of 42,000 American families combined, KFF Health News found.
Over the span of about two decades, the settlement money will total about $60 billion, an opioid settlement tracker estimates. This sum is divided amongst state governments, counties, and city departments.
Settlement money comes from prominent pharmaceutical and drug companies sued for pushing painkillers and fueling the opioid crisis, such as Allergan — now acquired by biopharmaceutical company AbbVie — which agreed to pay up to $4.25 billion dollars in settlements over a period of 13 years.
These large amounts are intended to pay for addiction treatment, recovery housing, and other initiatives that public health researchers and affected families agree can make restitution to save lives and remediate the problem, KFF Health reported.
Over 105,000 people die from drug overdoses in a year, with opioids a direct factor in over 7 out of every 10 overdose deaths, according to the National Center for Drug Abuse Statistics (NCDAS).
Drug overdoses have killed over 1.25 million people since 1999, but are down 2.7 percent year-over-year in 2026, per NCDAS.
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