Aneri Pattani
In the guts of Appalachia, legislation enforcement is commonly seen as being on the entrance line of the dependancy disaster.
Bre Dolan, a 35-year-old resident of Hardy County, West Virginia, understands why. Throughout her childhood, when her dad had dependancy and psychological well being crises, cops have been usually the primary ones to reply. Dolan calls them “good men and women” who “care about seeing their community recover.”
But she’s skeptical that they’ll mitigate the basis causes of an dependancy epidemic that has racked her house state for many years.
“Most of the busts that go down are addicts,” she mentioned — individuals who want remedy, not jail.
Dolan’s father was considered one of them. And so was she.
Now 14 years into restoration, she’s been shocked to see many native officers spending opioid settlement cash — an inflow of money from corporations accused of fueling the overdose disaster — on police Tasers, cruisers, evening imaginative and prescient gear, and extra.
“How is that really tackling an issue?” Dolan mentioned. “How will it help families battling addiction?”
Nationwide, greater than $61 million in opioid settlement funds have been spent on legislation enforcement-related efforts in 2024, based on a yearlong investigation by KFF Health News and researchers on the Johns Hopkins Bloomberg School of Public Health and Shatterproof, a nationwide nonprofit targeted on dependancy. That included initiatives that public well being specialists largely help, corresponding to hiring social employees to accompany officers on overdose calls, in addition to actions they’re extra skeptical of, corresponding to beefing up police arsenals.
Over practically 20 years, state and native governments are set to obtain more than $50 billion in opioid settlement cash, which is meant for use to struggle dependancy. The settlement agreements even outlined suggested uses and established different guardrails to restrict unrelated makes use of of the funds — as happened with the Tobacco Master Settlement Agreement of the Nineteen Nineties.
But there’s nonetheless vital flexibility with these {dollars}, and what constitutes a great use to at least one particular person will be deemed waste by one other.
To Stephen Loyd, an dependancy drugs physician who was as soon as hooked on opioids and has served as an knowledgeable in a number of opioid lawsuits, some legislation enforcement bills fall into that second class.
Drones and police officer salaries aren’t “in the spirit of what we wanted to use the money for when we were fighting for it,” Loyd mentioned.
“People died for this money. Families were torn apart for this money. And to not spend it to try to make our system better, so that people don’t have to experience those losses going forward, to me, is unconscionable,” he mentioned.
As a part of this investigation, KFF Health News and its companions compiled essentially the most complete nationwide database of opioid settlement spending to this point, that includes greater than 10,500 examples of how the cash was used (or not) final 12 months. The staff filed public data requests, scoured authorities web sites, and extracted expenditures, which have been then sorted into categories, corresponding to remedy or prevention. The findings embrace:
Nearly $2.7 billion — that’s the quantity states and localities spent or dedicated in 2024, based on public data. The lion’s share went to investments dependancy specialists contemplate essential, together with about $615 million to remedy, $279 million to overdose reversal medicines and associated coaching, and $227 million to housing-related packages for individuals with substance use problems.
Smaller, although notable, quantities funded legislation enforcement initiatives — corresponding to making a capturing vary and tinting patrol automotive home windows — and prevention packages that specialists known as questionable, corresponding to placing on a fishing match.
Some jurisdictions paid for fundamental authorities providers, corresponding to firefighter salaries.
The cash is managed by totally different entities in every state, and about 20% of it’s untrackable via public data.
This 12 months’s database, together with the expenditures and untrackable percentages, shouldn’t be in contrast with the one KFF Health News and its companions compiled last year, because of methodology changes and state finances quirks. The database can not current a full image as a result of some jurisdictions don’t publish studies or delineate spending by 12 months. What’s proven is a snapshot of 2024 and doesn’t account for choices in 2025.
Still, the database helps counteract the secrecy among some of those in cost of settlement money and confusion amongst these tracking it.
‘How My Population Would Like Me To Vote’
Dolan has seen intergenerational dependancy up shut. When her father was excessive, he generally kicked teenage Dolan out of the home along with her toddler siblings. She began ingesting early and progressed to different medication, finally touchdown in jail.
Although she managed to search out restoration on her personal, even touchdown a job as an EMT, she desires to make the trail simpler for others.
If settlement cash have been used to rent social employees or construct household restoration packages, it may change the course of a child’s life, she mentioned.
“Maybe people could have helped my dad get into recovery and gave him therapy,” she mentioned. “Anything could have happened.”
But many native officers say legislation enforcement is likely one of the few instruments they’ve, particularly in rural areas. And their constituents imagine it’s efficient.
“If the goal was treatment and prevention, it would have been better to throw [the money] into a big grant system and give it to treatment centers,” mentioned Cris Meadows, metropolis supervisor of Oak Hill, West Virginia, which paid more than $67,000 for a drone and surveillance cameras for its police division. “Unfortunately, local governments are really not set up to do that.”
Clarkdale, Arizona, Town Manager Susan Guthrie mentioned her city purchased nearly $15,000 worth of drones as a result of they assist with enforcement — corresponding to recording crime scenes and conducting search-and-rescue operations — in addition to schooling, when officers work together with youngsters at group occasions.
Similar views nationwide have led to spending that features:
About $12,000 for rifle suppressors (also called silencers) in Alexandria, Indiana.
About $21,000 for Tasers in Mooresville, Indiana.
About $49,000 to replace outdated body cameras and Tasers in Hardy County, West Virginia.
Nearly $70,000 in Lewisburg, West Virginia, so as to add a police officer to the county’s drug job power, change that officer regionally, purchase weapons and autos, and tint automotive home windows.
Several elected officers mentioned their selections mirror native politics.
That’s “how my population would like me to vote,” Hardy County Commissioner Steven Schetrom mentioned of his fee’s purpose to spend a few quarter of its settlement cash on legislation enforcement.
Mooresville Town Council President Tom Warthen informed KFF Health News, “People have petitioned our government for less taxes but have never petitioned for less services” from the native police power. With federal and state finances cuts looming, the city have to be resourceful, he mentioned, including that the Tasers have been purchased with a portion of settlement funds that don’t have any restrictions.
After these purchases, an Indiana fee issued a list of legislation enforcement gear that it cautioned in opposition to shopping for with restricted settlement {dollars}. California, Kansas, and Virginia have launched comparable lists.
Research backs these restrictions. Studies have proven that drug busts and arrests can exacerbate the overdose crisis. Officers responding to overdoses usually arrest people, making individuals who use medication fearful of calling 911 or seeking treatment via police.
In distinction, equipping cops with overdose reversal medicines has been shown to save lives. That’s a key part of an $18 million effort in Texas, the state with the best share of reported legislation enforcement spending.
Police and Firefighter Salaries
Some locations used settlement funds to take care of fundamental first responder providers.
For instance, Mantua Township, New Jersey, used about $79,000 to “offset police salary and wages” and, based on its public spending report, plans to do so annually. Township officers didn’t reply to requests for remark.
Los Angeles County allocated $1 million to cowl a portion of firefighter salaries and advantages final 12 months and estimates it would use one other $1 million this 12 months.
County fireplace division spokesperson Heidi Oliva mentioned opioid funds have been used to fill a finances hole till income kicked in from a new tax voters approved final November.
The use of funds was “appropriate,” she mentioned in an e mail, as a result of “the opioid crisis presents a significant burden to EMS response, from dispatch through arrival at hospitals, clinician mental health/burnout, and a variety of other factors.”
Using opioid cash to interchange different income is legal in most places. But it’s considered bad practice.
“I don’t want to see this money used to make up for stuff that would be paid for anyway,” mentioned Daniel Busch, chair of the FED UP! Coalition, a nationwide advocacy group representing many mother and father who’ve misplaced kids to dependancy.
Settlement {dollars} are “the only financial representation from the governments and from the drug companies” of households’ losses, Busch mentioned. To see that cash used to take care of the established order is “painful” and “distressing.”
Busch fears this observe will become more common as states grapple with federal finances cuts.
Already in New Jersey, lawmakers allocated $45 million in settlement funds to well being programs to cushion in opposition to anticipated Medicaid losses — a transfer opposed by the state’s attorney general, opioid settlement advisory council, and advocates.
However, some states are taking proactive steps.
Colorado released guidance this 12 months in opposition to such actions.
“These dollars can’t be part of budget games where we simply backfill existing programs,” state Attorney General Phil Weiser informed KFF Health News. “We have to build on whatever we’re doing because it hasn’t been enough.”
Other states, corresponding to Maine, Maryland, and Kentucky, are newly requiring native governments to report how they spend the cash, which can make it simpler to identify disputed practices. Officials in Delaware, Hawaii, Massachusetts, and Missouri mentioned they count on to revamp their public reporting programs to extend transparency by early 2026.
In Mississippi, which produced no substantive public studies final 12 months, the lawyer normal’s workplace has set up a website that may host spending data after Dec. 1.
Jennifer Twyman is anxious to see some optimistic modifications.
“We have people literally dying on our sidewalks,” mentioned the Louisville, Kentucky, advocate.
Twyman struggled with opioid misuse for 20 years and now works with Vocal-KY to finish homelessness and the battle on medication. To her, any spending that doesn’t immediately assist individuals with dependancy betrays the settlement’s function.
“It is the blood from many of my friends, people that I care deeply about,” she mentioned. “That money could have been me, could have been my life.”
Read the methodology behind this challenge.
KFF Health News’ Henry Larweh; Shatterproof’s Kristen Pendergrass and Lillian Williams; and the Johns Hopkins Bloomberg School of Public Health’s Abigail Winiker, Samantha Harris, Isha Desai, Katibeth Blalock, Erin Wang, Olivia Allran, Connor Gunn, Justin Xu, Ruhao Pang, Jirka Taylor, and Valerie Ganetsky contributed to the database featured on this article.
The Johns Hopkins Bloomberg School of Public Health has taken a number one function in offering steering to state and native governments on the usage of opioid settlement funds. Faculty from the varsity collaborated with different specialists within the subject to create principles for using the money, which have been endorsed by over 60 organizations.
Shatterproof is a nationwide nonprofit that addresses substance use dysfunction via distinct initiatives, together with advocating for state and federal insurance policies, ending dependancy stigma, and educating communities in regards to the remedy system.
Shatterproof is partnering with some states on initiatives funded by opioid settlements. KFF Health News, the Johns Hopkins Bloomberg School of Public Health, and the Shatterproof staff that labored on this report aren’t concerned in these efforts.
