W.Va. local governments get 24.5% of opioid settlement funds, but the oversight and how the funds are spent varies

Graph by Hannah Heiskell, data from West Virginia First Memorandum of Understanding 

In 2021, West Virginia lost more than one thousand residents due to opioid overdose deaths. Between 2021 and 2024, the state ramped up its prevention and treatment efforts, some of which now benefit from opioid settlement dollars. As investigative student reporters from West Virginia University’s Reed School of Media discovered, how those funds are spent varies widely throughout the state.

"West Virginia will receive about $980 million from the settlement, split into payments over 18 years," reports Hannah Heiskell for Mountain State Spotlight. "The West Virginia First Foundation – a nonprofit created by the state Legislature – will control the spending of 72.5% of the funds, local governments 24.5%, and the West Virginia Attorney General’s Office 3%."

How local governments spend their chunk of settlement funds is limited by state guidance, but includes "increasing access to treatment or prevention-education programs."

With those constraints in mind, WVU student reporters looked at "how local governments oversee that money, including the process through which they take applications, make awards and account for spending," Heiskell explains. Since each local government can make its own decisions, "oversight and accountability built into local spending can be markedly inconsistent from county to county – with some doing very little to collect the advice and opinions of addiction experts or people with lived experience."

Local funding is often decided by county commissioners, who are not subject to the oversight by the West Virginia First Foundation. "While county commissioners are not required to have expertise in substance use disorders or follow a specific application, review, or awarding process, Laura Lander, addiction therapist and associate professor at West Virginia University’s Rockefeller Neuroscience Institute, said this thinking confused her," Heiskell reports.

"Without input from external sources and stakeholders, Lander said funding awards are subject to a commissioner’s individual bias," Heiskell writes. Lander told her, "Clearly, in other counties, based on what I’ve seen, the money used for law enforcement has the county commissioner’s ear, and we see lots of money going towards police vehicles."

Kanawha County Commission has opted to share some details by "posting all applications to their website for the public and other organizations to review," Haskell writes. "In contrast to many counties in the state, the Preston County Commission has taken a more deliberate approach to its spending. . . . It's one settlement and 55 systems."