Reporting on Addiction launches hub for journalists covering opioid addictions, deaths and settlement dollars

As opioid settlement money continues to be divvied out to state and local governments, reporters can help their communities understand where the money is coming from and discern who and how their regional governments are spending it.

Reporting on Addiction, a collaborative project of the Opioid Policy Institute and 100 Days in Appalachia, provides reporters with an "Opioid Settlement Resource Hub" filled with robust story ideas and insights to use when covering the history, dollar amounts, tools and impact of opioid settlement funds in local communities.

For journalists looking to explain the history of opioids in the U.S. and the background of the settlements, the hub provides story angles and questions for reporters to consider, as well as examples from reliable news sources for context.

Once an audience knows more about how opioid addictions and overdose deaths negatively impacted their community and how settlement spending plans aim to spur recovery, journalists can create community-specific settlement tracking tools that serve as a valuable public resource. The hub provides links for numerous ways to investigate and report on settlement spending.

Is it working? Journalists can help their audiences measure if opioid settlement plans and spending are slowing the opioid crisis within their communities. Stories that evaluate the results and how plans evolve will become increasingly crucial as programs are implemented and more data becomes available.

A virtual chat on Sept. 17 will explain how journalists can track and report on opioid settlement fund spending

As part of its mission to help journalists cover opioid lawsuit settlement fund spending in their communities, Reporting on Addiction will host a virtual chat with Mississippi Today’s Allen Siegler and Kate Royals on Sept. 17 at 1 p.m. EST. 

Interested journalists can register here.

During the 30-minute session, Siegler and Royals will discuss:

• How to explain settlement spending with audiences that need specific and clear details on why opioid spending is vitally important to the future health of their communities.
• Outline how they work together -- as reporter and editor -- to shape stories that include complex public health and financial information that readers understand and find engaging.
• Tips on how to pitch accountability stories that get approved.

Siegler is Mississippi Today’s mental health reporter. He has reported on public health for nonprofit newsrooms such as Mountain State Spotlight, an investigative outlet in West Virginia, and Healthbeat, a startup with bureaus in Atlanta and New York City. He holds a master of public health degree.

Royals became Mississippi Today’s managing editor in June. She previously served as the newsroom’s community health editor. Under her leadership, the health team won the 2023 Bill Minor Prize for Investigative Reporting for its series “Shaky Science, Fractured Families,” which she co-reported.

Reporting on Addiction is a collaborative movement staffed by media professionals working to decrease addiction stigmas by sharing leading practices for covering all types of addiction.

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."

Proposed $7 billion Purdue settlement advances; leaves Sacklers exposed

Adobe Stock photo

Since last July when the U.S. Supreme Court rejected the Purdue Pharma opioid bankruptcy agreement, negotiation has continued. The latest offer from the Sackler family may have enough support from stakeholders to stick.

"OxyContin maker Purdue Pharma’s latest plan to settle thousands of lawsuits over the toll of opioids could soon move forward after every U.S. state involved agreed to it," reports Geoff Mulvihill of The Associated Press. U.S. Bankruptcy Court Judge Sean Lane "is being asked to clear the way for local governments and individual victims to vote on it next."

If Lane moves the agreement forward, impacted parties have until Sept. 30 to vote "on whether to accept the deal, which calls for members of the Sackler family who own the company to pay up to $7 billion over 15 years," Mulvihill explains. Roughly $6.5 billion of the settlement will be taken from the Sackler's wealth, and "potentially more than $850 million would go directly to individual victims."

The biggest change the reworked plan offers is that it does not guard Sackler family members from civil liability suits related to the opioid crisis. Groups that reject this settlement can continue litigation against Sackler family members. Mulvihill adds, "Under the plan, the Sackler family members would give up ownership of Purdue."

The $7 billion the Sacklers have put on the table pales in comparison to their exposure. Mulvihill reports, "The settlement is a way to avoid trials with claims from states alone that total more than $2 trillion in damages. Thousands of local governments and other groups have also sued Purdue."

While the settlement is an attempt to hold the Sackler family accountable for its part in the prescription drug crisis, the family will remain exceptionally wealthy and will continue to run its global pharmaceutical company, Mundipharma, which operates in the United Kingdom, Canada, Germany and Singapore. 

Microgrant deadline extended for reporting on opioid settlement funds

Reporting on Addiction, a collaborative movement staffed by media professionals working to address addiction, is extending its deadline to apply for 2025 microgrants for journalists reporting on opioid settlement funds in Kentucky, Maine, New Jersey or New York.

June 20 is the new deadline. Apply here.

As billions in opioid settlement funds enter the U.S. economy, how that money will be spent is unclear. Especially for individuals, families and communities touched by the opioid and fentanyl crisis, having journalists who use their investigative skills to follow who spends the money and on what is of vital importance. Watchdog reporters are needed as a primary, trustworthy source for people who want to hold public officials accountable for how these funds are used to address the addiction crisis.

To support this vital journalistic effort, Open Society Foundations is partnering with Reporting on Addiction to offer four microgrants ($500–$1,000 each) for journalists reporting in Kentucky, Maine, New Jersey and New York to investigate how opioid settlement funds are being allocated and spent.

Grants will support long-term reporting that help your audience understand the opioid settlements and show them where and how funds are being spent. Priority will be given to submissions focused on:

• Spending (or a lack of spending) related to evidence-based prevention, addiction, harm reduction, treatment and/or recovery.
• Issues with waste, fraud, abuse, or mismanagement of opioid settlement funds.
• Incorporating the perspectives of impacted community members.
• Helping communities understand the spending decision-making process (or lack of process).

Story pitch requirements: Pitches can be for any platform, print, digital, radio, television, podcast, etc. Freelancer submissions are welcome, but must have a letter of support from a publisher.

Grant awardees will receive free training: Awardees must agree to attend two virtual Reporting on Addiction trainings, share their final story, and have a commitment from a newsroom editor to publish their reporting by Feb. 1, 2026. Freelancers should secure a publication commitment before applying and supply supporting documentation.

States promised opioid settlement spending transparency, but many have already strayed from commitment

When states and local governments anticipated billions in opioid settlement dollars, 12 states committed to 100% spending transparency, "promising annual reports 'specifying the activities and amounts,' they have funded," reports Aneri Pattani of KFF Health News. "But many of those reports remain difficult, if not impossible, for the average person to decipher."

Idaho settlement dollars are an example. The attorney general’s website hosts "more than 90 standardized spending reports from state and local entities. Sounds great. But in reality, it reads like this: 'In fiscal 2023, the city of Chubbuck spent about $39,000 on Section G, Subsection 9.' Cracking that code requires a separate document," Pattani explains. "The Idaho attorney general’s office, which oversees the state’s opioid settlement reports, did not respond to requests for comment."

New Hampshire has a different transparency problem. "The state government controls 85% of the state’s settlement funds and posts reports from grant recipients on its opioid abatement website," Pattani reports. "The reports explain the projects and populations served but lack a key detail: how much money each organization received."

Accessing dollars and cents details means searching through "the opioid abatement advisory commission’s meeting minutes, which date back several years" or other state government meetings and notes.

Graph by Aneri Pattani and Lydia Zuraw, KFF Health News and Christine Minhee, OpioidSettlementTracker.com

Idaho and New Hampshire aren't the only states falling short of their commitment. Other states have zero reporting, even though many residents are asking for the information. Pattani writes, "One of the loudest and most frequent questions from the public has been: Where are the dollars going? Victims of the crisis, along with their advocates and public policy experts, have repeatedly called on governments to transparently report how they’re using these funds, which many consider 'blood money.'"

Of the 12 states that promised spending accountability, seven have "reported 100% of their expenditures in a way that is easy for the public to find and understand," Pattani reports. "There are also states such as Indiana that didn’t originally promise 100% transparency but are now publishing detailed accounts of their expenditures."

Sharing settlement spending information not only helps the public hold state and local officials accountable for their spending choices, but it can also foster hope. Norman Litchfield, the director of addiction medicine at St. Luke’s Health System in Idaho, told Pattani, "A lot of people simply are just not aware that these funds exist and that these funds are currently being utilized in ways that are helping."

Supreme Court blocks Purdue Pharma opioid settlement; agreement 'broke a basic tenet of bankruptcy law'

OxyContin's success made the Sacklers billionaires
and sparked the U.S. opioid crisis. (A.S. photo)

The U.S. Supreme Court rejected the Purdue Pharma opioid bankruptcy agreement that would have safeguarded Sackler family members from civil liability suits related to the opioid crisis.

"In a 5-to-4 decision, the justices found that the deal, carefully negotiated over years with states, tribes, local governments and individuals, had broken a basic tenet of bankruptcy law by shielding members of the Sackler family from lawsuits without the consent of those who might sue," reports Abbie Van Sickle of the New York Times. Purdue Pharma, which was owned by the Sackler family who developed and marketed the prescription painkiller OxyContin, is "largely considered to have ignited the [opioid] crisis."

Meanwhile, there are more than 100,000 opioid victim families waiting for financial restitution from Purdue Pharma. For some, the ruling is considered a setback. Other family members welcomed the decision. Van Sickle writes, "Although most creditors who voted on the proposed plan supported it, Justice Gorsuch wrote, 'fewer than 20 percent of eligible creditors participated' and 'thousands of opioid victims voted against the plan, too, and many pleaded with the bankruptcy court not to wipe out their claims against the Sacklers without their consent.'"

As Van Sickle reports, the court's majority "homed in on the method the Sacklers used to insulate themselves from opioid-related lawsuits, finding that a third party could not use the bankruptcy system to shield themselves from litigation, binding others without their consent. . . . This approach, Justice Gorsuch wrote, allowed them to win relief 'without securing the consent of those affected or placing anything approaching their total assets on the table for their creditors.'"

The proposed deal would have required the Sacklers to pay up to $6 billion over 18 years, but its building blocks demonstrate the tightrope negotiators are trying to walk between getting family members, states and tribes money now, even if the agreement shielded the Sacklers' personal wealth. "In a strongly worded dissent, Justice Brett M. Kavanaugh, "warned of the consequences for the tens of thousands of families seeking compensation," Van Sickle reports. "Justice Kavanaugh wrote that upending the settlement to prevent the Sacklers from escaping future litigation would only add to the pain of opioid victims and their families."

Within the deal's bankruptcy reorganization, Purdue Pharma "would become a 'public benefit' company with a mission focused on opioid education and abatement," Van Sickle reports. "The company, with the help of the Sacklers’ planned contributions, offered individual victims payments from a base amount of $3,500 up to a ceiling of $48,000." Purdue Pharma has committed to working toward a new settlement deal.

A simple tool can help identify and treat addiction while creating data for future programs and policies

Using evidence-based addiction screening tools can help
current and future patients. (Adobe Stock photo)

Treating opioid addiction requires practitioners to use multifaceted approaches, and adding process for regularly screening for Opioid Use Disorder is a small tool that can make big difference in patient intervention and data-driven policy, reports Kaitlyn Levinso of Route Fifty. "An under-utilized 'starting point for evaluating care is measuring what portion of the population is diagnosed with OUD. Knowing this information will help policymakers understand how well treatment systems identify people with OUD, which is the first step in getting them needed care,' said Alexandra Duncan, project director of Pew Charitable Trust's substance use prevention and treatment initiative."

Only two states are measuring for OUD as a part of their regular assessment tools for Medicaid patients. "Indiana and West Virginia have leveraged the Screening, Brief Intervention and Referral to Treatment, or SBIRT, model, an evidence-based approach for talking with patients about the use and misuse of drugs and alcohol," Levinso writes. "It helps health care providers flag concerning substance use behaviors in Medicaid patients and intervene with necessary resources and services to aid patient prevention or treatment and recovery of SUDs."

The Indiana SBIRT program provides practitioners with alcohol and drug abuse screening tools, Levinso reports. They also use "the CRAFFT tool, which helps identify substance use and associated behaviors in youth and adolescents, among others. The SBIRT model has been expanded for use at community health centers, federally qualified health centers and rural health centers in Indiana."

As states receive opioid settlement funds distributions, it could be an opportune time to focus on screening as a relatively inexpensive way to combat OUD. Duncan told Levinso: "These data will provide states with crucial information on allocating scarce resources more effectively, whether through increasing SUD screening or other data-driven treatment system improvements."

Opioid settlement funds won't be enough for some of the country's hardest-hit regions to rebuild and recover

For many counties, the opioid settlement funds won't be
enough to address the losses. (Adobe Stock photo)

As the first $50 billion in opioid-related settlement funds gets distributed to states, counties and municipalities, a painful reality is setting in: It won't be enough for these places to rebuild or recover what has been lost, report Arian Campo-Flores and Jon Kamp of The Wall Street Journal. 

Community leaders are finding that "the funds only cover a fraction of their wish list. Some of their projects likely aren't even eligible because of confusion over restrictions on how the money can be used."

Whitley County, Kentucky, is an example of a region that received settlement funds, but county leaders quickly recognized that the money would only scratch the surface of what is needed to spur recovery, the Journal reports. Whitney Wynn, a Horizon Health outpatient facility director, "wants to establish the area's first detox facility. Ideally, she said, such a center could send patients to a residential treatment site. But the settlement money wouldn't cover both projects."

Other regions are using the settlement money paired other funding to create facilities and programs to support change. "In Dickenson County, Va., officials are allocating $250,000 of roughly $330,000 in settlement funds received thus far for the rural area's first residential treatment facility," Campo-Flores and Kamp write. "The project's price tag is $7.7 million, so the remainder is coming from sources including a loan from a regional economic development authority."

Kentucky is expected to receive about $900 million in settlement funds, with "half administered by the state and half going to local governments," the Journal reports. While that sounds like big money, it isn't when compared with what the crisis has cost. "In 2017, Kentucky's estimated cost from deaths and lives undermined by addiction exceeded $24 billion. Per-capita costs there were among the nation's highest."

Robbie Williams, a judge-executive in Floyd, Kentucky, told the Journal the $1 million the country has received so far is just "a drop in the bucket" compared with what the opioid crisis has cost the community. He added, "We have so many unmet needs; we really don't know where to start."

The Journal reports, "Meanwhile, the opioid crisis — which started with pain pills and is now fueled by fentanyl — continues killing at a record pace. "

Some opioid settlement money is used to raise salaries and replace other funding; victims' families say that's wrong

Addiction recovery advocates say redirecting funds isn't
in the 'spirit of the settlement.' (Adobe stock photo)

As opioid settlement funds hit state, county and city coffers, some have been diverted for staff salary increases and already-established budgets. Victims' families and addiction treatment advocates argue the practice, formally known as known as supplantation, is not what the money was intended to do, reports Aneri Pattani of KFF Health News. "Local officials say they're trying to stretch tight budgets, especially in rural areas. But critics say it's a lost opportunity to bolster responses to an ongoing addiction crisis and save lives."

Commenting on what many see as misguided spending, Robert Kent, former general counsel for the Office of National Drug Control Policy, told Pattani, "To think that replacing what you're already spending with settlement funds is going to make things better — it's not. Certainly, the spirit of the settlements wasn't to keep doing what you're doing. It was to do more."

Opioid disbursements in Scott County, Indiana, are an example of how the money and disagreements on how to spend it are playing out. "In 2022, the county received more than $570,000 in opioid settlement funds," Pattani writes. "According to reports it filed with the state, it spent about 45 percent of that on salaries for its health director and emergency medical services staff. The money usually budgeted for those salaries was freed to buy an ambulance and create a rainy-day fund for the health department."

On balance, throughout the national waves of intense addiction trials -- from prescription to heroin to fentanyl -- many cities and counties redirected thousands of dollars to respond to the crisis. Now that settlement funds are coming in, "They want to recoup some of those expenses," Pattani reports. Some states have "restricted substituting opioid settlement funds for existing government spending, according to state guides created by OpioidSettlementTracker.com and the public health organization Vital Strategies."

While community spending can be complex, there are tools to help citizens identify the amount of opioid dollars their community has received to date. Pattani adds, "Use our searchable database to find out. Then, ask elected officials how they're spending those dollars. In many places, dedicated citizens are the only watchdogs for this money."

Opioid settlement payments to state and local governments can now be tracked with this online tool

KFF Health News tool, from BrownGreer data

Beginning in 2022, state and local governments started receiving opioid settlement funds from companies that made, sold or distributed prescription opioids. Tracking the flow of opioid money into communities can now be done using a new online database from KFF Health News, report Aneri Pattani, Lydia Zuraw and Holly K. Hacker. "Determining how much money has arrived is the first step in assessing whether the settlements will make a dent in the nation’s addiction crisis."

The database reflects only the largest settlement so far, $26 billion to be paid by pharmaceutical distributors AmerisourceBergen (now called Cencora), Cardinal Health and McKesson, as well as opioid manufacturer Janssen (now known as Johnson & Johnson Innovative Medicine). The $26 billion will be paid over two decades, KFF News reports. "As of late February 2024, more than $4.3 billion had landed in government coffers."

This first piece does not include settlements with other drug manufacturers and retailers, such as Walmart, Walgreens and CVS. Data from these companies will be added in July, according to BrownGreer, the settlement firm that gets the money and makes the payments. It is not handling some additional settlements, such as the agreement between Kentucky and four Midwestern states with regional supermarket chain Meijer.

Other settlements, including with OxyContin manufacturer Purdue Pharma, are pending.

As states receive more than $50 billion in opioid settlement money, companies are competing to get some of the funding

Caution is advised with settlement money.
(Photo by JP Valery, Unsplash)

Money from opioid settlements began to hit state coffers in November, and now a long line of companies and service providers want to help states spend it. Experts are urging caution, reports Aneri Pattani KFF Health News. Marketing pitches for everything from funding new psychedelic research to providing law enforcement with lassos instead of tasers have been flooding state and local officials in charge of distributing the more than $50 billion in settlement funds.

The billions in payments were intended as a punishment and warning to drug companies whose aggressive, harmful and often dishonest marketing practices "fueled an epidemic that progressed to heroin and fentanyl and has killed more than half a million Americans," Pattani explains. "The settlement money, arriving over nearly two decades, is meant to remediate the effects of that corporate behavior."

But as the dollars began to flow to states in early November, "a swarm of private, public, nonprofit, and for-profit entities began eyeing the gold rush," Pattani writes. "Some people fear that corporations, in particular — with their flashy products, robust marketing budgets, and hunger for profits — will now gobble up the windfall meant to rectify it."

JK Costello, director of behavioral health consulting for the Steadman Group, a firm that is being paid to help local governments administer the settlements in Colorado, Kansas, Oregon and Virginia, "receives multiple emails a week from businesses and nonprofits seeking guidance on how to apply for the funds," Pattani adds. "To keep up with the influx, he has developed a standard response: 'Thanks, but we can't respond to individual requests, so here's a link to your locality's website, public meeting schedule, or application portal.'"

KFF Health News "obtained email records in eight states that show health departments, sheriffs' offices, and councils overseeing settlement funds are receiving a similar deluge of messages," Pattani reports. "In the emails, marketing specialists offer phone calls, informational presentations, and meetings with their companies. Alabama Attorney General Steve Marshall recently sent a letter reminding local officials and vet organizations to reach out.

While some private sector companies will be partners, "the key, agree public health and policy experts, is to critically evaluate products or services to see if they are necessary, evidence-based, and sustainable — instead of flocking to companies with the best marketing," Pattani reports. "And, ultimately, failure to do due diligence could leave some jurisdictions holding an empty bag."