Stockings and concerts: How some venues spent opioid settlement money

Officials in Irvington, New Jersey, had an idea. To raise awareness about the dangers of opioid use and addiction, the town can host concerts with popular R&B artists such as Q Parker and Soulchild Music. It spent more than 600 thousand dollars In 2023 And 2024 To pay for shows, and even foot the bill for VIP trailers for performers. Bought cotton candy and popcorn machines.

In many cases, this type of community event may go unnoticed. But the Irvington concerts stood out because of their funding source: settlement money from companies accused of fueling the opioid overdose crisis.

As part of the national settlements, more than a dozen companies that sell prescription painkillers are expected to pay state and local governments. Up to $50 billion Over the course of nearly two decades. Governments are supposed to spend most of the windfall on fighting addiction. Officials who even negotiated the settlements Suggested uses indicated It created other guardrails to avoid a repeat of the Tobacco Master Settlement Agreement of the 1990s, including: Trivial amounts I went to anti-smoking programs.

But there is still a lot of flexibility with these dollars, and what constitutes good use by one person may be considered waste by another.

In Irvington, town officials said they used the money appropriately because the concerts reduced stigma around addiction and connected people to treatment. But the state comptroller is acting Kevin Walsh She called the concerts a “waste” and “abuse” of the settlements, which resulted in hundreds of thousands of Americans being killed by overdoses.

Similar disputes are escalating across the country, as officials begin spending settlement money in earnest, all while trying to solve the problem. Federal grants reduced and Looming cuts to Medicaidthe federal state general insurance program The biggest motivation To treat addiction.

To shed light on these discussions, KFF Health News and researchers at Johns Hopkins Bloomberg School of Public Health and Break resistanta national nonprofit focused on addiction, undertook a year-long effort to document settlement spending in 2024. The team filed public records requests, searched government websites, and extracted expenditures, which were then turned into Categorized into categories Such as treatment or prevention.

The result is a database of more than 10,500 ways settlement funds were used (or not used) in the past year—the most comprehensive national resource of its kind. Some highlights include:

• States and localities spent or obligated nearly $2.7 billion in 2024, according to public records. The bulk went to investments that addiction experts consider critical, including about $615 million for treatment, $279 million for anti-overdose medications and related training, and $227 million for housing-related programs for people with substance use disorders.
• Law enforcement equipment, such as night vision equipment, and prevention efforts that experts described as questionable, were funded in smaller, but notable, amounts, such as hiring a magician for drug awareness.
• Some jurisdictions have paid for basic government services, such as firefighter salaries.
• The funds are controlled by different entities in each state, and about 20% of them cannot be traced through public records.

This year’s database, including untraceable expenses and percentages, should not be compared to the database of KFF Health News and its partners. Collected last yearbecause of Methodology changes And quirks in the state budget. The database cannot provide a complete picture because some jurisdictions do not publish reports or identify spending by year. What is shown is a snapshot from 2024 and does not take into account decisions made in 2025.

However, the database helps counter the trend towards… Secrecy among some of them Responsible for settlement funds And confusion Among people who are trying Track it.

More than $237 million — about 9% of total trackable spending in 2024 — has been allocated to efforts broadly aimed at addiction prevention, according to public records. These ranged from organizing community outreach events, such as concerts in Irvington, to hiring mental health counselors in schools.

Several examples have raised alarm for researchers, including:

• Suffield, Connecticut, held a 50’s style sockwhere children and the elderly He wore poodle skirtswith inflatable guitars, and pledged to remain drug-free.
• Vernon, Connecticut, Hosted a mixed martial arts demonstrationOne of the fighters spoke about his experience with addiction.
• Hardee County, West Virginia, Spent $60,000 To repair the school track.

He said “there is no evidence” to support these efforts Linda Richterwho leads prevention-oriented research at the nonprofit Partnership to End Addiction.

Elected officials like these events because “you can announce to the community that you’ve done something,” she said. But unless they are part of larger initiatives that include other approaches, such as screening students for mental health concerns or supporting parents struggling with addiction, they are unlikely to have a lasting impact.

When the settlement funds make those one-time payments, little is left over For strategies “We know the business,” Richter added.

School council speakers were also popular, with three Connecticut cities spending more than $30,000 for former Boston Celtics player Chris Herren He shared his addiction story With students.

“You have 1,200 kids in the gym and you can hear a pin drop when he talks,” Monroe Superintendent of Schools Joe Kobza said. He described Herrin’s talks to students and parents as “very moving.”

Richter said that emotional influence is not necessarily effective. Speakers often talk about drugs ruining their lives even though they have become wealthy celebrities. “The messages are very mixed,” she said.

Many local officials admitted that their spending decisions were not based on evidence. But they said they meant well. They received little guidance on how to use the money.

The goal is to raise awareness and combat loneliness, said Kelly Giannuzzi, former director of youth services in Suffield, who organized the stocking.

Hardee County Commissioner Steven Chitrum He said spending money on track repairs made sense, because he saw the positive impact the sport had on his son’s life. He wanted other kids to have the same opportunity.

Vernon spokesman David Owens said the mixed martial arts event was in town Kick-off to Ongoing campaignaims to show people that athletics can help them build relationships and avoid drugs. He said this event brought out young people who are often difficult to reach.

But the city has no way of knowing whether the event has had lasting significance.

In New Jersey, Acting Comptroller Walsh issued a report This summer Irvington town officials are calling for repayment of settlement money spent on concerts.

“If they’re going to have big parties, that’s up to them and the taxpayers,” Walsh told KFF Health News. “But they can’t use opioid money for that.”

He also noted that the concerts were political rallies for Mayor Tony Vos.

Irvington officials strongly objected to the report and unsuccessfully sued Walsh to try to prevent its publication. This is “misleading and completely wrong,” Vos told KFF Health News.

The town distributed overdose reversal medications at concerts and posted messages about seeking help, Voss said. The town said at least four people sought treatment at the site Her lawsuit.

“We felt like we did everything right,” Voss said.

However, some of the research Irvington cited in the lawsuit to support his case seemed irrelevant, such as A Studying in rural Ghana and graduate thesis.

Irvington officials did not respond to questions about those citations.

As this conflict continues – and others like it across the country – people affected by the crisis say it is important to remember the moral weight of these settlements.

“It’s blood money,” he said. Stephen Lloydan addiction medicine doctor who was addicted to opioids and has served as an expert in numerous opioid-related lawsuits.

He has seen many family members lose their parents, children and siblings.

“I don’t know what I would look like to a family” if the money wasn’t used to prevent further losses, he said.

He reads methodology behind this project.

Henry Larue of KFF Health News; Shatterproof Christine Pendergrass and Lillian Williams; Abigail Winiker, Samantha Harris, Isha Desai, Katebeth Blalock, Erin Wang, Olivia Alran, Connor Gunn, Justin Xu, Ruhao Pang, Jirka Taylor, and Valerie Janetsky, Johns Hopkins Bloomberg School of Public Health, contributed.

the Johns Hopkins Bloomberg School of Public Health She has played a leading role in providing guidance to state and local governments on the use of opioid settlement funds. Faculty from the school collaborated with other experts in the field to create Principles of using moneyWhich has been adopted by more than 60 organizations.

Break resistant is a national nonprofit organization that addresses substance use disorder through distinct initiatives, including advocating for state and federal policies, ending the stigma of addiction, and educating communities about the treatment system.

Shatterproof is collaborating with some states on projects funded by opioid settlements. KFF Health News, the Johns Hopkins Bloomberg School of Public Health, and the Shatterproof team that worked on this report are not involved in these efforts.