Opioid Settlement Spending Tracker

Opioid settlement funds are intended for treatment, recovery, and prevention. But with billions flowing through thousands of local governments and agencies, tracking where the money actually goes requires vendor-level transparency that most states do not yet provide.

This investigation extracts spending data from state reports — PDFs, spreadsheets, and web portals — and cross-references recipients against campaign finance and relief-fund databases to surface potential mission drift.

Scale

Across all 50 states, we track $24 billion in opioid settlement allocations from 8 settlements (Distributor, Janssen, Teva, Walgreens, CVS, Allergan, Walmart, Kroger) to 6,297 recipients. Combined with the KFF Health News national database and 10 state-specific extractions, we document $3.8 billion in spending — just 16% of funds allocated.

States with Spending Data

West Virginia: A Case Study in Mission Drift

A manual review of all 70 vendor-level spending rows in West Virginia confirmed that the automated mission-drift classification is accurate:

Notable line items:

• $333K for a county radio system upgrade
• $208K for a law enforcement shooting range
• $133K transferred to a city general fund “to pay bills, and make payroll” (categorized under “media campaigns to prevent opioid use”)
• $65K to promote a part-time police officer to full-time
• $500K to Huntington’s Quick Response Team — the only six-figure treatment expenditure

Only 22.8% of West Virginia’s documented spending reaches treatment, recovery, or prevention services. The majority funds police equipment under settlement categories broad enough to technically qualify.

Mission-Drift Flags

The pipeline flagged 2,880 spending transactions for editorial review across six categories: opaque descriptions (generic “services” or “support” labels), capital/construction spending, legal and PR vendors, administrative overhead, large non-direct expenditures, and consultant-heavy patterns.

These flags are triage signals for journalists, not conclusions. The West Virginia spot-check (above) confirmed that flagged items warrant investigation.

Caveats

• Vendor-level detail available for 10 states; KFF national data covers 35 states at disbursement level
• CT and SC report municipality totals only — no vendor visibility
• Mission-drift flags reflect category taxonomy, not confirmed misuse
• Spending data mixes FY2023-24 and FY2024-25 across states
• Vendor political-spending matches (155) include medium-confidence word-overlap

Data Sources & Attribution

National spending data from the KFF Health News opioid settlement database, a project of KFF Health News, Johns Hopkins Bloomberg School of Public Health, and Shatterproof. Used under Creative Commons license for non-commercial purposes.

State-specific vendor-level data extracted from official state reports: Michigan DHHS, Pennsylvania (via Spotlight PA), Oregon OHA, Indiana FSSA, West Virginia First Foundation, Virginia VOAA, New Jersey ELEC, Connecticut DMHAS, South Carolina SCORF, Massachusetts AG.

Campaign finance crossref uses FEC bulk individual contributions (2020-2024, 191M records). PPP crossref uses SBA FOIA data (968K loans).

What this analysis adds beyond existing trackers: KFF Health News and other trackers categorize how settlement money is spent. This investigation additionally cross-references settlement vendors against federal campaign finance and relief-fund databases to identify political connections — and applies automated mission-drift classification to flag spending that may not align with settlement intent.

Downloads

• State-level rollup (CSV)
• Top recipients by spending (CSV)

For newsrooms: contact editor@thepublicledgers.org for the full dataset and mission-drift flag file.