Opioid settlement funds go primarily to state and local governments, with separate pots for federally recognized tribes and a narrower set of payments to individual victims through bankruptcy trusts. The national settlements with drug distributors, manufacturers, and pharmacy chains total more than $50 billion, paid out in installments to states, counties, cities, and tribal nations over roughly two decades.1National Opioids Settlement. Executive Summary At least 85% of every dollar is restricted to opioid remediation: treatment, prevention, and recovery. The rest is where most of the public arguments happen.
States, Counties, and Cities Are the Main Recipients
The bulk of settlement money flows to governments, not individuals. Each state negotiated an internal agreement, often called a Memorandum of Agreement or state-subdivision agreement, that sets the split between the state government and its cities and counties. The local share varies widely by state, generally landing somewhere between roughly 15% and 50% of what the state receives.
Within a state, the money is divided among local jurisdictions using a data-driven formula built on three equally weighted factors: opioid-related overdose deaths in the jurisdiction, the number of residents with opioid use disorder, and the volume of opioids shipped to pharmacies in the area. Population figures also feed into the final calculation. The design intentionally pushes more money toward the places hit hardest.
A national administrator, the firm BrownGreer, calculates each government’s share, collects payment instructions from more than 5,600 beneficiary governments, and distributes the funds. By mid-2025, more than $13.6 billion had already been paid out across the country.1National Opioids Settlement. Executive Summary Once a city, county, or state receives its share, the money has to be held in an account dedicated to opioid remediation rather than mixed with general revenue.
The payers behind these flows are the companies that manufactured, distributed, or dispensed opioids: the three major distributors (McKesson, Cardinal Health, AmerisourceBergen), Johnson & Johnson, pharmacy chains Walgreens, CVS, Walmart, and Kroger, and manufacturers Teva and Allergan, with additional deals involving McKinsey, Publicis Health, Endo, and Mallinckrodt. Purdue Pharma and the Sackler family resolved their claims through bankruptcy, with a January 2025 agreement requiring $7.4 billion to satisfy government and private claims.2Congressional Research Service. National Opioid Litigation: Settlement Agreements as of January 2025 None of these payments arrive as a lump sum; communities receive annual installments running into the late 2030s.
Tribal Nations Have Their Own Settlements
Federally recognized tribes and tribal health organizations negotiated separately from state and local governments. The combined value of tribal opioid settlements exceeds $1.5 billion, also paid in installments. Tribes that received distributions in 2025 must complete a Tribal Opioid Abatement Use Report by January 31, 2026.3Tribal Opioid Settlements. Tribal Opioid Settlement The reporting obligation parallels the one applied to state and local governments: funds must go to remediation, and spending must be documented.
Individual Victims and the Bankruptcy Trusts
The government settlements do not pay individuals directly. People harmed by specific opioid products can seek compensation only through separate bankruptcy trusts, and most of those filing windows have already closed.
The two primary vehicles are the Purdue Pharma Personal Injury Trust and the Mallinckrodt Opioid Personal Injury Trust. The Mallinckrodt trust uses a “hub and spoke” structure, with the central trust distributing funds to beneficiary trusts covering personal injury victims, people affected by neonatal abstinence syndrome, hospitals, and insurance companies.4Mallinckrodt Opioid Master Disbursement Trust II. Mallinckrodt Bankruptcy Qualifying generally requires documented medical evidence of opioid use disorder, prescription records, and proof of resulting harm.
The hard news: the Purdue Pharma Personal Injury Trust closed claim submissions on July 28, 2025, and states that claims filed more than 15 days after that date will not be considered qualified. A narrow late-filing window for extraordinary circumstances has also closed.5Purdue Personal Injury Trust. Purdue Personal Injury Trust The Mallinckrodt trust set a June 15, 2025 deadline for neonatal abstinence syndrome claims, three years after the plan’s June 16, 2022 effective date.6Mallinckrodt Opioid Personal Injury Trust. Home If those dates passed without a filing, there is likely no path to recover against those particular trusts. Other bankruptcy proceedings, such as Endo’s, may run on different timelines.
Payment amounts vary. Some trusts pay small fixed sums; others pay several thousand dollars depending on the severity of documented injuries. Each claim is reviewed individually by the bankruptcy court and designated trustees, so the gap between filing and payment can be months or longer.
What Governments Can Actually Spend the Money On
At least 85% of every settlement dollar must go to opioid remediation. The settlement agreements include a detailed, approved spending list, known as Exhibit E, broken into “core strategies” and a broader menu of permissible uses.7National Opioids Settlement. Exhibit E – List of Opioid Remediation Uses
The core strategies most states prioritize include:
- Expanding naloxone distribution to first responders, families, schools, and uninsured individuals.
- Funding medication-assisted treatment with buprenorphine or methadone combined with counseling, particularly for uninsured people.
- Screening, treatment, and wrap-around services (housing, transportation, childcare) for pregnant and postpartum women with opioid use disorder for up to 12 months after delivery.
- Evidence-based care for babies born with neonatal abstinence syndrome and long-term monitoring for affected families.
- Warm hand-off programs that connect overdose survivors in emergency departments directly to treatment before discharge.
- Medication-assisted treatment inside jails and prisons, plus transitional support on release.
- Prevention programs including public awareness campaigns, school-based education, and prescriber training.
- Syringe service programs and other harm-reduction work.
- Data collection and research evaluating which strategies are working.
Exhibit E also approves spending on recovery housing, outpatient counseling, criminal justice diversion, first responder training, and coordination infrastructure.7National Opioids Settlement. Exhibit E – List of Opioid Remediation Uses The list is deliberately broad, giving local officials room to address whatever aspect of the crisis is most pressing locally.
The 15% That Can Go Elsewhere
Up to 15% of settlement funds can be spent on something other than opioid remediation. In practice that could mean general budget needs, attorney fees, or litigation costs. Any non-remediation spending has to be reported to the national settlement administrator with a full accounting of how the money was used. The reporting deadline for non-remediation expenditures through June 30, 2026, is September 30, 2026.8National Opioid Settlements. National Opioid Settlements The 15% provision is where diversion pressure is most likely to show up, which is why the transparency rule exists.
Attorney Fees Come Out of the Pot
Private attorneys who represented governments are paid from settlement proceeds. In the $26 billion distributor and Johnson & Johnson settlement, the federal court capped contingency fees for individually retained attorneys at 15% of the funds. Attorneys who collect from the fee fund have to waive the right to enforce any higher percentage in their original contracts. A narrow exception exists for extraordinary cases, but 15% is the default.
The cap is structured to work with the 85% abatement requirement: remediation gets at least 85%, and fees come from the rest alongside other non-remediation costs. Local governments planning programs should factor that reduction into what they can realistically deploy.
How the Public and Providers Can Track or Access the Money
Every state has some oversight structure. Roughly 15 states have created councils with direct decision-making authority over allocations, and about 24 states plus Washington, D.C., have advisory councils that recommend priorities to another body that makes the final call. Both models typically require members to disclose conflicts of interest.
On reporting, any government spending settlement money outside opioid remediation must file a Non-Opioid Remediation Use Report with the national settlement administrator, identifying the amounts and explaining how the money was used. This includes attorney fees, investigation costs, and litigation expenses.8National Opioid Settlements. National Opioid Settlements Many states also publish public dashboards showing which projects received funding and what outcomes followed. The settlement agreements do not spell out severe clawback penalties for misuse; the primary enforcement mechanism is transparency and the political pressure it creates.
For nonprofits and community-based providers, settlement money is reachable only indirectly. The funds themselves go to governments, but many states and counties pass a portion through competitive grant programs. Some states run centralized grant portals administered by their opioid settlement council; others leave it to individual counties to decide whether and how to solicit applications. There is no single national application. A treatment center, recovery housing program, or prevention initiative looking for funding has to monitor state and county websites or contact the local opioid settlement coordinator to find out what, if anything, is open in that jurisdiction.