Last year, 3,651 Ohioans died because of an opioid overdose. The year before, that number was even higher.
Since the opioid epidemic began with doctors over-prescribing pain medication in the ‘90s, Ohio has been one of the states hardest hit. The high rates of addiction, overdoses and deaths not only shattered people’s lives here, they also put a significant burden on the health care, criminal justice and social services systems.
In response to that burden, attorney generals across the country, including Ohio’s, and some local governments independently, sued pharmaceutical companies for their role in making and distributing the drugs. Rather than go to court to prove they weren’t aware that opioids were being improperly dispensed, companies like Cardinal Health, Janssen Pharmaceuticals and Walgreens settled.
Over the next nearly two decades, more than $50 billion from those settlements will flow across the country — including many hundreds of millions to Ohio. Some of that money is now starting to reach local communities, where everyone from legislators to people dealing with addiction hope it can help.
How much money is Ohio getting from these settlements?
The amount of money coming to Ohio is massive: about $2 billion over the course of 18 years. That’s double what Taylor Swift was expected to make in ticket sales during her international tour last year.
The money isn’t coming from just one lawsuit, but rather from a series of settlements, including the following:
- $808 million from a settlement with opioid distributors Cardinal Health, McKesson and AmerisourceBergen
- $679.6 million from a settlement with Teva, Allergan, CVS and Walgreens
- $185 million from a settlement with Johnson & Johnson and Janssen Pharmaceuticals Inc.
- $24.7 million from a settlement with McKinsey & Co.
Ohio is receiving more money than most other states in the country. Only California, Florida, Texas, New York and Pennsylvania are receiving more. That’s partly because the state was hit so hard by the opioid epidemic. Thousands of people have died from opioid overdoses in Ohio each year for the past decade.
![A box of Narcan nasal spray sits on a table top.](https://npr.brightspotcdn.com/dims4/default/83f2fd3/2147483647/strip/true/crop/1760x990+0+0/resize/880x495!/quality/90/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2Ff3%2Fc8%2F28f187964d5dac5e3835f6725e6d%2Fezgif-4-efff925ca4.jpg)
But the state was also pretty aggressive in taking legal action against companies connected to the opioid epidemic, and was involved in both national and independent settlement agreements.
How is this money being distributed across the state? Who’s actually getting it?
Ohio decided its settlement funds would be distributed according to a unique plan it came up with called the OneOhio agreement, which splits the money into three pools:
- 30% of the settlement funds are allocated for more than 2,000 townships, villages, cities and counties across the state to address their immediate needs
- 15% go to the state to “leverage statewide buying power to offer prevention, treatment and recovery support services”
- 55% go to the OneOhio Recovery Foundation — a nonprofit organization formed specifically to oversee how the settlement money is spent
The OneOhio Recovery Foundation is made up of government appointees, members of the legislature and members from different communities across Ohio.
Since it was founded in December of 2021, the organization has seen its share of controversy. Frustrated by a lack of transparency, Harm Reduction Ohio, an organization that advocates for drug policy reform, sued the group. Last year, the state supreme court ruled in its favor, arguing the foundation is functionally a public entity and therefore subject to sunshine laws. But Gov. Mike DeWine later signed a two-year state budget exempting it from public records and meeting laws.
Local communities, the state and the OneOhio Recovery Foundation get allotted amounts of settlement money each year and independently determine how to spend it from there.
Are there guidelines on how the money has to be spent?
Most of the settlements specify that 85% of the funds must be used to address the opioid epidemic.
But that can be broadly interpreted. Louisiana, for example, is allocating money to its police department to help with law enforcement, while Rhode Island is using funds to open a facility where people can use drugs safely.
How are Ohio communities using the money so far?
Local communities in Ohio have received more than $150 million of the funds already. Most have been slow to put it to use, while some have already started spending it.
Ashtabula County in the far northeast corner of the state, for example, has given money to its crime enforcement agency, which investigates narcotics trafficking, and to a local police department to purchase a new breath test machine.
Montgomery County, which encompasses the Dayton area, is using opioid settlement funds to renovate its jail — adding more than 100 additional medical beds.
The city of Medina, south of Cleveland, allocated more than $26,000 of its funds to a program called ‘Hope on the Move’ to give people rides to recovery services.
And north central Ohio’s Knox County is using settlement money to help cover the costs of children taken into custody during the epidemic.
The OneOhio Recovery Foundation is beginning its first round of grants this year, and will allocate up to $51 million to Ohio-based non-profits, for-profits and government entities. The guidelines for eligibility include evidence-based programs and services, forward looking strategies for prevention, and treatment and recovery support services.
Why pay attention?
This isn’t the first time Ohio has received a massive payout from legal settlements.
Back in the late 1990s, the state received about $10 billion over 25 years from settlements with tobacco companies. The money was meant to be used for tobacco prevention and cessation programs and public health initiatives. But over time, a big portion of the money was diverted to the budget and other programs.
This time, most of the national settlements specify that states must spend at least 85% of the payouts to address the opioid epidemic. That epidemic continues to cast a shadow over Ohio. More than 4,000 Ohions died of an unintentional drug overdose last year, according to the CDC. Most were from opioids.
But a lack of transparency and enforcement makes it difficult to see if communities are following the rules and using the money to address the epidemic.
How will the Ohio Newsroom be covering this story?
We want to know — is this settlement money being spent on evidenced-based programs? Who’s profiting from the dollars? And is the money making a difference in the lives of those still in the throes of addiction?
So, we’re starting a series we’re calling our ‘Settlement Story of the Month.’ Just like its name suggests, once a month we’ll bring you a story about how this money is being spent, who’s in charge of spending it and whether it’s making a difference.
The billions of dollars pouring into Ohio from the second largest settlement in history is an important state and local story, and one that will certainly have long-lasting impacts on people’s lives.