State and local governments will, over the next nearly two decades, receive billions of dollars from companies accused of sparking the opioid epidemic. KFF Health News is, in a yearlong series, investigating the use — and misuse — of this cash.

Our stories provide a national perspective on issues ranging from the distribution formulas that determine how much money each locality receives to the lack of public reporting on how settlement dollars are spent. We’ve also compiled databases and sets of documents that we hope can help others investigate opioid settlement stories in their communities.

Please always credit KFF Health News for the reporting and the people who created different data sets for those resources, as specified below.

Tips to get started:

1. Learn the basics of where this money is coming from, what it can be used for, and who controls it.

The existence and distribution of settlement funds are the result of a long and complex legal process. Here’s a three-minute video that breaks down what you need to know to get started.

Also check out these state-by-state guides created by Christine Minhee, founder of, and the public health organization Vital Strategies. They provide a quick overview of how the money flows through each state.

2. Determine how much money your city, county, and state have received so far.

KFF Health News obtained from the settlement administrator and made public for the first time a trove of documents that show how much money each government received from four opioid companies in 2022 and 2023. Once you know what your locality has received, you can ask officials questions about how it’s being used.

3. Find out what information your state or local governments are required to report about their use of settlement funds.

Start with this interactive map, created by KFF Health News and Minhee, of It synthesizes analysis of hundreds of written plans, statutes, executive orders, and public statements to show how much your state promises to publicly report about its spending. Click on a state to see details, including:

  • The percentage of funds an average person would be able to track.
  • The percentage of funds that will be reported to some oversight body but not necessarily shared with the public.

To see the language that underpins these numbers — including the specific laws and legal documents that require reporting on the money — check out this table at

4. Access those reports.

Once you know what your state is required to report, go find it. If reports are displayed online, links are shown via the interactive map. If reports are kept by an agency, that agency is identified in the table. Reach out and ask for the reports, citing the legal requirements listed in the table if necessary.

If you cannot find a report — despite it being mandated in legal language — that may be a story itself.

5. Dig into the spending decisions.

Once you have reports on how the funds were used, dig into specifics. The national settlements came with a list of recommended strategies. Check if your community’s use aligns with them.

Ask how these spending decisions were made. Were community members involved in identifying priorities? Was there a fair and open process to apply for grants?

The settlement dollars will be paid out over nearly two decades. Do these reports reflect one-off spending decisions or ongoing allocations over that time? Is there a plan to evaluate the impact of the money after a few years and reshape future priorities?

6. If your state or local government has no public reporting requirement, that might be its own story.

A KFF Health News investigation found nearly half of all states have not enacted any specific reporting requirements. If yours is one of them, ask why. Some have called settlement funds “blood money” for those who died of overdoses and feel they have a right to know how the payouts are used.

You can use the interactive map to compare the level of transparency in your state to that of similar or neighboring states. Pay attention to not only the public reporting but also the reporting required to an oversight body; ask why that information is not made public as well.

Talk to people in recovery, family members who have lost loved ones to overdoses, treatment providers, advocates, and others in the field about what consequences the lack of transparency is having in your community.

7. Check for any reports suggesting your state or local government spent money in ways unrelated to the opioid crisis.

Even states that have no reporting requirements of their own are subject to a bare-minimum national standard: reporting how much money they use on expenses unrelated to the opioid epidemic. (This can be at most 15% of the state’s settlement cash.)

Reports from state and local governments can be found here. Governments are required to submit reports only if they determine they’ve used funds for non-opioid purposes, so you may not see a report from your community. Those that do file reports list only a dollar amount, so you’ll need to contact the person who signed off for details about how that money was used. New reports are filed approximately every six months.

8. Get help for further reporting.

Reporting on Addiction has guidelines, source recommendations, and other tips that can help. During a “virtual fireside chat” the organization hosted, KFF Health News senior correspondent Aneri Pattani shared tips with reporters on where to start and how to cover the opioid settlement at the community level. Watch the 30-minute session here.

Minhee, who created the state-by-state guides and analyzed public reporting requirements, has other resources on her site, showing which lawsuits states engaged in and how they’re planning to spend the money.

Pattani is also available to share advice. Reach her at

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.


This story can be republished for free (details).

By Aneri Pattani
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.