By Rob Kent
A few in the media have drawn attention to the ways in which state and local governments are spending opioid settlement funds. Many of those stories have expressed concerns and made comparisons to the ways in which the tobacco settlement funds were not used to address tobacco related issues.
While I share those concerns, I am equally focused on the slow pace at which the funds are being distributed and whether they are being used to replace current spending efforts which violates the spirit of the settlement agreements, and, in a few places, it also violates the law. My concern is rooted in a belief that state and local government officials will use the lack of urgency to make an argument that the funds should be spend on unrelated needs, like fixing roads and bridges. I am also concerned that federal government officials will use the slow pace to try to reduce federal funding dedicated to the addiction care system arguing that they can use unspent settlement funds.
To highlight my concerns, I am going to use one state, New York, as an example. Many have historically viewed New York as a leader with how they address addiction issues, so how they and what they do is always scrutinized.
New York State will receive almost $3 billion over the span of the opioid settlement agreement and their state government officials have regularly touted the fact that $400 million of the $500 million they have already received has been “made available” to the stakeholders trying to save lives. Many, including myself, have asked these same government officials how much of the money that has been “made available” has been received and spent by the addiction care providers. Our requests have received little response! The lack of response makes it difficult for us to determine whether they are violating the state law that makes it illegal to replace, or supplant, current state spending.
NYS government officials also tell anyone who asks questions about spending to look at their “Opioid Settlement Fund Tracker” (https://oasas.ny.gov/fy-2023-opioid-settlement-fund-initiatives) for answers. Interestingly, when you look at that webpage, few answers are found. However, the webpage will direct you to press releases issued by the Governor announcing who received awards! There is no information about whether any awardees have received a penny!
The lack of a response, or publicly available information, led us to file a Freedom of Information Law (FOIL) request with the State Comptroller, the state government official who pays the bills for NYS government. Thanks to the Office of the State Comptroller’s responsiveness to our FOIL request, we are now able to analyze the spending and the answers to some of our questions is troubling.
A review of the state payments shows that less than $150 million has been paid to providers for services through May 2025. More $150 million of the total funds received have been turned over to local governments as required by the settlement agreements. The funds given to local governments are completely outside the authority of the state and little is known about how they are spending those funds. Thus, local governments have received more funds than state government has spent, and the state is counting the transfer of funds in those that they have “made available.” It is also troubling that NYS has spent more than $30 million to buy only one version of the life-saving medication, naloxone, although many other versions are available for purchase and a competitive procurement would have made it possible for the state to buy more of the product with their $30 million investment.
The bottom line is that the state still has almost $200 million in settlement funds available to be spent. These funds sit idle at the same time as state government takes a victory lap over the reduction in overdose deaths in 2024. News flash – the 2025 overdose deaths numbers are going up again!
State governments need to spend the money, and they should start by investing in the beleaguered addiction care system workforce! They should invest in making Opioid Treatment Program services available in every part of every state as methadone is proving to be a most important intervention with the ever-changing street opioids.
Rob Kent Esq. is the former general counsel for the White House Office of National Drug Control Policy and the former general counsel for the New York State Office of Addiction Services and Supports. He is president of Kent Strategic Advisors, LLC;