Settlement Savvy: How Utah is Using Opioid Settlement Funds

July 5, 2024

In February 2022, the first of several large settlements was finalized in the nationwide, multi-district litigation against opioid manufacturers and distributors. These settlements, worth an estimated $26 billion, were with Janssen (J&J) and the “Big 3 Distributors” (Cardinal, McKesson, and Amerisource Bergen). Additional settlement agreements have been reached with McKinsey and Company (a consulting firm involved with marketing to physicians), Walgreens, CVS, Teva, Walmart, and Allergan.

As a result of being a participant in the litigation, Utah will receive nearly $495 million from opioid settlements over 17 years. Of that amount, $248.7 million will go to the state government, while counties will receive $242.3 million. The most recent settlement agreement was with Mallinckrodt, where Utah has already received the full payment of $3.8 million (see the last row in the table below).

Source: Utah Governor’s Office of Planning and Budget

There are limitations on how settlement funds can be spent; approved categories include supporting addiction treatment, addiction prevention activities, and recovery. Over the past three General Sessions, the Utah Legislature has worked with the Attorney General’s Office, the Department of Health and Human Services, and the Governor’s Office of Planning and Budget to review funding proposals and appropriate settlement proceeds for a variety of programs that support opioid-impacted individuals in Utah.

The Legislature and partner agencies review settlement agreements and receipts continually throughout the year to determine the appropriate amount of funding available each Session for appropriation. This review focuses on funds deposited, settlement distribution tables, prior appropriations, and the results of ongoing litigation. The table below includes current appropriations that have been made using settlement proceeds, according to the session the funding was appropriated. The funding item titles are linked to their descriptions in COBI:

Funding ItemGeneral SessionOngoingOne-Time
USARA Recovery Community Centers2024$500,000
PROUD: Pathway to Recovery from Opiate Use Disorder2024$351,200
Expanding Care for Pregnant Patients with Substance Use Disorder2024$200,000
Substance Use Disorder Recovery and Animal Companions2024$225,000
Spy Hop Youth Prevention Services2024$200,000
Matching Funds for Counties Using Opioid Funds in County Jails or Receiving Centers2023$1,000,000
Emergency Department/Urgent Care induction to Medications for Opioid Use Disorder2023$1,200,000
OUD Treatment Expansion in Rural Communities2023$1,300,000
State Opioid Settlement Appropriation – Shifting Efforts Upstream2023$2,184,300
Primary Prevention2023$443,400
Behavioral Health Prescription Digital Therapeutic Pilot2023$300,000
Support for Pregnant Moms with Substance Use Disorder2022$2,800,000

The Legislature has included intent language for each of these appropriations requiring a report within three years that details:

  1. outcomes achieved,
  2. advisability of continuing funding, and
  3. challenges faced in reaching desired outcomes.

This follow up provides the legislature with the information necessary to decide whether to continue appropriations or redirect funds to new programs, with the goal of achieving the highest benefit from settlement proceeds.