01/14/2026
A National Roadmap for Spending Opioid Settlement Funds in 2026: Supporting Communities & Ending the Overdose Crisis
This third annual edition of “A National Roadmap for Opioid Settlement Funds: Supporting Communities & Ending the Overdose Crisis” provides crucial guidance for elected officials, government agencies, and other entities and individuals tasked with the allocation of funds won in settlements with opioid manufacturers and distributors. This updated Roadmap is divided into six sections:
- Purpose, Context, and Philosophical Grounding: How did we get here–decades into a failed War on Drugs that has torn apart families, filled jails and prisons, and exacerbated public health harms–and how can we use opioid settlement funds to build something better?
- State Settlement Spending and Supplantation Amidst Federal Funding Cuts: Unique to the third edition, this Roadmap presents a criteria that states should use when determining whether it is ever appropriate to fill federal funding gaps with state settlement funds.
- Proven Solutions: This Roadmap outlines the following evidence-based public health services and systems of care that states can create and/or expand to protect people from the harms of using drugs—Public Health and Harm Reduction, Housing and Supportive Services, and Repairing Racial and Economic Harms.
- Proven Harms: This Roadmap urges that not a single dollar go toward the following punitive, outdated, and ineffective drug war approaches that prioritize stigmatizing and arresting people who use drugs—Criminalization/Police/Jails, Family Separation, “Treatment” Without Evidence-Base, Ineffective Prevention Programs, Corporate Exploitation & Overpriced Products, and Supplantation or General Fund Use.
- Governance and Accountability: This Roadmap calls for an equitable and transparent process for choosing how and where to spend the funding, led by directly impacted people who understand the potential harms of using drugs, have experienced the far greater harms of the War on Drugs, and who understand that harm reduction saves lives.
- Call to Action: This Roadmap calls on those responsible for the allocation of settlement funds to invest in the outlined approaches that are proven to get people the care they need, reduce overdose and other harms, and make communities healthier.
If followed, the Roadmap will help turn the tide of our tragic and preventable overdose crisis. It will:
- Significantly reduce the number of people who are harmed by using drugs;
- Help move houseless people who use drugs into stable homes;
- Help states navigate federal funding cuts while still protecting settlement funds;
- Reunite families and strengthen communities.
What’s new in this year’s Roadmap
- An acknowledgment of federal funding changes and a caution against using these settlement dollars to fill budget gaps.
- Updated lists of funding priorities and prohibited uses, based on developments over the past year.
- Timely examples of some of the best and worst spending across the country since the 2024 Roadmap.
