States are getting $50 billion in opioid cash. And it's an issue in governor's races
By Aneri Pattani
Last year, more than 100,000 Americans died of drug overdoses. Advocates and family members marked the tragic toll with cardboard grave markers on the lawn of the U.S. Capitol on Sept. 23. Aneri Pattani/KFF Health News hide caption
toggle caption Aneri Pattani/KFF Health NewsLast year, more than 100,000 Americans died of drug overdoses. Advocates and family members marked the tragic toll with cardboard grave markers on the lawn of the U.S. Capitol on Sept. 23.
Aneri Pattani/KFF Health NewsOpioid settlement cash is not inherently political. It's not the result of a law passed by Congress nor an edit to the state budget. It's not taxpayer money. Rather, it's coming from health care companies that were sued for fueling the opioid crisis with prescription painkillers.
But like most dollars meant to address public health crises, settlement cash has nonetheless turned into a political issue.
Gubernatorial candidates in several states are clashing over who gets bragging rights for the funds — which total and are being distributed to state and local governments over nearly two decades.
, an associate professor of political science at the University of Kentucky. It "is a lot more compelling and unifying a political argument than taking a position on something like abortion," for which you risk alienating someone no matter what you say.In Kentucky, Attorney General Daniel Cameron, the Republican candidate for governor, wants sole credit for the hundreds of millions of dollars his state is receiving to fight the opioid epidemic. In a post on X, formerly Twitter, that his opponent, former attorney general and current Democratic Gov. Andy Beshear, "filed a lot of lawsuits during his time [in] office, but in this race, there is only one person who has actually delivered dollars to fight the opioid epidemic, and it's not him."
However, Beshear filed nine opioid lawsuits during his tenure as attorney general, several of which led to the current payouts. At a , Beshear defended his role: "That's where these dollars are coming from — cases that I filed, and I personally argued many of them in court."
Beshear leads Cameron ahead of the Nov. 7 election., founder of , who is closely following how attorneys general handle the money nationwide, said voters likely don't know that the opioid settlements are national deals crafted by a coalition of attorneys general and private lawyers. So when one candidate claims credit for the money, constituents may believe "he's the sole hero in all of this."
Trail of Truth is the name of the event in Washington, D.C. in September. It aims to push elected officials to take more action to address the country's overdose epidemic. Aneri Pattani/KFF Health News hide caption
toggle caption Aneri Pattani/KFF Health NewsTrail of Truth is the name of the event in Washington, D.C. in September. It aims to push elected officials to take more action to address the country's overdose epidemic.
Aneri Pattani/KFF Health NewsCandidates in other states are touting their settlement credentials, too. North Carolina Attorney General Josh Stein, a Democrat, lists securing opioid settlement funds at the top of the "accomplishments" section of .
West Virginia Attorney General Patrick Morrisey, a Republican gubernatorial candidate for 2024, has repeatedly boasted of securing the "highest per capita settlements in the nation" in news conferences and on and his .
In Louisiana, Attorney General Jeff Landry, a Republican who was recently elected governor, ran on a , with endorsements from Louisiana sheriffs and prosecutors. As attorney general, he led negotiations on dividing opioid settlement funds within the state, resulting in an 80% to parish governments and 20% to sheriffs' departments — the largest direct allocation to law enforcement in the nation.
It's a common joke that AG stands for "aspiring governor," and officials in that role often use big legal cases to advance their political careers. Research shows that attorneys general who participate in multistate litigation — like that which led to the opioid settlements and before it — are .
But for some advocates and people personally affected by the opioid epidemic, this injection of politics raises concerns about how settlement dollars are being spent, and whether the money will truly address the public health crisis. Last year, more than 100,000 Americans .
, director of VOCAL-KY, an advocacy group that in housing and health care.
VOCAL-KY director Shameka Parrish-Wright, foreground, at a protest outside the Drug Enforcement Administration building in Arlington, Virginia, in June. Aneri Pattani/KFF Health News hide caption
toggle caption Aneri Pattani/KFF Health NewsVOCAL-KY director Shameka Parrish-Wright, foreground, at a protest outside the Drug Enforcement Administration building in Arlington, Virginia, in June.
Aneri Pattani/KFF Health News"What I see in my state is a lot of press conferences and news pieces," says Parrish-Wright, a Democrat who is active in local politics. "But what plays out doesn't get to the people" — especially those deeply affected by addiction.
For example, when Beshear celebrated a decrease in the state's overdose deaths, overlooked the , Parrish-Wright says.
And when Cameron's appointee to the state's opioid abatement advisory commission announced that $42 million of settlement funds were — a psychedelic drug that has shown potential to treat addiction — Parrish-Wright's first thought was "most poor people can't afford that." To obtain it, people often have to travel out of the country.
The ibogaine announcement caused additional controversy. It's an experimental drug, and, if approved, the $42 million allocation would be the single-largest investment from the commission, which is housed in Cameron's agency. that a billionaire Republican donor backing Cameron's gubernatorial campaign stands to reap massive profits from the drug's development.
Neither Cameron's office nor his campaign responded to requests for comment.
Beshear's office declined an interview request but referred KFF Health News to his previous public statements, in which he criticized the potential investment in ibogaine. He has suggested Cameron — whose campaign has emphasized support for police — is not putting his money where his mouth is.
"If you only provide $1 million to law enforcement and $42 [million] to pharma, it doesn't seem like you're backing the blue. It seems like you're backing Big Pharma," Beshear .
Minhee, founder of OpioidSettlementTracker.com, says she's concerned that mixing politics with settlement funds could result in ineffective investments nationwide.
"If some of this money is going to be politicized to advance careers of attorneys general who support the war on drugs, then that is literally using monies won by death to feed into more death," she says.
Parrish-Wright, of VOCAL-KY, says she worries that candidates — and some voters — will forget about the significance of the money once ballots are cast.
"We cannot let it fade after the election cycle," she says.
Her solution depends in part on politics. She's on the ballot herself Nov. 7, for a seat on Louisville's Metro Council. If she wins, she says, she intends to keep the settlement in the public conversation.
Correction Nov. 1, 2023
An earlier version of this story misspelled the last name of West Virginia Attorney General Patrick Morrisey as Morrissey.
