Follow the money: New dashboard tracks use of opioid settlement funds

by Danielle J. Brown, Maryland Matters
June 1, 2026

Maryland has received more than $380 million from a nationwide settlement with pharmaceutical companies for the opioid crisis — and could get a total of almost $750 million over the course of 15 years to combat further overdoses and fatalities.

To track the hefty payout, the Maryland Office of Overdose Response published a new dashboard to let state officials, overdose resource organizations and everyday Marylanders see where those dollars are going.

“By making this information accessible to the public, we are helping ensure these settlement dollars are invested intentionally, responsibly, and in ways that create meaningful change for Marylanders,” Lt. Gov. Aruna Miller (D) said in a statement Thursday announcing the dashboard.

While overdose fatalities connected to opioid use have fallen by 57% in recent years, advocates and addiction specialists say there’s still plenty of work to do to help the almost 1,000 Marylanders who are still dying from opioid-related causes annually.

“All the money in the world for treatment, naloxone and all those things – it can help,” said Dr. Christopher J. Welsh, an addiction specialist and associate professor of psychiatry for the University of Maryland Medical System. “But we really need to be doing larger things to address these inequities that are leading people into addiction and then making it harder for them to get out of it.”

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Welsh said the new dashboard can help the public keep track of those dollars to ensure that they are spent effectively for overdose reduction over the next 10 to 15 years.

“It really is up to the states to figure out how best to use the money,” he said. “It’s a good thing to have the information where people can see it. It seems like the state is doing the job of trying to make things as transparent as possible.”

A national legal challenge against pharmaceutical companies and distributors claimed that overprescription of painkillers like oxycodone starting in the late ’90s led to a sharp increase in overdose fatalities, a trend that only just started to reverse in 2023.

Those companies, which include Purdue, Walgreens and CVS, among others, agreed to pay out more than $50 billion to help states address the opioid crisis and lower overdoses, according KFF, a health care advocacy and research group.

Maryland expects to bring in upwards of $747 million over the next 15 years through the settlement payments, according to the Prescription Opioid Settlement Dashboard. That figure does not include separate settlement payments to Baltimore, which opted to pursue legal challenges independent of the states due to the heightened impact that the opioid epidemic had on the city.

State officials are funneling those dollars into the Maryland’s Opioid Restitution Fund, created in 2019 to support state and local efforts to address the opioid crisis.

A quarter of the settlement payouts will go to local governments to cover their specific needs to address the opioid crisis. Another 15% of those dollars will be available for the state to use at its discretion, and the remaining 60% will be used to fund various related grants at the state and local level.

The new settlement dashboard shows that as of last July, Maryland has received more than $380 million in settlement payments. The state has already spent about $15 million of those dollars while sending out $18 million to local and city governments. The state’s dashboard will be updated annually each fall.

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Most of the spending so far has gone to programs that assist with treatment of opioid use disorder, which includes a wide range of resources such as behavioral health services, peer-to-peer recovery programs, re-entry coaching at local corrections departments and the purchase of buprenorphine or other medications that help treat opioid use disorder.

Meanwhile, the Moore administration has touted a sharp decrease in fatal opioid-related overdoses in recent years. Fatalities peaked in 2020 and 2021, with more than 2,500 Marylanders dying from opioid-related overdoses in both those years.

Welsh says that the spike in fatal overdoses was likely due in part to increased mental health needs amid the early years of the COVID-19 pandemic, as well as a greater likelihood of people using dangerous substances alone — without someone nearby who could intervene in the case of an accidental overdose.

Additionally, there is increased awareness of how to access and administer naloxone, a medicine that reverses an opioid overdose, commonly known by the brand name Narcan.

Those reasons and more are why Gov. Wes Moore (D) early this year touted a 57% reduction in overdose fatalities since the pandemic, aligning with a nationwide trend that has also seen overdose fatalities drop.

Maryland Special Secretary of Overdose Response Emily Keller wants to keep that trend going, using the settlement dollars to boost those efforts.

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“We owe it to the communities across Maryland that have borne the brunt of this crisis to use the funds as effectively and transparently as possible,” Keller said in a written statement Thursday.

“The new dashboard highlights Maryland’s commitment to supporting proven and effective strategies that can reduce overdoses and increase access to life-saving care. And while not unlimited, these funds can be a difference maker in our efforts to save lives,” she said.

State data shows that hundreds are still dying from opioid-related overdoses, particularly when fentanyl is involved. From May 2025 through April 2026, there were 969 opioid-related deaths in the state, according to the Maryland Department of Health’s data dashboard on overdoses in the state.

With a total of 1,269 total overdose deaths in that time frame, that means about 76% of all overdose deaths involved an opioid of some kind. Fentanyl contributed to 850 of those deaths.

While anyone can struggle with opioid use disorder, Welsh says that there are systemic challenges that make the opioid epidemic harder on lower-income communities.

He says that state officials need to keep those challenges in mind as they use the settlement dollars to combat the effect opioids have had in Maryland.

“All of these things will help, but it’s still kind of a Band-Aid to the larger issues that we have,” Welsh said. “There’s still so much disparity between the people who have practically nothing and people who have a lot. Addiction can hit everyone, but certainly we see … it’s hitting a lot more disadvantaged people.”

Maryland Matters is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Maryland Matters maintains editorial independence. Contact Editor Steve Crane for questions: editor@marylandmatters.org.