When opioid manufacturers, distributors, and other companies agreed to pay billions of dollars to settle lawsuits over their role in the nation’s opioid crisis, the money came with an obvious purpose.
Communities had been devastated by addiction and overdose deaths. The settlements were intended to help those communities respond to that devastation, including through treatment, prevention, recovery, and other programs designed to address the consequences of opioid addiction.
But now an investigation into Louisiana’s use of that money is raising a much bigger question.
Who is making sure the money actually goes where it is supposed to go?
A joint investigation by KFF Health News, Verite News, The Current, and the Gulf States Newsroom contacted every sheriff’s office in Louisiana to find out how the offices were spending their shares of opioid settlement funds. What reporters found provides a troubling case study in the challenges of managing billions of dollars intended to address a national public health crisis.
A Massive Pool of Settlement Money
The opioid settlements are among the largest attempts in American history to make communities financially whole after a public health catastrophe.
Beginning in 2021, a series of settlements with opioid manufacturers, distributors, and other companies began sending money to states and local governments. Nationally, the settlements are expected to provide more than $50 billion.
That money is arriving because the opioid epidemic has been extraordinarily destructive. More than 800,000 Americans died from opioid-related overdoses between 1999 and 2023, according to the data cited by the investigating news organizations.
The settlement money, therefore, represents more than another government revenue stream.
For families who lost someone to an overdose, it represents an opportunity to prevent other families from experiencing the same loss.
That makes accountability particularly important.
Louisiana Took an Unusual Approach
Louisiana’s system is unusual.
The Louisiana Opioid Abatement Task Force says the state’s settlement agreement directs 80% of the proceeds to parishes and 20% to sheriffs.
That 20% share makes Louisiana an outlier. The KFF Health News investigation described it as the largest allocation specifically earmarked for law enforcement among the states.
Louisiana is projected to receive more than $621 million in settlement funds over 21 years. Based on the state’s allocation formula, sheriffs could ultimately receive approximately $124 million.
The state’s own settlement framework describes the money as being intended for opioid abatement efforts.
The question is what happens after the money reaches individual sheriff’s offices.
Following the Money
That question turned out to be surprisingly difficult to answer.
The investigation found that Louisiana sheriffs should have received approximately $18.8 million from the settlement fund through 2025. Reporters asked all 64 sheriff’s offices how they had spent their money.
Forty-three offices provided spending information. Twenty did not provide expenditure information, while five additional offices reported spending nothing. Together, that represented approximately $10.6 million in settlement funds that remained unreported in the investigation.
That does not necessarily mean the money disappeared.
There is an important distinction between money that has not been publicly accounted for and money that has been stolen or improperly spent. The investigation does not establish that the unreported funds were misappropriated.
The problem is that the public should not have to guess.
When governments receive money specifically designated for a public purpose, taxpayers and residents should be able to determine how much was received, where it went, and what it accomplished.
What Sheriffs Are Buying
The spending that could be documented raises another set of questions.
According to the investigation, Louisiana sheriff’s offices reported spending more than $8.1 million. Much of that money went toward crime-fighting equipment, including surveillance cameras and drug-detection products. Other expenditures included addiction treatment in jails, educational programs, public-awareness campaigns, mobile applications, counseling, training, and other services.
Some of those purchases could have a legitimate connection to the opioid epidemic.
A sheriff’s office dealing with overdoses and drug trafficking may reasonably argue that certain equipment helps address the crisis. Law enforcement is unquestionably part of the response to illegal drug distribution.
But that does not automatically mean every law enforcement purchase is an appropriate use of opioid settlement money.
That distinction is at the heart of the controversy.
The Spending Was Not Necessarily Illegal
It is important not to overstate what the investigation found.
The journalists did not determine that the sheriffs were breaking the law. Instead, they asked an independent panel of experts whether individual expenditures appeared consistent with the intended purpose of the settlement funds.
The panel included a public health policy expert, an addiction medicine physician, and a Louisiana resident in recovery who lost his son to a fentanyl overdose.
Of the $8.1 million in reported spending reviewed, the panel determined that approximately $5.4 million, or 66%, represented expenditures it considered inappropriate.
That is a significant finding, but it should be understood for what it is.
It is an independent assessment of whether the spending fits the intended purpose of the settlement money. It is not a legal ruling.
That distinction actually makes the story more interesting.
The question is not simply whether someone violated a rule.
The question is whether the rules themselves are strong enough to make sure the money accomplishes what it was intended to accomplish.
Louisiana’s Own Auditor Raised Concerns
The latest investigation did not uncover the accountability problem from scratch.
The Louisiana Legislative Auditor examined the state’s opioid settlement system in 2025 and found significant weaknesses in oversight.
The auditor reported that the Louisiana Opioid Abatement Task Force is an advisory body and that oversight of how settlement funds are spent remains limited. The audit also found that 21 sheriff’s offices failed to respond to the auditor’s survey.
There is also an important difference in reporting requirements.
Parish governments are required to report their opioid settlement expenditures. Sheriffs are not subject to the same proactive reporting requirement.
That means the public can have more difficulty determining how sheriff’s offices spend their settlement allocations.
The state’s own auditor, therefore, identified an oversight problem before the latest investigation showed what that problem looks like in practice.
Why This Matters Beyond Louisiana
It would be easy to dismiss this as a Louisiana problem.
That would be a mistake.
Every state is receiving some form of opioid settlement money. The amounts and distribution systems vary, but the underlying challenge is the same.
There is a finite amount of money available to address addiction, overdose, and recovery. Every dollar spent on one purpose is a dollar that cannot be spent somewhere else.
That does not mean police equipment is automatically a waste of money. It means communities need a way to determine whether an expenditure actually contributes to reducing the damage caused by opioid addiction.
A new camera system might be valuable. So might medication-assisted treatment, recovery housing, counseling, overdose prevention, or programs aimed at preventing young people from becoming addicted in the first place.
The important question is not which category sounds better.
It is which investments actually work.
The People Who Lost the Most Deserve an Answer
There is an emotional dimension to this issue that can easily get lost in spreadsheets and government documents.
The KFF investigation highlighted the story of Danny Bolner Jr., a Louisiana resident in recovery who lost his son to a fentanyl overdose in 2016. He is now raising his son’s daughter.
For people like Bolner, opioid settlement money is not an abstract budget item.
It exists because communities suffered enormous losses.
That does not mean every dollar must be spent on treatment rather than law enforcement. It does mean the public has a legitimate reason to demand evidence that the money is serving the purpose for which it was intended.
The settlements were created in response to a crisis that killed hundreds of thousands of Americans.
The response should be measured against that reality.
Transparency Should Not Be Optional
There is a simple lesson in the Louisiana investigation.
If a government agency receives millions of dollars in settlement money, the public should be able to see how that money is spent.
That information should not require reporters to contact every sheriff in the state, make repeated phone calls, send public-records requests, and build their own database because no government agency is providing a comprehensive public accounting. The KFF investigation took five months and contacted all 64 Louisiana sheriffs.
Louisiana’s experience shows why stronger reporting requirements matter.
The state’s Legislative Auditor has already identified weaknesses in oversight, while the latest investigation demonstrates how difficult it can be for the public to follow the money.
Guidance is useful, but guidance is not the same thing as accountability.
The Money Cannot Treat an Addiction If Nobody Tracks It
The opioid settlements are a rare opportunity.
Communities that have spent decades dealing with addiction now have billions of dollars that can potentially be invested in treatment, prevention, recovery, and other strategies.
But money alone does not solve a public health crisis.
The money has to reach effective programs. The programs have to be evaluated. The spending has to be transparent. And governments need to be able to explain to the public what was accomplished.
Louisiana’s experience shows what can happen when those safeguards are weak.
The central question should not be whether sheriffs deserve a role in fighting the opioid epidemic. They clearly do.
The question is whether money intended to repair the damage caused by the opioid epidemic should be spent without clear public reporting and meaningful oversight.
Americans should not have to take anyone’s word for it.
They should be able to follow the money.
—Greg Collier
