The District is set to receive more than $100 million from companies accused of contributing to the opioid epidemic. This money is meant to help address the damage caused by a crisis that has taken thousands of lives locally, but now advocates wonder where and how the funds are being spent.
The settlements resulted from litigation against manufacturers, distributors and other companies accused of contributing to widespread opioid addiction and overdose deaths. The money was intended to help governments address damage caused by the epidemic through treatment, prevention, recovery services and efforts to reduce overdose deaths.
“Tragically, hundreds of D.C. residents continue to lose their lives every year to opioid overdoses, and far too many members of our community struggle with opioid addiction,” said D.C. Attorney General Brian Schwalb in a July 2025 statement.
However, as D.C. prepares its fiscal 2027 spending plan, a dispute has emerged over whether millions of those settlement dollars will fund new and expanded responses to the opioid crisis or cover services previously financed by the city’s general budget.
The National Academy for State Health Policy’s opioid settlement tracker shows how D.C. is spending money on treatment, prevention, harm reduction, and other opioid-related services. So far, D.C. has approved at least $18 million in government subsidies and grants.
At issue is roughly $2.3 million in opioid settlement money designated to help pay the District’s Medicaid contribution and at least $5.5 million to support addiction treatment centers previously funded through the general budget, according to documents obtained by KFF Health. Critics say replacing existing city funding with settlement money violates District law requiring that the funds “supplement, and not supplant,” other spending.
“If the opioid settlement funds were not there, I feel pretty confident that these things would have been funded, because they have to be funded,” Chad Jackson, chair of the District’s Opioid Abatement Advisory Commission, told KFF Health.
Questions About Spending
While D.C. continues to receive money from settlements, state and local governments nationwide are expected to receive more than $50 billion over nearly two decades.
The District created an Opioid Abatement Fund and an advisory commission to help guide the use of its share. The Department of Behavioral Health’s (DBH) Office of Opioid Abatement administers settlement-funded initiatives and grants addressing opioid use disorder, overdose prevention, treatment and recovery.
But advocates are questioning whether settlement dollars are expanding the city’s response or replacing money D.C. would have spent anyway.
District law says money from the opioid abatement fund “shall supplement, and not supplant” other funding.
“It’s a pretty tightly written law where the intent is very clear: Do not supplant,” said Shelly Weizman, associate director of the Center on Addiction and Public Policy at Georgetown Law’s O’Neill Institute.
If settlement dollars replace general-fund money previously used to support treatment, the overall amount spent on those services may remain unchanged. KFF found that substituting settlement dollars for existing general funding would keep overall treatment spending flat rather than increase it.
More than 80 people and 30 District organizations signed a letter objecting to the proposed use of the money. The letter, sent to DBH Director Barbara Bazron, D.C. Council member Christina Henderson (I-At-Large), chair of the Council’s Committee on Health, and Schwalb, accused DBH of planning to use opioid settlement funds to “pay off its own debts.”
The dispute subsequently drew questions from Henderson and Schwalb.
“We are also concerned that DBH may be using the settlement monies for other unauthorized purposes,” Henderson and Schwalb wrote in a July 17 letter to the department.
They specifically questioned the $2.3 million designated for the District’s Medicaid contribution and asked DBH to explain, by July 31, how it determined that using settlement funds was legal. It was unclear whether DBH met that deadline.
Additionally, D.C. has announced grants and programs financed with settlement proceeds, including expanded youth treatment services, overdose response, peer recovery programs and community-based opioid prevention and treatment efforts.
Jackson, who is himself in recovery, has argued that the fiscal 2027 proposal crosses the line established by District law.
Queen Adesuyi, a D.C.-based harm reduction advocate and partner at Reframe Health and Justice, has also challenged the proposed spending.
“These funds were awarded to D.C. for very specific reasons and with a specific mandate, which are to remediate issues related to the opioid crisis in new and innovative ways,” Adesuyi told KFF.
Calls for ‘Interventions That Are More Courageous’
Department of Behavioral Health spokesperson Denise Reed said the council approved a legally certified budget that uses local resources, including the opioid settlement fund, to provide grants to 17 community-based organizations.
Those providers served nearly 9,800 residents last year, including about 3,500 people receiving medication-assisted treatment for opioid addiction, according to DBH.
Reed emphasized DBH is “committed to compliance with all statutory requirements governing opioid settlement funds.”
A spokesperson for Mayor Muriel Bowser (D) didn’t immediately respond to The Informer’s request for comment.
Meanwhile, the District continues to struggle with an unpredictable illicit drug supply and overdose deaths even as settlement money becomes available, which Adesuyi says makes decisions about how funds are spent particularly consequential.
“The drug supply is getting a lot more unpredictable, which calls for some nimbleness, and it calls for interventions that are more courageous,” Adesuyi remarked. “Unfortunately, DBH is not meeting the mark when it comes to that.”
As questions about funding and resources continue, the harm reduction advocate emphasized the challenges facing D.C. residents in the meantime.
“It’s frustrating, it’s disappointing, and it’s enraging,” she said, “because people are dying unnecessarily in the District to overdose.”
