Improving Public Health Through Litigation: Evaluating the National Opioid Settlements and Their Potential Impact on Abating the Opioid Epidemic

In the United States, the opioid epidemic grows deadlier every year. Despite the ample evidence available about effective practices and services that may be used to reduce opioid overdose deaths, little progress has been made to curb the crisis. Rampant individual and structural stigma around opioid use disorder (OUD), historic underfunding of treatment and harm reduction strategies, and a focus on the criminalization of addiction have led to little effective policy change and a lack of public support for effective practices. However, recent litigation between states and opioid companies have resulted in massive settlements and millions of dollars being distributed across the country to be used for opioid remediation. Through analyzing who is in charge of the funds, the public reporting of the funds, and initial expenditures made by states, this thesis attempts to examine the potential for these opioid settlements to create lasting change and abate the opioid crisis. The findings reveal that each state is taking its own direction; however, recurring themes in spending suggest that while states are giving significant attention to harm reduction strategies and services that target BIPOC individuals with OUD, they are still relying on law enforcement and the criminal justice system as key players in opioid use control. The results of this study support the need for more transparent funding and better data collection in order to draw further conclusions.