How Wisconsin's Local Governments Are Using Opioid Settlement Funds

Understanding the Opioid Settlement Funding in Wisconsin

Wisconsin and its local governments are set to receive over $780 million by 2038 as part of a national legal settlement related to the opioid crisis. This funding is expected to play a significant role in efforts to reduce drug-related deaths. However, tracking how this money is spent remains a challenge.

While Wisconsin has made strides in making some information accessible, advocates argue that there is still room for improvement, especially regarding transparency at the local level. Some local governments have not submitted required reports on time, and errors were found in documents from more than a dozen local entities. The state receives 30% of the settlement funds and maintains a web page detailing its spending.

The remaining funds flow to 71 counties and 16 municipalities, excluding Polk County, which declined to join the lawsuit. These funds are meant to address a public health crisis that claimed the lives of at least 14,747 Wisconsinites between 2000 and 2023.

Local governments have spent $20 million in the first three years of disbursements, investing in areas such as residential treatment, jail recovery programs, police technology, and school-based drug prevention initiatives. However, this amount represents less than 15% of what local governments have received. With over $115 million in county and municipal accounts as of last December and about $400 million more on the way, spending is expected to increase significantly in the coming years.

Transparency and Reporting Challenges

A 2021 state law requires local governments to spend opioid settlement funds on approved uses related to the opioid crisis. However, the law does not mandate that local officials report how they spend the money. Instead, counties and municipalities are required to report only the amounts received and spent, along with year-end balances.

Debates continue nationwide about the best use of settlement funds, including discussions on spending on policing versus harm reduction programs. Experts emphasize the importance of transparency and involving people directly impacted by the opioid epidemic in decision-making processes.

Rick Schaefer, who lost his job and home due to an opioid addiction, believes that those affected should have a greater say in how the funds are used. He suggests that more individuals with lived experience should be involved in the work. While some localities have included people with lived experience on advisory committees, others have been less proactive in engaging the community.

Lessons from Past Settlements

Drug overdose rates in Wisconsin and across the country dropped in 2024, marking the first annual decline since 2019. Giavana Margo, Wisconsin program manager for Vital Strategies, notes that while progress is being made, significant challenges remain. Disproportionate harm continues to affect Black and Indigenous communities, with older Black men in Milwaukee facing an increasing share of drug-related deaths.

Wisconsin saw over 1,000 drug-related deaths between February 2024 and February 2025, according to preliminary U.S. Centers for Disease Control data. Advocates stress the need for strategic use of settlement funds to save lives, drawing lessons from past experiences with tobacco settlements.

In 1998, states settled with tobacco companies for an estimated $246 billion over the first 25 years. However, much of the funding was used to plug budget holes rather than support tobacco prevention efforts. Wisconsin currently spends less than 12% of what the CDC recommends on prevention.

Current Efforts and Future Goals

Wisconsin’s Department of Health Services has detailed $36 million in opioid settlement spending so far, much of it funding treatment center construction and renovation. The state is among 20 with some level of public reporting requirements for all settlement funds at both state and local levels.

However, the reports are not as easily findable as they could be. They are published as PDFs on the Joint Finance Committee website, alongside hundreds of other unrelated reports. While the Wisconsin Counties Association has created a resource page for county officials, the process of accessing this information can be cumbersome.

Some local governments have faced issues with reporting, including delays and discrepancies in figures. For example, the city of Milwaukee initially failed to report two years of spending but later submitted detailed reports after being contacted by a reporter. Several local governments also corrected missing expenditure figures and misreported receipts after discrepancies were flagged.

Public Input and Community Engagement

Public input is crucial in ensuring that settlement funds are used effectively. Many local governments have reported purchasing drugs like Narcan and training for its use. However, DUO Wisconsin members, an organization for current and former drug users, believe that more needs to be done to involve people with lived experience in decision-making.

Jess Morrow, a DUO member, highlights the difficulty in finding ways to get involved and knowing if one's voice will be heard. Dane County, which includes people with lived experience on its advisory committee, has held public meetings on opioid settlement spending. Rick Rose, a Dane County supervisor, emphasizes the importance of meeting people where they are to streamline the allocation process.

Despite these efforts, nearly 30 counties and municipalities reported spending zero settlement dollars so far. Some cited a lack of guidance on how to appropriately use the funds. While delaying spending might make sense in some cases, advocates stress the need for public explanations and the potential to save lives now.

As the opioid crisis continues, the focus remains on ensuring that settlement funds are used effectively and transparently to address the ongoing public health emergency.