For opioid victims, payouts fall short while governments reap millions

Christopher Julian's opioid journey is familiar to many Americans.

He was prescribed painkillers as a teenager for a series of sports injuries. He said the doctor never warned him they could be addictive. Julian didn't learn that fact until years later, when he was cut off and began suffering withdrawal symptoms. At that point, he started siphoning pills from family members and buying them from others in his southern Maine community.

After his brother died of brain cancer in 2011, Julian used opioids to cope with more than physical pain.

He stole to support his addiction, cycled in and out of jail and treatment, and overdosed 10 times, he said. His mother once gave him CPR on their bathroom floor.

Life was "hell on Earth," said Julian, now 43 and in long-term recovery.

Like tens of thousands of others who have suffered similarly, Julian filed claims for compensation from pharmaceutical companies accused of fueling the opioid crisis.

Earlier this year, he received his first payout: $324.58.

That's enough to fill his car with gas about eight times or pay about a tenth of the rent for an apartment he shares with his fiancee and two children.

Meanwhile, Maine's Cumberland County, where Julian lives, has received more than $700,000 in opioid settlement money and expects nearly $1.6 million more in the coming years, according to a newly updated database from KFF Health News. Jurisdictions throughout his state have received more than $68 million to date, and governments nationwide have raked in upward of $10 billion, the database shows.

That discrepancy between individuals' and governments' compensations highlights a sense of injustice felt by people directly affected by the crisis who say their suffering is the reason that governments secured these settlements.

Opioid settlements with companies like Purdue Pharma, Walmart, and Johnson & Johnson have led to headline-grabbing multibillion-dollar payouts, but most of the windfall is flowing to state and local governments, not directly to victims of the crisis.

Only a handful of companies — those that filed for bankruptcy, including Purdue Pharma, Mallinckrodt, Endo, and Rite Aid — have set aside payouts for individuals. To qualify, people must have filed claims within a certain window and provided documents proving they were prescribed painkillers from that company. Even then, many victims will receive just a few thousand dollars, lawyers and advocates estimate. Most of these companies have not started paying yet, so victims might have to wait months or years more before seeing the cash.

In contrast, state and local governments have already received settlement money. To understand the size of those payouts, KFF Health News in January downloaded data from BrownGreer, the court-appointed firm administering many national opioid settlements, and used it to update a searchable database that allows users to determine how much their city, county, or state has received or expects to receive each year.

Governments are receiving that money because attorneys general argued that their states' public safety, health, and social service systems were harmed by the opioid crisis. Jurisdictions are supposed to spend settlement money on addiction treatment, recovery, and prevention programs. But many affected individuals and families say governments have failed to adhere to that mission.

"At the very minimum, they could spend these dollars right to prevent the future loss of life," said Ryan Hampton, a national recovery advocate and previous co-chair of a committee in the Purdue Pharma bankruptcy case, where he represented victims. "That is the opposite of what we've seen to date."

In Pennsylvania, a group of bereaved family members raised similar concerns to Democratic Gov. Josh Shapiro, who finalized opioid settlements when he was attorney general.

"Instead of directing funds toward evidence-based solutions, you and your administration have allowed counties to divert these resources into law enforcement, ineffective programs, and initiatives that already have other funding streams available — disrespecting both our families and the lives lost," they wrote in a letter dated Feb. 14. "Meanwhile, bereaved families — many of whom have lost everything — have no financial relief."

'Governments were way more powerful'

To be sure, many governments have spent millions of settlement dollars on treatment programs, recovery supports, distribution of overdose reversal medications, and other efforts. Some officials in charge of the money say those services, which reach many residents, can have a greater impact than individual payouts.

Will Simons, a spokesperson for the Pennsylvania governor, said in a statement that the Shapiro administration has invested nearly $90 million of settlement funds into treatment, recovery, harm reduction, and prevention initiatives, including prevention programs for youths, a drug and alcohol call center, and loan repayment programs aimed at retaining workers in the addiction treatment and recovery field.

Many of the awarded organizations "support families who have lost loved ones to this crisis, providing counseling and other family supports," Simons said.

A few jurisdictions have created fairly modest funds directed at individuals, such as one in Boston to aid families who have lost loved ones to addiction, and a fund in Alabama for grandparents having to raise children because of parental substance use.

But nationwide, there's little that resembles the widespread cash payments that many advocates, like Hampton, originally envisioned.

In the mid-2010s, Hampton said, he and other advocates considered filing class action lawsuits against pharmaceutical companies but realized they didn't have the resources.

A few years later, when state attorneys general began pursuing cases against those companies, victims were thrilled, thinking they would finally get compensation alongside their governments. Hampton and other advocates held rallies, shared their stories publicly, and galvanized support for the states' lawsuits.

In 2019, when Hampton became co-chair of the Official Committee of Unsecured Creditors in Purdue Pharma's bankruptcy and arrived at the negotiating table with state attorneys general and other entities, he thought "everybody was there to take on the big bad pharmaceutical company and to put victims' interests first," he said. But as the negotiation proceeded among various creditors vying for the company's assets, he said, "governments were way more powerful than victims and believed that they were more harmed than victims in terms of cost."

Details of the Purdue settlement are still being finalized, and payments are unlikely to start until next year, but estimates suggest state and local governments will receive the lion's share, while more than 100,000 victims will split a fraction of the bankruptcy payout.

Mallinckrodt, a manufacturer of generic opioids, is the only company that had begun paying victims as of early 2025, said Frank Younes, a partner at the Nebraska-based law firm High & Younes, which is representing personal injury claimants in several opioid bankruptcies.

After paying roughly 25% in administrative fees to the national trust overseeing the bankruptcy and an additional 40% in attorney fees, some of his clients have received between $400 and $700, Younes said.

He expects payouts from two other companies — Endo and Rite Aid — "will be even lower."

But many victims won't receive anything. Some didn't know they could file claims until it was too late. Others struggled to obtain medical records from shuttered doctors' offices or pharmacies that didn't retain older documents.

Out of nearly 20,000 people who contacted Younes' firm to participate in the various opioid bankruptcies, he said, only about 3,500 were able to file.

'Do something for these families'

John McNerney was told his Purdue Pharma claim didn't qualify, because he hadn't been prescribed enough OxyContin to meet the threshold. He submitted claims for Mallinckrodt and Endo instead.

McNerney, 60, who lives in Boca Raton, Florida, said he suffered a spinal injury decades ago from a fall during a plumbing repair. For years afterward, he was prescribed various painkillers. Once his doctors cut him off, he began using pills a friend bought off the street. McNerney spent about $30,000 on rehabs before he entered long-term recovery.

Now when he sees governments spending settlement money on police cars or library books about addiction "instead of putting 100% of it into rehab," he said, "it really bothers the heck out of me."

"I haven't received a nickel," he said.

In Ohio, a group of affected families were similarly frustrated that money wasn't reaching them or the places where they thought it was needed most.

The families teamed up with local nonprofits to submit grant applications to the OneOhio Recovery Foundation, which controls most of the state's opioid settlement funds. They asked for several million dollars to put toward family support groups, training for family members who take in children whose parents have substance use disorders, and emergency cash aid for families to buy cribs or school supplies and cover funeral costs.

Jackie Lewis, a member of the group, said that when her 34-year-old son, Shaun, died of an overdose, she had to pay his funeral costs by credit card. She has filed a claim in the opioid bankruptcies but hasn't received any money yet.

"Too many families didn't have a credit card to do that with," Lewis said. "There are families I've talked to that couldn't do flowers. Some had to do a cremation instead of a traditional funeral."

Her group did not receive funding in the first round of grants from the OneOhio Recovery Foundation.

Connie Luck, a spokesperson for the foundation, said the legal documents that established the foundation do not allow direct payments to individuals affected by the crisis. The foundation has awarded over $45 million to 245 projects throughout the state, including dozens that provide family support services like child care and rental assistance.

"We deeply empathize with those who have lost loved ones to the opioid epidemic — their pain is real, and it fuels the Foundation's mission to end this crisis and prevent it from happening again," Luck said in a statement.

In Maine, Julian has made peace with his $325 payout, deciding to consider it a surprise bonus rather than compensation for his years of suffering.

But he hopes governments will use their more substantial sums to provide real help — food and rental assistance for people in recovery and more treatment beds so no one has to wait six months to enter rehab as he once did.

"They're getting millions of dollars," said Julian, who has lost numerous close friends to overdose. "They could do something for these families that have suffered great losses."

KFF Health News data editor Holly K. Hacker contributed to this article.

Methodology

For more than two years, KFF Health News has been tracking how state and local governments use — and misuse — billions of dollars in opioid settlement funds. This database marks our third update of data showing how much money state and local governments have received through national settlements with companies that made or distributed prescription painkillers.

BrownGreer, the court-appointed firm administering many national opioid settlements, tracks how much money it has delivered to various state and local governments, as well as how much is allocated to those jurisdictions for future years. It initially kept this information private.

In 2023, KFF Health News negotiated to obtain that information and made it public for the first time. Five months later, BrownGreer began posting updated versions of the information on a public website.

Last year, KFF Health News downloaded BrownGreer's data on payouts from pharmaceutical distributors AmerisourceBergen (now called Cencora), Cardinal Health, and McKesson, as well as opioid manufacturer Janssen (now known as Johnson & Johnson Innovative Medicine), and used the state-by-state spreadsheets with separate entries for each settling company to create a searchable database.

This year, KFF Health News has updated that database with new data from BrownGreer, including payouts from opioid manufacturers Allergan and Teva, as well as CVS, Walgreens, and Walmart pharmacies.

KFF Health News downloaded data from BrownGreer's website between Jan. 20 and 24, 2025, concerning payouts from all companies. Users can use the database to determine the total dollar amount their city, county, or state has received or expects to receive each year.

Although this is the most comprehensive data available at a national scale, it provides just a snapshot of all opioid settlement payouts. Other settlements, including with OxyContin manufacturer Purdue Pharma, are still pending. This data does not reflect additional settlements that some state and local governments have entered into beyond the national deals, such as the agreement between Illinois, Indiana, Kentucky, Michigan, and Ohio and regional supermarket chain Meijer. As such, this database undercounts the amount of opioid settlement money most places have received and will receive.

Payment details for some states are not available, because those states were not part of national settlement agreements, had unique settlement terms, or opted not to have their payments distributed via BrownGreer. A few examples:

• West Virginia declined to join several national settlements and instead reached individual settlements with many of these companies.
• Texas and Nevada were paid in full by Janssen outside the national settlement, so their payout data reflects payments only from other companies with which they entered national settlements.
• Florida, Louisiana, and Pennsylvania, among others, opted to receive a lump-sum payment via BrownGreer then distribute the money to localities themselves.

BrownGreer shows that several states received some of their anticipated 2027 payment from the distributors (AmerisourceBergen — now called Cencora — Cardinal Health, and McKesson) early in 2024. However, for three states — Colorado, Michigan, and Washington — BrownGreer does not provide data on how much of this prepayment went to each locality. As such, locality payments in these states may be undercounted for 2024 and overcounted for 2027.

For Oregon, BrownGreer shows 2024 payments from Walmart as fully paid in its statewide data but lists some August 2024 payments for localities as "projected." Since the data was downloaded well past that August 2024 date, we have included those "projected" amounts in the 2024 paid total for Oregon localities. No other states had this discrepancy.