Where do these monies live?

Alabama’s local share is distributed to its local governments and governmental public health units.[1]

• For Alabama’s settlement with McKesson and Janssen, 40% is allocated to litigating local governments and 10% is allocated to litigating governmental public health entities (i.e., public hospitals, county health departments, boards of health).[2]

• For Alabama’s settlement with Endo, 40% is allocated to litigating political subdivisions.[3]

• For Alabama’s opioid-related bankruptcy settlements, 50% is allocated to political subdivisions.[4]

• According to a presentation from the Office of the Alabama Attorney General, 50% of the state’s settlements with Teva, Allergan, CVS, and Walgreens will “go[] to local entities.”[5]

• Local governments also received funds from a settlement with Walmart, negotiated by the Alabama Attorney General on behalf of Alabama cities and counties.[6]

With limited exceptions,[7] this share must be spent on uses consistent with the national settlement agreement’s (non-exhaustive) ,[8] which includes prevention, harm reduction, treatment, recovery, and other strategies.

Local governments and governmental public health entities decide autonomously. Decisionmakers for the local governments and governmental public health entities will decide autonomously how to spend their share of opioid settlement funds on approved uses (e.g., uses).[9]

No, supplantation is discouraged but not prohibited. Like most states, Alabama does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 50% local share may be spent in ways that replace (or “supplant”) – rather than supplement – existing resources.

However, in its annual reports, the has described a “shared commitment to using abatement funds recovered from statewide opioid settlements to supplement and strengthen resources available to Alabama communities and families for substance use disorder prevention, harm reduction, treatment, and recovery.”[10]

Up to each locality (neither public nor intrastate reporting required). Opioid settlement expenditures are not officially published in a centralized location for this share.

Visit OpioidSettlementTracker.com’s for an updated collection of states’ and localities’ available expenditure reports.

Unlike most states, Alabama chose not to participate in some of the national settlement agreements.[11] Pursuing individual settlement agreements with the companies involved in the opioid litigation means that Alabama’s opioid settlement scheme is not automatically subject to all the features (and protections) of the “national” settlement agreements’ opioid remediation-related terms. For example, Alabama’s McKesson and Janssen settlement agreements do not specify any amount that must be used exclusively towards forward-looking abatement strategies.[12]

1. See . Alabama Attorney General Office press release. March 4, 2024 (“As with previous opioid settlements, the State will share settlement funds with local governments and public hospitals”). Compare (50% going to the State, 40% going to the Political Subdivisions [Litigating Local Governments], and 10% going to the Litigating Governmental Public Health Entities) with (“50% going to the Political Subdivisions [“any Alabama municipality, county, municipal agency, county agency”] and 50% going to the State”). ↑

2. McKesson Special Master Report 1 (“Pursuant to Sec. B. l of the McKesson and Janssen Opioid Settlement Allocation Agreement, "The State, Political Subdivisions [Litigating Local Governments] and Litigating Governmental Public Health Entities … shall divide all Settlement Funds with 50% going to the State, 40% going to the Political Subdivisions [Litigating Local Governments], and 10% going to the Litigating Governmental Public Health Entities”). ↑

Where do these monies live?

Alabama’s 50% state share is held in the state’s Opioid Treatment and Abatement Fund.[1]

What can this share be spent on?

With limited exceptions,[2] this share must be spent on uses consistent with the national settlement agreements’ (non-exhaustive) Exhibit E.[3] The Alabama Opioid Overdose and Addiction Council’s eight priorities, which “align” with Exhibit E,[4] further identify a subset of its many interventions it thinks “would assist in changing the trajectory of the opioid crisis in Alabama.”[5]

Who ultimately decides how to spend this share (and how)?

Oversight Commission on Alabama Opioid Settlement Funds recommends, Opioid Overdose and Addiction Council guides, state legislature decides. The Alabama state legislature ultimately decides via appropriation how to spend funds from this share after consulting with the Oversight Commission on Alabama Opioid Settlement Funds (Commission) and Opioid Overdose and Addiction Council (Council).[6],[7]

• The Commission, created in 2023, is specifically tasked to “develop a statewide plan for the investment and use of opioid settlement funds and review the expenditure of funds appropriated to agencies and entities.”[8]

• The , created in 2017,[9] is generally responsible for assisting the governor in developing a statewide response to the overdose crisis and identifying spending priorities that reflect the state’s needs.[10]

No, supplantation is discouraged but not prohibited. Like most states, Alabama does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 50% state share may be spent in ways that replace (or “supplant”) – rather than supplement – existing resources.

However, in its annual reports, the has described a “shared commitment to using abatement funds recovered from statewide opioid settlements to supplement and strengthen resources available to Alabama communities and families for substance use disorder prevention, harm reduction, treatment, and recovery.”[11]

No (neither public nor intrastate reporting required). Opioid settlement expenditures are not officially published in a centralized location for this share.

Visit OpioidSettlementTracker.com’s for an updated collection of states’ and localities’ available expenditure reports.

Unlike most states, Alabama chose not to participate in some of the national settlement agreements.[12] Pursuing individual settlement agreements with the companies involved in the opioid litigation means that Alabama’s opioid settlement scheme is not automatically subject to all the features (and protections) of the “national” settlement agreements’ opioid remediation-related terms. For example, Alabama’s McKesson and Janssen settlement agreements do not specify any amount that must be used exclusively towards forward-looking abatement strategies.[13]

1. See 2024 AL House Bill 479 (appropriating settlement funds from the “Opioid Treatment and Abatement Fund”). But see . Alabama Attorney General Office press release. March 4, 2024. Accessed August 6, 2024 (“The State’s share of the settlement funds will be deposited directly into the State’s General Fund”). ↑

2. See, e.g., McKesson Special Master Report (describing special master fees and attorneys’ fees). ↑

3. See . Alabama Opioid Overdose and Addiction Council. December 31, 2022 (describing Exhibit E’s “core strategies” list under “Approved State Use of Abatement Funds” and stating that “[t]he agreement reached by the State of Alabama with various parties restricts the use of any settlement funds to abatement strategies only. The priorities recommended by the Council align with the approved strategies”). Note that the state’s Janssen (Johnson & Johnson) settlement includes its own approved use exhibit with a non-exhaustive list of opioid remediation strategies that is similar but not identical to the national settlement agreements’ Exhibit E. The Janssen approved uses exhibit’s list of opioid remediation strategies are grouped into three categories: Opioid Community Innovation & Recovery (e.g., treatment, prevention, and harm reduction), Opioid Statewide Innovation & Recovery (e.g., resources for dashboards and stigma reduction training), and Opioid Recovery Sustainability (e.g., funding for child and family supports and syringe service programs). Johnson & Johnson Sign-On Exhibit A. ↑

Here are the entities that ultimately decide how each of Alabama’s opioid settlement shares are spent:

• 50% state share:

• 50% local share: decisionmakers for municipalities, counties, and governmental public health entities (i.e., public hospitals, county health departments, boards of health)