How are Wisconsin’s local governments spending millions in opioid settlement payouts?

Wisconsin and its local governments are expected to receive more than $780 million by 2038 as part of a national legal settlement over the role of drug makers, distributors and pharmacies in the opioid crisis — potentially transformational funding in efforts to reduce drug deaths.

But it’s not easy to track where some of that money is going. 

While Wisconsin does a better job than many states in making that information accessible, advocates say it has room to improve, particularly when it comes to transparency around local spending. Not every local government has filed required reports on time, and Wisconsin Watch and WPR found reporting errors on documents submitted by more than a dozen local governments.

The state gets 30% of the settlement funding and documents its spending on a web page.

The rest flows to 71 Wisconsin counties (all but Polk, where the county board declined to join Wisconsin’s lawsuit) and 16 municipalities, according to Wisconsin’s settlement agreement finalized in 2022.

It’s considered compensation for a public health crisis that killed at least 14,747 Wisconsinites between 2000 and 2023.

Local governments have spent $20 million during the first three years of disbursements, investing in strategies ranging from residential treatment and jail recovery programs to technology for police and T-shirts for school-based drug prevention programs.

The millions spent so far make up less than 15% of what local governments have received. With more than $115 million sitting in county and municipal accounts as of last December and about $400 million more on the way, local spending will likely ramp up in the coming years.

But transparency varies across local governments. 

A 2021 state law requires that local governments spend opioid settlement dollars within a list of approved uses related to the opioid crisis. But the law does not require local officials to tell the state how they spend it. Instead, counties and municipalities are required to report only how many settlement dollars they have received and spent, alongside their year-end balances.

Debates have unfolded nationwide about how to use settlement funds — including about the merits of spending on policing or programs that promote supervised drug use to reduce harm.

In making those decisions, local governments should be transparent and involve people directly impacted by the opioid epidemic, experts say.

Rick Schaefer lost his job and house after developing an opioid addiction. He accepts he’ll never be made whole.

“But we should be more involved in how the (settlement) money is spent,” Schaefer said, adding that most people he talks to know little about the settlement funding. While he wishes people would pay more attention, he wants governments to better engage the public.

“I want to see more people with lived experience doing the work,” he said.

Some localities have followed that practice by including people with lived experience on advisory committees. Others post detailed spending information online, conduct regional surveys and hold community listening events.

The majority of Wisconsin’s local governments elaborate on their plans in supplementary annual surveys by the Wisconsin Counties Association.

Milwaukee County is seen nationally as a model for transparency and public involvement. It submitted nearly 30 pages of details to the state this year alongside its required figures.

But a dozen counties and municipalities have skipped or minimally answered the optional questions. Multiple municipalities failed to report opioid settlement spending totals one to two years after state deadlines. And seven governments submitted reports only after a reporter asked why theirs was missing. 

The Wisconsin Department of Justice reviews the reports annually and has flagged and reported issues when they are identified, but the department “does not have any enforcement role with respect to the submission of these reports,” spokesperson Samantha Standley said in an email.  

The Legislature’s Joint Finance Committee also receives the reports annually. Co-chairs Rep. Mark Born, R-Beaver Dam, and Sen. Howard Marklein, R-Spring Green, did not respond to requests for comment.

Lessons from tobacco settlement 

Drug overdose rates dropped in 2024 across Wisconsin and the country, the first annual decline since 2019. 

The decrease represents major progress, said Giavana Margo, Wisconsin program manager for Vital Strategies, a national nonprofit working to reduce overdose deaths.

Still, plenty of work remains, and progress is uneven.

Black and Indigenous communities continue to face disproportionate harm from the opioid epidemic. In Milwaukee, for instance, older Black men are accounting for a growing share of drug deaths as fentanyl creeps into cocaine supplies. 

Wisconsin still saw more than 1,000 drug-related deaths from February 2024 to February 2025, preliminary U.S. Centers for Disease Control data show.

Settlement dollars have the potential to save lives if spent strategically, Margo said.

That did not happen the last time states reaped billions in compensation for a public health crisis. 

States, including Wisconsin, settled with tobacco companies in 1998 for an estimated $246 billion over the first 25 years. 

While states promised to use the funding to fight tobacco use, the bulk went toward plugging budget holes. Most states still spend less on tobacco prevention than the CDC recommends.

For its part, Wisconsin receives hundreds of millions each year from settlements and taxes on tobacco but spends less than 12% of what the CDC recommends on prevention. 

Advocates want to avoid a repeat as opioid settlement funds flow in, said Kristen Pendergrass, vice president of state policy at Shatterproof, a national nonprofit focused on the addiction crisis. It’s why experts call for transparency.

Wisconsin is off to a better start this time.

The Department of Health Services opioid settlement web page details $36 million in department spending so far — much of it funding treatment center construction and renovation. 

Wisconsin is among 20 states with some level of public reporting requirements for 100% of settlement funds at the state and local levels, according to OpioidSettlementTracker.com.

Many states lack any reporting requirements for locally disbursed funds, leaving interested residents to sift through county board minutes and a scattering of local government websites. 

Wisconsin’s annual reporting requirement creates a central location for spending information, Margo said, even if it’s not as robust or accessible as it could be. 

States such as Minnesota and Indiana break down local spending on dashboards and spreadsheets linked on health and substance abuse-related websites. Wisconsin’s reports aren’t as easily findable. They are published as PDFs on the Joint Finance Committee website, alongside hundreds of other spending reports unrelated to opioids. The reports are also available by request through the state DOJ. The Wisconsin Counties Association separately published the 2023 and 2024 spending reports to a resource page created for county officials.

The city of Milwaukee receives more settlement funding than any local government except for Dane and Milwaukee counties. But it failed to initially report two years of spending and receipts after “an oversight resulted in delays,” wrote Comptroller Bill Christianson. After being contacted by a reporter the city submitted reports detailing more than $500,000 in spending, and it created procedures to meet future reporting deadlines.

Some local government officials said they didn’t know they were required to submit reports if they had yet to spend any settlement money. Several corrected missing expenditure figures, misreported receipts and mismatched account balances between years after a reporter flagged discrepancies. 

Calls for public input

The overdose reversal drug Narcan saved Schaefer’s life multiple times before he started his recovery journey and became a certified peer support specialist. Growing availability of Narcan and other harm reduction resources is likely fueling the decline in overdose deaths — at least in part, Schaefer said.

Many Wisconsin local governments have reported purchasing drugs like Narcan and training for its use. 

“Things are going in the right direction,” Schaefer said. “So let’s decide where to throw more money. What else can we try?”

He and other members of DUO Wisconsin, an organization for current and former drug users, hope governments will listen to people with lived experience. Their proximity to the crisis forges unique perspectives.

Many local governments have launched advisory councils and seek public input, including from people affected by the opioid crisis. Twenty-one local governments in annual reports to the state mentioned soliciting some form of community input. 

But even in those cases, people don’t always know how to get involved or whether they will be listened to, said Jess Morrow, a DUO member.

“How do you even begin to look or find out?” she asked. 

Morrow and Schaefer live in Dane County, which holds public meetings on opioid settlement spending and includes people with living experience on its advisory committee.

“When you look at the successes of other counties and other states, it’s meeting people where they’re at,” said Dane County Supervisor Rick Rose, who helped create that committee.

He aims to streamline the county’s allocation process so more dollars can more quickly flow where needed.

“This disease is changing every day,” Rose said.

Several local governments reported spending money on test strips for the potent drug fentanyl and xylazine, a veterinary sedative increasingly found in illicit drugs. But DUO members say people are also unknowingly buying drugs cut with harmful substances strips don’t test for, like plastic and dog dewormer.

“Everybody who uses probably has way too many (test strips), because they’re everywhere,” Schaefer said. “We need something that does a better job of accurately telling you, really what’s in everything. … The technology is improving to get us there.”

Some local governments have yet to spend

Nearly 30 counties and municipalities reported spending zero settlement dollars so far, including several who said they weren’t sure how to spend it.

Monroe County in 2023 cited as a barrier “minimal information available and guidance on how to appropriately use opioid settlement funds.”

Delaying spending could make sense in some scenarios, Pendergrass said. Governments might want to take extra time for research and outreach. Or they could invest in interest-earning accounts that grow funds for ambitious future projects. But they owe an explanation to the public, she said.

And the funds could save lives now.  

“It’s great news that overdose rates are going down,” Pendergrass said. “But we can’t take our foot off the brake because people are still dying every day.” 

This article first appeared on Wisconsin Watch and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.