New York Counties Have Received Millions From Opioid Lawsuits, But Many Won’t Say How They’ve Spent It

Tasers, virtual reality headsets, and a baby shower. These are just some of the ways New York counties spent their share of opioid settlement dollars this past year.

Over the past four years, counties have received over $330 million from legal settlements with pharmaceutical companies for their role in fueling the opioid crisis. But how counties have spent that money remains in many cases a mystery, despite a new mandate aimed at improving transparency.

Some counties don’t appear to have posted spending disclosures at all, despite a state requirement to do so that took effect in November.

At least 46 counties have posted disclosures. Some, like Seneca County, provided detailed breakdowns. Others reported only broad categories of spending. Onondaga County, home to Syracuse, reported spending over $1.4 million in 2024 across five spending areas, such as “treatment” and “special populations.” It didn’t provide further information, like who the money went to or for what programs.

“It really tells you nothing about where the money is going,” said Aliya-Begum Jessa, a policy research associate at Legal Action Center, a public health advocacy group. The money received by counties, in what are known as direct share allocations, is separate from other opioid settlement dollars overseen by the state’s Office of Addiction Services and Supports.

At least five counties reported spending $0 over the past year, including areas hard hit by overdoses just a few years ago, like Warren and Delaware counties. 

Last month, Jessa combed through each county’s website until she came across a webpage or document that looked like it might relate to the new reporting mandate. She shared her findings with New York Focus, which also conducted its own review.

The state mandate is vague. It requires local governments to annually post online “information regarding how such funding was utilized,” but doesn’t specify what information must be disclosed.

In an email, an OASAS spokesperson said the agency is planning to post a webpage containing links to available county reports by mid-January, but that it has no plans to review the submissions. “Our role is to collect and share information,” the spokesperson wrote. “We do not analyze spending or oversee the content of these reports.”

The spokesperson declined to comment on what steps the agency is taking to ensure counties comply with the reporting mandate.

In a November report, the Drug Policy Alliance urged the state for “measurable” standardized reporting, along with better planning to ensure local and state efforts don’t duplicate each other. “There is currently no coordinated, measurable state plan to reduce overdose deaths where the crisis is most severe,” the report noted.

Christine Khaikin, senior health policy attorney at Legal Action Center, is worried the lackluster spending and reporting could be a sign of waning urgency around the opioid crisis.

“There’s probably a sense that ‘We solved it,’ because rates have gone down a little bit,” she said of the state’s overall decrease in overdoses and deaths, particularly for white New Yorkers. “They’re still astronomically high and not going down for Indigenous communities and Black communities. … It’s still a crisis.”

When counties have reported more information, the disclosures have raised potential red flags.

Jessa commended Albany County for posting a detailed disclosure, but highlighted one line item: $6,165 for virtual reality headsets at Albany Medical College. Virtual reality therapy is being researched as an alternative to opioids for pain management, but has yet to yield solid evidence of effectiveness.

While settlement funds are intended to support communities battling addiction, much of the dollars that counties receive are unrestricted, allowing more general spending. In Essex County, expenditures included evidence-based treatment directly related to drug use, but also more general public health initiatives for infants such as a community baby shower.

In Sullivan County, almost 75 percent of the nearly $350,000 that officials spent from July 2024 to June 2025 went towards public service announcements, school-based prevention programs including an anti-vaping campaign, and various law enforcement line items such as surveillance cameras and $37,000 worth of taser guns.

“That’s really got nothing to do with serving the people who are impacted and struggling with overdose,” Khaikin said of the law enforcement line items. “It’s really bolstering the police department.”

Clinical support, previously the county’s single largest spending category, won’t be renewed in the upcoming year; the county will draw on other state funds for treatment programs, such as a new detox center. Nearly $1.7 million in settlement funds sits idle in the county’s coffers. 

Public service announcements and anti-drug campaigns at schools have been shown to have mixed results at best when it comes to deterring drug use.

In an email, Sullivan County’s health and human services commissioner John Liddle justified the spending as an “all of the above” approach that reflects the county’s continuing progress on reducing overdoses. Overdose deaths in the county have fallen to a fraction of 2022 levels, when it topped the state for most overdose deaths per capita.

Responding to advocates’ concerns over unspent funds, Liddle said the county has a long-term strategy. “We are shaping our expenditures so that funding will last long enough to support 5–10 additional years’ worth of effort on this issue,” he wrote.

Some counties did prioritize the types of programs advocates say deliver solid results. In Madison County, nearly $1 million has bolstered housing support and naloxone distribution. 

Funds went towards affordable mobile home units for six families struggling with addiction, the construction of four tiny homes as future transitional housing units, and a pot of money for repairs to compensate landlords who rent to tenants considered high-risk by the county. Naloxone distribution included the installation of 73 kits in public areas, as well as a staffer working full-time on naloxone training across the county.