Maryland’s $670 Million Opioid Settlement: Where The Money Is Going

ANNAPOLIS, Md. — Communities across Maryland continue to address the lasting effects of the opioid crisis through prevention, treatment, recovery and public health efforts. One source of support is Maryland opioid settlement funds, which come from legal settlements involving companies connected to the opioid epidemic.

The scale of that funding is significant. Based on currently finalized settlements, Maryland and its subdivisions are projected to receive roughly $670.8 million over the next 18 years, according to the Maryland Opioid Restitution Fund Primer published by the Maryland Office of Overdose Response (MOOR). The state continues to add to that total as new settlements are finalized — Maryland Attorney General Anthony G. Brown announced in July 2026 that the state would receive an additional $13 million from settlements with drugmakers, saying the money would fund treatment and recovery efforts to help Marylanders break the cycle of addiction, according to the Baltimore Sun.

For residents in Southern Maryland, Anne Arundel County, Baltimore, Washington and communities throughout the state, these funds represent an opportunity to strengthen services that can reduce overdoses, expand access to care and support people in recovery. While spending decisions vary by jurisdiction and over time, the overall purpose remains focused on responding to harms caused by the opioid crisis.

Understanding how these funds work can help residents follow local decisions, participate in public discussions and better understand how settlement dollars differ from traditional tax revenue.

What Are Opioid Settlement Funds?

Opioid settlement funds generally result from legal agreements between state and local governments and companies involved in the manufacturing, distribution or marketing of opioid medications. Rather than serving as unrestricted revenue, these settlements are intended to support efforts related to opioid prevention, treatment, recovery and other responses to the public health impacts of opioid use disorder.

In Maryland, funding from these settlements flows into the state’s Opioid Restitution Fund (ORF), which is governed by Maryland’s State Finance and Procurement Article § 7-331 and administered by MOOR, a state agency operating under the Maryland Department of Health. State law and the State-Subdivision Agreements of 2022 and 2023 outline how the money can be spent and how it is divided between the state and local jurisdictions.

Many settlements provide payments over multiple years instead of a single lump sum. That long-term structure can allow governments to plan programs with a longer horizon, although annual funding levels may vary.

Because settlement agreements often include expectations for how money should be used, state and local governments typically direct funding toward strategies that address opioid-related harms instead of unrelated budget needs.

How Maryland Communities May Use Settlement Dollars

Although specific projects differ from one jurisdiction to another, Maryland opioid settlement funds commonly support initiatives designed to improve public health and expand access to services.

Under Maryland’s allocation structure, 70% of settlement funds subject to the state-subdivision agreements are distributed to the state’s 58 local subdivisions, while the remainder supports statewide programs administered by MOOR. Separately, researchers at the Johns Hopkins Bloomberg School of Public Health’s Opioid Principles project have tracked Maryland’s broader Opioid Settlement Fund allocation as 60% directed to a Targeted Abatement Subfund, 25% to localities and 15% to the state.

MOOR administers a competitive grant process for organizations seeking funding. As of October 2025, MOOR had awarded $10.3 million in fiscal 2026 competitive grants and block grants, according to reporting by the Maryland Association of Counties (MACo). The agency has also directed funding toward more targeted initiatives, such as a Buprenorphine Training Program that will provide local governments up to $5,000 per county to train paramedics to administer the medication, established under Chapter 759 of 2025.

Local jurisdictions run their own grant programs as well. In Baltimore City, the Mayor’s Office of Recovery Programs made $2 million available for community organizations through its Fiscal Year 2026 Opioid Restitution Fund Community Grants, with awards spread across project periods of up to two years.

In many Maryland communities, local governments work alongside health departments, behavioral health providers, hospitals and community groups to identify priorities. Rural counties, suburban communities and urban areas may face different challenges, so spending plans often reflect local needs.

Oversight And Accountability

Residents often ask how settlement funds are monitored. While oversight processes vary depending on the settlement and the level of government receiving the money, accountability is an important part of managing public funds.

Maryland has taken specific legislative steps to build in oversight. Legislation passed in 2025 — House Bill 798 and Senate Bill 589 — requires MOOR and the Maryland Department of Health to develop and maintain an interactive public dashboard detailing Opioid Restitution Fund spending, according to MACo. The same reporting notes that the legislation also clarified allowable uses of ORF spending and increased public transparency requirements more broadly.

At the state level, MOOR is supported by the Opioid Restitution Fund Advisory Council, which makes funding recommendations, according to the Maryland Opioid Restitution Fund Primer. Local jurisdictions that wish to receive Targeted Abatement Fund dollars must submit a Local Abatement Plan, and unspent funds tied to plans that have not been submitted remain held in the Opioid Restitution Fund; more than $11.7 million in such funds remained unaccessed as of the end of fiscal year 2025, according to MOOR’s Fiscal Year 2025 Opioid Restitution Fund Expenditure Report.

State and local governments may also hold budgeting processes or public meetings where spending plans are discussed. Some jurisdictions publish information about funded programs or invite community input before making major decisions.

Transparency helps residents understand where money is going and whether funded programs align with the intended purpose of the settlements. Community members interested in these decisions can often follow county government meetings, health department updates or state announcements for additional information.

Settlement Funds Are Only Part Of The Solution

Although Maryland opioid settlement funds can provide meaningful support, they are not expected to solve every challenge related to substance use on their own. The Maryland Association of Counties has noted that while overdose deaths have declined in recent years, they remain higher than 2015 levels, underscoring that settlement dollars are one tool among several needed to address the crisis.

Long-term progress often depends on sustained collaboration among health care providers, schools, law enforcement, social service agencies, employers, nonprofit organizations and community members. Access to affordable treatment, stable housing, mental health care and recovery support all play important roles in reducing opioid-related harms.

Settlement funding can help expand these efforts, but many successful programs also rely on other public funding sources, grants and local partnerships.

Frequently Asked Questions

What are Maryland opioid settlement funds? They are funds from legal settlements related to the opioid crisis that are intended to support prevention, treatment, recovery and other efforts addressing opioid-related harms. In Maryland, these funds flow into the state’s Opioid Restitution Fund, administered by the Maryland Office of Overdose Response.

Can settlement funds be used for any government expense? Generally, settlement funds are intended for opioid-related purposes rather than unrelated government spending, although specific requirements depend on the applicable settlement agreements and policies, including Maryland’s State Finance and Procurement Article § 7-331.

Who decides how the money is spent? State and local governments typically make spending decisions through budgeting and planning processes that may involve health departments, community organizations and public input. In Maryland, MOOR administers state-level funding with guidance from the Opioid Restitution Fund Advisory Council, while local governments manage their own share through Local Abatement Plans.

How can residents learn about local spending? Residents can monitor county government agendas, health department updates, MOOR’s public reporting and other public announcements for information about proposed programs and funding decisions.

Related Article From The BayNet

• Marylanders Join The First Substance Use Awareness Rally In Annapolis
• Maryland To Receive Share Of $29.6 Million Generic Drug Price-Fixing Settlement
• Gov. Hogan Announces Appointments To Opioid Restitution Fund Advisory Council
• State Releases New Strategic Plan for Opioid Crisis Response
• New Law Expands Naloxone Access to All Marylanders

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