This information was compiled based on information from publicly available legislation, state memorandums or executive orders, state websites, and press releases, as well as supplemental interviews with state officials with a role in administering opioid settlement funding.
It offers a snapshot of settlement spending and priorities at the state level (e.g., funding administered by state agencies or designated statewide abatement funds) as well as laws, agreements, and processes that the state has established for allocating funds. NASHP does not track spending at the local or county level, but includes any relevant state-level reports or dashboards that capture local spending within a state. For details on the definitions used here, check out the definitions at the bottom of this page. You can also get an overview of opioid settlement decisions in all states.
Settlement Spending Status
Background
The North Dakota Department of Health and Human Services (DHHS),which receives legislatively appropriated funding from the state share of settlement funds, is tasked with distributing the funding through grant programs. Grant awardees are selected using guidance from the Opioid Settlement Advisory Committee recommendations, and DHHS publishes summaries of grant awards.
Has the state awarded settlement funds?
Yes. The 2024–2027 opioid settlement fund grant opportunity awarded grantees for projects across a variety of priorities, including expanding community-based treatment, enhancing the behavioral health workforce, and implementing syringe service programs, among others. A press release highlights these awardees and features information such as award amounts and project descriptions. Budget reports track progress toward expending the total amount of funding legislatively appropriated to DHHS, which includes the grant program as well as additional state expenditures such as purchase of naloxone, support for Tribal implementation of opioid abatement strategies, and administrative support for the advisory committee.
Has the state announced priorities or recommendations for spending?
Yes. From various listening sessions hosted by the Opioid Settlement Advisory Committee, a list of recommendations was compiled to inform grant awards and priority areas for settlement allocations. Recommendations are sorted into categories (e.g., “across the continuum” and “treatment”), with examples including strengthening adolescent prevention, increasing access to medication for opioid use disorder, and addressing addiction as a whole rather than targeting specific substances.
Previous spending details
Budget reports from previous years and summaries of previous grant award cycles are available on the state’s settlement site, beginning with 2023.
Statewide reporting of local spending
Political subdivisions receiving funding from the city and county share of settlements are required to submit allocation plans to the Behavioral Health Division before making expenditures — these allocation plans are housed on the advisory committee’s website.
State Settlement Website or Dashboard
Spending Plans and Agreements
Process for Settlement Disbursement
An executive order establishes an Opioid Settlement Advisory Committee to provide spending recommendations to the Department of Health and Human Services.
State and Political Subdivision Split
Structure
State-Controlled (>50 percent of funding controlled by states)
Allocation Formula
85 percent state, 15 percent counties and cities
