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Statement from Public Health Experts on Announcement of Opioid Settlement


Members of a coalition of 50+ leading public health groups who issued a set of five guiding principles for spending opioid settlement funds in January are reacting to the announcement of the $26 billion settlement deal between a group of state attorneys general and Cardinal Health, AmerisourceBergen, McKesson, and Johnson & Johnson. The coalition, organized and led by faculty at the Johns Hopkins Bloomberg School of Public Health, encourages the use of five guiding principles to determine the best use of the funds:

  1. Spend money to save lives.
  2. Use evidence to guide spending.
  3. Invest in youth prevention.
  4. Focus on racial equity.
  5. Develop a transparent, inclusive decision-making process.

“With more Americans dying of overdose than ever before, the proceeds from opioid litigation are arriving at a critical moment. Now the challenge is to spend them wisely. By following five core principles, states and localities can proceed with evidence, inclusion, and transparency and save many lives.”

— Joshua Sharfstein, MD
Professor of the Practice in Health Policy and Management
Director, Bloomberg American Health Initiative
Johns Hopkins Bloomberg School of Public Health;

“States, counties, and cities can use five key principles, endorsed by over 50 organizations, to help them determine how to spend this new money. The principles stress the importance of investing in evidence-based programs, including those that address youth prevention and racial equity, to save the most lives.”

— Mary Bassett, MD
Director, FXB Center for Health and Human Rights
Harvard University

“Tens of billions of dollars will soon be awarded to various state and local jurisdictions to rectify the lethal legacy opioid manufacturers, distributors, and others have created. Taking hard lessons from the tobacco settlement era, in which funds were not used consistently or astutely to affect public health outcomes, these principles provide commonsense guidance and a clear framework by which state and local officials can ensure that funds are used to save lives now and turn the tide of the addiction epidemic. It is imperative that states are well informed and utilize this framework to implement evidence-based solutions and programs that incorporate quality measurement.”

— Gary Mendell
Founder and CEO

“These new resources will help public health organizations address the devastating toll that substance use has taken on communities across the country. Underscoring the need for a focus on racial equity is critically important in light of the fact that people of color are more likely to face barriers in accessing treatment and recovery support services and are disproportionately arrested and incarcerated for drug-related offenses. Allowing scientific evidence to guide spending, keeping all decision-making as fair and transparent as possible, investing in youth prevention, and actually spending the money on lifesaving programs rather than using it to patch budget gaps will ensure states, cities, and counties invest the money in strategies that will help save the most lives.”

— Georges Benjamin, MD
Executive Director
American Public Health Association

“With these funds, states and localities have the opportunity to invest in an evidence-based public health response to drug use, incorporating a harm reduction approach to save lives now. The overdose epidemic is a devastating public health crisis that should never have happened, and applying the five core principles can help to shape a supportive and equitable landscape where it can never happen again.”

— Daliah Heller
Director, Drug Use Initiatives
Vital Strategies

“Billions of dollars from opioid settlement funding will provide states and localities with a unique opportunity to address critical gaps in our current prevention, treatment, and recovery infrastructure. By following these five core principles, states can ensure that this funding will support evidence-based approaches that can make a lasting impact on the addiction crisis.”

— Mark McClellan, MD, PhD
Duke-Margolis Center for Health Policy

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Media contacts: Barbara Benham at and Carly Kempler at