Local Wisconsin governments have received more than $160 million in settlement payments from drug makers, distributors and pharmacies that were sued for their role in the country’s opioid epidemic.
Wisconsin and 87 local governments are expected to receive more than $874 million by 2038, up from projections Wisconsin Watch reported in 2025.
The Wisconsin Department of Health Services gets 30% of the state’s settlement payments and documents its spending online while updating the Legislature quarterly.
The rest flows to 71 Wisconsin counties (all but Polk, whose board declined to join Wisconsin’s lawsuit) and 16 municipalities, which started receiving it in 2022. Each tracks and spends the funds a little differently.
As Wisconsin Watch previously reported, it’s not always easy to follow the money. But all local governments must provide the Legislature and the Wisconsin Department of Justice annual reports that include basic accounting. Many also answer optional questions from the Wisconsin Counties Association.
Wisconsin Watch created a database with the most recently reported local government settlement spending information. Here are some trends and notable findings:
- Money stayed in the bank. Just eight local governments had spent more than half of their opioid settlement funds by the end of 2025, while 16 hadn’t spent any.
- Officials wonder: What happens after the money runs out? Even with millions still available and more payments on the way, local officials are already worried about what happens when the money runs out. Several local governments said the eventual end of disbursements could put staff positions and programs in jeopardy.
- At least 17 local governments used some settlement dollars to support law enforcement. Multiple counties and municipalities hired specially trained co-responders who accompany officers on calls involving mental health or substance use issues. Other governments bought surveillance cameras, drug-checking equipment or vehicles or hired drug task force investigators.
- Funds flowed to foster care. Counties oversee foster care and have long cited parental substance use as a driver of family separation. About a dozen counties are using funds for foster care or services aimed at preventing family separations.
- Transportation barriers. A dozen local governments identified transportation as a major barrier to accessing opioid-related services. Several counties used settlement dollars last year to help residents travel to treatment and other services.
- Prevention prevails. The Wisconsin Counties Association asked local governments to break their settlement spending into 10 categories. Counties reported spending the most, nearly $6 million, on prevention — defined as efforts to prevent opioid use disorder and to screen for the condition. More than a dozen local governments funded school-based prevention programs, including youth peer support and DARE.
- Counties spend on jail treatment. People leaving jails and prisons face a high risk of overdose. Local governments reported spending more than $2 million on treatment for incarcerated people. The number of county jails providing medications for opioid use disorder doubled between 2021 and 2024, according to the Wisconsin Policy Forum. More than 20 governments described spending settlement dollars for jail-based programming, including several that provided medications for opioid use disorder.
- Early signs of progress. Many local governments cited plunging overdose rates as success. Statewide overdoses fell by more than 42% between 2023 and 2024. More work is needed, multiple officials acknowledged, considering that opioid overdoses remain far higher than a decade ago. Still, they see expanded access to opioid reversal medications and treatment services as something to celebrate.
What stands out to you? Explore the database and tell us what you notice or want us to investigate — or if you have any questions. Submit a tip or email editor@wisconsinwatch.org.
