Dec 3
2025
Opioid epidemic funds lack oversight, transparency
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Overdose-reversal drugs at a liquor store on Niagara Street in Buffalo’s Riverside neighborhood. Photo by Adam Smith-Perez.
This is the second of two stories about government’s response to the opioid epidemic.
Nearly half a billion dollars intended to address the opioid epidemic has flowed through state agencies in New York over the past four years, the result of an ongoing legal battle against opioid manufacturers and distributors for abetting addiction.
Experts have concerns about how those funds are being deployed — not just by the state, but by the counties, cities and towns that have been granted shares of the money.
The City of Buffalo, for example, has spent only a third of the opioid settlement money it has been sent by the state, according to an Investigative Post analysis, and many of those expenditures have only a tenuous connection to fighting addiction and overdoses.
Erie County has done a better job with its share. Niagara County refused to provide Investigative Post data on its use of the money.
State law dictates that these settlement dollars be spent on addiction treatment, prevention and recovery. The state Legislature created an advisory board of government-appointed experts to recommend how the money should be spent annually.
Board members say they don’t know exactly where much of the funding has gone, whether hard-hit communities are really getting the help they need, and why hundreds of millions remain unspent.
“We’re in the fifth year of this money at the state level. Money from 2023, 2024 is just getting out the door,” Tracie Gardner, appointed to the Opioid Settlement Fund Advisory Board by the state attorney general in 2024, told Investigative Post.
“Either the money is sitting there and not being utilized where there is clear urgency or the money is not going to where it is best utilized.”
There were at least 8,626 opioid overdose deaths statewide between 2023 and 2024, according to data from the state health department — a death rate of 22 people per 100,000 residents.
New York has been lauded for its efficiency in distributing opioid settlement money to treatment programs. But the advisory board’s 2025 report, published Nov. 1, reveals that the board and impacted members of the public feel the state is not fulfilling its duty to equitably, efficiently and transparently distribute funds.
Robert Kent is former general counsel to the Office of Addiction Services and Supports, the state agency that oversees a majority of the state’s opioid settlement dollars. Kent wrote in a September letter to the board that he was “shocked and saddened” when he learned $200 million in settlement monies remained unspent.
Kent discovered this after filing a Freedom of Information Act request to the comptroller.
“It appears … that the board has not been fully informed as to how much money has been spent, how much is still available to be spent, and whether the investments made have had an impact,” Kent wrote, before urging the board to recommend “immediately mak[ing] all unspent funds available” to the governor and Legislature.
Another key batch of funds also sits unspent by design: $35 million in accrued interest on unspent opioid settlement dollars.
“To date, the state has not released a formal plan for these dollars,” the advisory board wrote in the report.
Gardner and other board members recommended that interest money support smaller organizations with budgets under $500,000. Historically, large-scale providers are the biggest recipients of state resources, the board found. It passed a motion requiring transparency around how the interest dollars are spent.
The board can only make recommendations, however.
“This is the fourth or fifth year of the report. I can tell you with confidence that it’s barely been looked at by the Legislature,” Gardner said. “We are constantly reminded by the governor with the settlement board that we are advisory only.”
“No transparency”
The state attorney general has won over $3 billion in litigation against opioid manufacturers and distributors, and money from these settlements is expected to be disbursed into 2041.
By Aug. 1 of every year, cities, counties and municipalities receiving opioid settlement money from the Office of Addiction Services and Supports must report how they spend those dollars. Per state law, the money must be used to fight, prevent or help individuals recover from opioid addiction.
Buffalo, for example, is subject to this reporting. The city has received almost $6 million from the Office of Addiction Services and Supports since 2023. Only $1.75 million has been spent, Investigative Post’s analysis found. Close to half that money went toward vehicles and equipment for the police and fire departments.
Rochester has received almost $4 million. According to an online spending tracker, Rochester officials have spent $1.13 million as of Oct. 2, or just over a quarter of the funds.
Advocates in Rochester say they’ve been in the dark for months as to any plan guiding the city’s use of funding.
“There has really been no transparency around how these dollars are to be spent,” said Kim Smith, a former Rochester City Council member who serves as state policy director for advocacy group Vocal-NY. “And we’ve been trying to follow this issue since April.”
Donate to support our nonprofit newsroomSmith told Investigative Post that she asked one of the leaders of Rochester’s opioid settlement task force for months of task force meeting minutes. That person rebuffed her request, emailing to set up a meeting instead.
Monroe County has yet to publish data on its spending of opioid settlement dollars.
Smith and other policy experts and community organizations told Investigative Post they couldn’t think of one model example for spending or oversight of opioid settlement money.
Monitoring funds is difficult, experts say, partially because funding comes from two sources: direct share funds, which are settlement dollars that require no oversight, and funds distributed through the Office of Addiction Services and Supports, which must be reported to that agency.
The direct shares go to cities, counties and municipalities, and account for about 47 percent of opioid settlement money. The rest are overseen by the Office of Addiction Services and Supports.
Toni Smith, state director at Drug Policy Alliance, says the two categories of funding — one subject to monitoring, audits and evaluation, and the other not — complicate oversight.
“There’s definitely a patchwork of ways that counties are and are not reporting on the use of funds,” she told Investigative Post.
Gardner, the state advisory board member, said the agencies charged with monitoring spending have a poor record for sharing information with the public.
“The money is going through the mental hygiene system, where there isn’t historically good transparency,” she said.
What others are doing
Investigative Post reached out to governments in Western New York and beyond to ask them how they were spending their opioid settlement money, and how they were monitoring and reporting on its use.
Erie County so far has received $32.7 million. Just $7.1 million has been spent so far, some of it to cover salaries for county employees who deal with addiction issues. The rest has been committed to long-term contracts with outside service providers, according to Kara Kane, public information officer for the county health department.
The county has contracts with Save the Michaels, Cazenovia Recovery, BestSelf Behavioral Health, ECMC, and D’Youville School of Pharmacy, among others. The county has a task force that helps guide the county’s use of opioid settlement funds. Kane said the county expects to receive an additional $34.2 million between now and 2040.
Niagara County has received $4.27 million in state agency funding since 2023. This year the county spent $160,242 on frontline worker training and a mental health leadership event. No other expenditure data were readily available. Laura Kelemen, director of the county’s Department of Mental Health, did not respond to repeated requests for information or comment.
The Town of Cheektowaga has received at least $61,000 in opioid settlement funds since 2023, according to state records. Dennis Debrowski, the town’s comptroller, said the money covered the salary of town drug court coordinator Meghan Greene, as well as “other drug programs, rehabs and counseling.”
A nationwide issue with no easy solutions
Bangor, Maine, established its own opioid settlement funds advisory committee in April 2025. The committee has “generally met twice a month” since, according to a city spokesperson.
In July 2024, the town of New Milford, Connecticut, voted to distribute over $24,000 of settlement funds directly to families.
Baltimore and Boston have both established boards that submit reports and recommendations to the state on spending.
Jonathan Stoltman, director of the Opioid Policy Institute, leads a team of researchers who look into spending plans as well as the “waste, fraud, abuse and mismanagement” of settlement funds across the country.
Stoltman noted that some states do certain things well. For example, Wisconsin requires extensive reporting on how officials arrived at spending decisions and community input, as well as on how much money’s been spent, how much remains, and how money will be spent in the future.
Stoltman also pointed to Arkansas, which has a state website that details upcoming grant deadlines.
Like Wisconsin, it shares public information on what counties fund but also projects they did not fund.
“I’ve seen stuff on there where I’m like, ‘That’s not a good way to spend the money.’ But at least they’re open about it. And that’s the first step,” Stoltman said.
“The second step for me is accountability if they’re spending it wrong.”
Stoltman said even when states have a solid process — New Jersey, for example — that won’t prevent them from misappropriating money, as was the case this June when the state diverted $45 million in settlement money to four hospitals — without any plan to use the money to abate opioid addiction.
Regina LaBelle, professor and director of addiction policy at the Georgetown Law Center, told Investigative Post that better access to information would allow for more accountability.
“There should be a place where the public can go, reporters can go to find out who’s voting, who’s making these decisions and what their potential conflicts might be,” LaBelle said.
“The issue has to be transparency first and foremost. And that’s the bottom line.”
Adam Smith-Perez, who covers urban affairs for Investigative Post, is a Report For America corps member.
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