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The Relationship Between State Fiscal Capacity and Opioid Settlement Expenditures.

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Title: The Relationship Between State Fiscal Capacity and Opioid Settlement Expenditures.
Authors: Lindenfeld, Zoe (AUTHOR), Mauri, Amanda I. (AUTHOR), Cantor, Jonathan H. (AUTHOR), McBain, Ryan (AUTHOR), Silver, Diana (AUTHOR)
Source: Substance Use & Misuse. 2026, Vol. 61 Issue 5, p779-782. 4p.
Subjects: Substance abuse, Cross-sectional method, Drug overdose, Resource allocation, Health policy, Census, Substance abuse treatment, State governments, Descriptive statistics, Surveys, Narcotics, Research methodology, One-way analysis of variance, Public health, Centers for Disease Control & Prevention (U.S.), Treatment programs, Data analysis software
Abstract: Introduction: The distribution of funds from national opioid settlements provides a critical opportunity for states to address the ongoing overdose crisis in the US. However, it remains unclear whether these funds have been spent by states with significant fiscal needs, in addition to higher opioid-related needs. Methods: We used data from KFF Health News to examine per capita opioid settlement spending across states, categorizing them into tertiles. Fiscal need, defined as the ability of governments to fund programs and services, was assessed using US Census of Governments data, and overdose crisis need was measured using Centers for Disease Control and Prevention overdose mortality data. We identified states as "higher overdose need" and "higher fiscal need" and calculated the mean per capita settlement funds spent for each category. Results: The mean settlement funds spent per capita were $3.45 (SD: 1.75) for tertile 1 (n = 16), $8.11 (SD: 2.04) for tertile 2 (n = 16), and $ 23.69 (SD: 28.12) for tertile 3 (n = 13). Tertile 3 had the highest overdose death rate (23.69, SD: 28.23), while tertile 2 had the highest fiscal need. States categorized as both higher fiscal and overdose need (n = 12) spent a mean of $21.48 (SD: 33.22) per capita, compared to $7.82 (SD: 4.59) in states with lower fiscal and overdose need (n = 21). Conclusions: States with higher fiscal and overdose needs spent the most settlement funds per capita in 2022–2023, suggesting effective targeting. Future research should examine whether the opioid settlement funds lead to reductions in overdose deaths, particularly in fiscally constrained areas. [ABSTRACT FROM AUTHOR]
Copyright of Substance Use & Misuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: The Relationship Between State Fiscal Capacity and Opioid Settlement Expenditures.
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  Data: <searchLink fieldCode="AR" term="%22Lindenfeld%2C+Zoe%22">Lindenfeld, Zoe</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mauri%2C+Amanda+I%2E%22">Mauri, Amanda I.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cantor%2C+Jonathan+H%2E%22">Cantor, Jonathan H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McBain%2C+Ryan%22">McBain, Ryan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Silver%2C+Diana%22">Silver, Diana</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Substance+Use+%26+Misuse%22">Substance Use & Misuse</searchLink>. 2026, Vol. 61 Issue 5, p779-782. 4p.
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  Data: <searchLink fieldCode="DE" term="%22Substance+abuse%22">Substance abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+overdose%22">Drug overdose</searchLink><br /><searchLink fieldCode="DE" term="%22Resource+allocation%22">Resource allocation</searchLink><br /><searchLink fieldCode="DE" term="%22Health+policy%22">Health policy</searchLink><br /><searchLink fieldCode="DE" term="%22Census%22">Census</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse+treatment%22">Substance abuse treatment</searchLink><br /><searchLink fieldCode="DE" term="%22State+governments%22">State governments</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Narcotics%22">Narcotics</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22One-way+analysis+of+variance%22">One-way analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Public+health%22">Public health</searchLink><br /><searchLink fieldCode="DE" term="%22Centers+for+Disease+Control+%26+Prevention+%28U%2ES%2E%29%22">Centers for Disease Control & Prevention (U.S.)</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+programs%22">Treatment programs</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Introduction: The distribution of funds from national opioid settlements provides a critical opportunity for states to address the ongoing overdose crisis in the US. However, it remains unclear whether these funds have been spent by states with significant fiscal needs, in addition to higher opioid-related needs. Methods: We used data from KFF Health News to examine per capita opioid settlement spending across states, categorizing them into tertiles. Fiscal need, defined as the ability of governments to fund programs and services, was assessed using US Census of Governments data, and overdose crisis need was measured using Centers for Disease Control and Prevention overdose mortality data. We identified states as "higher overdose need" and "higher fiscal need" and calculated the mean per capita settlement funds spent for each category. Results: The mean settlement funds spent per capita were $3.45 (SD: 1.75) for tertile 1 (n = 16), $8.11 (SD: 2.04) for tertile 2 (n = 16), and $ 23.69 (SD: 28.12) for tertile 3 (n = 13). Tertile 3 had the highest overdose death rate (23.69, SD: 28.23), while tertile 2 had the highest fiscal need. States categorized as both higher fiscal and overdose need (n = 12) spent a mean of $21.48 (SD: 33.22) per capita, compared to $7.82 (SD: 4.59) in states with lower fiscal and overdose need (n = 21). Conclusions: States with higher fiscal and overdose needs spent the most settlement funds per capita in 2022–2023, suggesting effective targeting. Future research should examine whether the opioid settlement funds lead to reductions in overdose deaths, particularly in fiscally constrained areas. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Substance Use & Misuse is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1080/10826084.2025.2571849
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      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 4
        StartPage: 779
    Subjects:
      – SubjectFull: Substance abuse
        Type: general
      – SubjectFull: Cross-sectional method
        Type: general
      – SubjectFull: Drug overdose
        Type: general
      – SubjectFull: Resource allocation
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      – SubjectFull: Health policy
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      – SubjectFull: Substance abuse treatment
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      – SubjectFull: State governments
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Surveys
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      – SubjectFull: Centers for Disease Control & Prevention (U.S.)
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      – SubjectFull: Treatment programs
        Type: general
      – SubjectFull: Data analysis software
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    Titles:
      – TitleFull: The Relationship Between State Fiscal Capacity and Opioid Settlement Expenditures.
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              Text: 2026
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              Y: 2026
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