HARRISBURG — As Pennsylvania officials continue spending millions of dollars in settlement money to fight the opioid epidemic, opportunities for the public to follow the funds and publicly weigh in increased over the past year. That’s partially due to the work of journalists and researchers.
But significant limits exist on both transparency and public participation — to the frustration of some families and others directly affected by the crisis.
There’s a lot at stake. Pennsylvania expects to receive about $2 billion over roughly two decades as a result of settlements and litigation with drug companies over their role in the opioid crisis, which kills thousands of people in the state each year.
As county officials and other local leaders prepare to receive hundreds of million dollars more in the years to come, they continue to wrestle with uncertainty over how they are allowed to spend the funds.
And while members of the public have been shut out of some decisions, Spotlight PA took several steps to elevate the voices of people directly affected by the opioid crisis.
Here are five things to know about what happened with opioid settlements this year.
Transparency on where the money is going increased
Most of Pennsylvania’s opioid settlement money that’s dedicated to addressing the crisis is going to counties and other local governments — 85% total. The remaining 15% goes to the state.
The money is overseen by the Pennsylvania Opioid Misuse and Addiction Abatement Trust and its 13-member board. The trust has the power to withhold funds from local governments if it decides they spent settlement money in ways they weren’t supposed to.
The public got more information this year on where Pennsylvania’s opioid settlement money is going. Some of this increased transparency began in late 2024 and had an impact throughout the year.
Building off prior transparency work, Spotlight PA in November 2024 created a first-of-its-kind searchable database tracking how tens of millions in opioid settlement dollars were being spent in Pennsylvania, program by program. The database was praised or cited by a prominent child protection advocate, families directly affected by the opioid crisis, a former member of the U.S. House of Representatives, and residents who reached out to their local officials with concerns of what they found.
The next month, KFF Health News and partners published their own searchable database, tracking settlement decisions in 2022 and 2023 across the country.
Increased transparency continued in 2025. For instance:
The Opioid Policy Institute in July launched what it calls the “the most comprehensive database of problematic opioid settlement spending.” The website includes a form that allows people to submit items for consideration that they consider waste, fraud, abuse, or mismanagement of the funds. The website highlights what the organization considers inappropriate spending on speaker fees, drug disposal pouches, body scanners for jails, and other items. The database includes dozens of examples from Pennsylvania, many of which cite Spotlight PA as a source.
Researchers from Penn State, Temple University, and the University of Pittsburgh in August announced the launch of their own website detailing opioid settlement spending by counties and some local governments — their website includes programs approved by the state’s opioid trust. The website notes it does not include funds distributed to an account controlled by state lawmakers. Researchers from those universities have assisted the trust in data collection, trust meeting minutes and other documents show. The researchers’ website says it is not affiliated with the state’s opioid trust.
KFF Health News and partners launched another database, tracking 2024 spending decisions across the country, including in Pennsylvania.
For some of Pennsylvania’s opioid settlement money, there are still limited details publicly available. Spotlight PA reported earlier this year that the state’s opioid trust is shielded from Pennsylvania’s open records law.
Earlier this year, a group of family members who lost loved ones to deaths related to substance use called for the removal of Tom VanKirk as chair of the trust, saying his “leadership has been marked by incompetence and a lack of transparency.” A response from the Trust encouraged participation at the local level, defended the decisions the trust has made, and said its website contains information on all programs reviewed and the results.
“The Trust has deep sympathy for those who have lost loved ones to the devastating impacts of the opioid epidemic,” the statement said.
Public participation increased, but limits remain
Last year, a first-of-its-kind nationwide survey from Spotlight PA and KFF Health News found that at least 14 powerful opioid settlement councils routinely block members of the public from speaking at their meetings. Following the reporting, Maine added regular public comment.
Pennsylvania’s opioid trust held its first public listening session in August.
Some speakers urged the board to take steps to allow more public comment and greater participation from families directly affected by the crisis. Trust members have acknowledged continuing to review local spending decisions in secret meetings, before making recommendations for the full board to consider. Trust officials have maintained they comply with Pennsylvania’s open meetings law.
At the end of the listening session, VanKirk said “we heard you, and we will be taking everything into account.” In December, VanKirk said the trust plans to have another listening session in August, but does not plan to have public comment at each regular meeting.
The response disappointed Gail Groves Scott, a public health policy researcher and one of the speakers at the August listening session.
“They’re still refusing to address the issue of transparency and why it’s necessary,” she said.
More money is on the way
A court order last year estimated that Pennsylvania could receive up to about $1.8 billion from two waves of agreements with multiple drug companies. Earlier this year, Attorney General Dave Sunday said a national settlement with members of the Sackler family and their company Purdue Pharma could bring up to $212 million more for the state.
Hundreds of millions of dollars have already flowed out to communities in recent years. The trust reported distributing about $300 million to the state, counties, and other local governments during the most recent annual reporting period.
More payments to counties and other local governments are expected to occur around the middle of December.
Counties still wrestle with uncertainty
Two Pennsylvania counties and the city of Philadelphia appealed to Commonwealth Court last year, challenging trust decisions to reject some of their opioid settlement programs. The disputes involve an outdoor youth program in Somerset County and a newsletter in Northampton County, as well as a home repair program and small business support program in Philadelphia.
Another case involves the question of law enforcement spending and whether it’s appropriate to spend money on a deputy district attorney in Chester County. The district attorney’s office said “the prosecutor in this position is charged with diverting additional individuals out of the traditional criminal justice system and into treatment.” Attorneys for the trust described the position as “a prosecutor who happens to interact with individuals with” opioid use disorder.
The three counties and Philadelphia had active cases in Commonwealth Court as of Dec. 2. Attorneys for the trust have defended the board’s denials in each case.
County officials have wrestled with uncertainty for years over what is or isn’t permitted in the use of settlement funds, Spotlight PA’s reporting has found.
Recently published findings from Penn State-affiliated researchers help shed light on the perspective of local officials, as the authors described initial confusion among county-level leaders and substance use service providers over settlement money decisions.
“They looked to the Trust for instructions and answers but did not feel like the Trust was providing what they needed,” they wrote.
The study was based on 66 semi-structured interviews and six focus groups conducted in 2023 across six Pennsylvania counties. One of the authors, Glenn Sterner, has received funding from the trust, according to a disclosure statement and a Penn State spokesperson. He has assisted the trust with data collection, meeting minutes show.
In the article, the researchers said “confusion was widespread,” and they described the “lack of assistance” from the state opioid trust as “a key concern for participants.”
At the trust’s December meeting, members supported creating a new position through the County Commissioners Association of Pennsylvania, which acts as an administrator for the trust, to assist with public engagement and communication.
Elevated voices
In response to members of the public feeling shut out of the process, Spotlight PA took significant steps to elevate voices of people who have lost loved ones or are dealing with the fallout of the opioid epidemic on a daily basis.
The news organization sought stories of people directly affected by the crisis, created an interactive tool that put readers in the role of opioid settlement decision-makers, answered reader questions, and hosted a public forum in Berks County in April. Spotlight PA also took the stories of those directly affected by the crisis to the state Capitol, including with an art display in September.
“Do not doubt the power of the connections you are creating, the change possible by those connections,” Cathleen Palm, a child protection advocate, wrote after the Berks County event.
Erika Shambaugh, who lost two children who both struggled with addiction before their deaths, also welcomed the chance to participate in the forum. “Our voices matter as did the voices of our loved ones,” she wrote afterward.
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