The companies that fueled the opioid epidemic are paying for it — more than $50 billion nationally, across settlements with the distributors, Johnson & Johnson, the pharmacy chains, and the Sacklers behind Purdue. Minnesota's running share is about $633 million so far, arriving in installments over roughly two decades.
That money is supposed to do one thing: repair the damage the epidemic did, and stop it from doing more. Whether it actually does depends entirely on whether anyone is watching where it goes. So let's watch.
The accountability bright spot
I'll lead with what Minnesota got right, because it's real and it's rare. Nationally, the great scandal of the opioid settlements is that about a third of the money is untrackable — states and counties took the cash with weak strings, and much of it vanished into general budgets, or bought things that have nothing to do with treating addiction.
Minnesota did better. It committed to publicly report 100 percent of its settlement spending — one of only about 20 states to do so. Counties are required to report to the state. There's a dedicated fund (the Opiate Epidemic Response Account) and an advisory council that's supposed to steer the money toward evidence-based uses, using the frameworks that experts at Johns Hopkins and RAND developed for exactly this. On the architecture, Minnesota is a model.
One correction worth making, because it matters: the money splits 75 percent to cities and counties, 25 percent to the state — the local governments get the larger share. That's a lot of independent decisions in a lot of county boardrooms, which is precisely why the transparency Minnesota built is the thing that keeps it honest.
The drift the receipts already show
Now the part transparency exists to catch. Even with good architecture, the reports show money meant to save lives going elsewhere:
- Blue Earth, Redwood, and Le Sueur counties spent $86,156 of opioid money on police K-9s in 2024.
- Lakeville police spent $196,998 on a drug-task-force officer.
- Minnetonka spent $94,425 on a drug-identification device and a fume hood — justified partly by a theory that officers can be harmed by fentanyl through skin contact, a theory that toxicologists and medical bodies have repeatedly debunked.
Reasonable people can argue a drug dog fights the drug trade. But the settlement money was meant for remediation — treatment, recovery, prevention, harm reduction — and the experts whose frameworks Minnesota itself adopted say enforcement spending like this is inconsistent with that purpose. Nationally the pattern is worse: more than $61 million of settlement money went to law enforcement in 2024, and more than $240 million to uses that aren't remediation at all. Minnesota's transparency is what lets us see our own version of the drift while it's small enough to correct.
The outcomes — genuinely hopeful, with an asterisk
Here's the encouraging context, straight from the death data. Minnesota's overdose deaths fell sharply: from a peak of 1,392 in 2022 to 1,341 in 2023 to 994 in 2024 — a 26 percent drop. And critically, opioid and fentanyl deaths kept falling into 2025 (fentanyl deaths dropped from 610 to 576). The slight uptick in total 2025 overdose deaths is driven by methamphetamine, not opioids — an important distinction the settlement money should account for.
But the asterisk is the part Minnesota should be least proud of. Minnesota has among the lowest overall overdose death rates in the country and among the largest racial disparities. American Indian Minnesotans die of overdose at roughly seven times the white rate; Black Minnesotans at about twice. A statewide average that looks good hides communities being devastated. Settlement money that doesn't reach those communities specifically isn't doing the job the settlement was won to do.
What works — and Minnesota knows it
The evidence on what saves lives is not mysterious, and Minnesota's own health department has adopted it: naloxone (the overdose-reversal drug) distributed widely and freely; medication for opioid use disorder — the treatments that actually work — made accessible without barriers; culturally specific recovery programs built by and for the communities hit hardest, like Minneapolis's investment in Turning Point; and detox and treatment capacity in the places that lack it. Money spent on those returns lives. Money spent on a drug dog returns a photo op.
What we can do
Enforce the remediation standard. Minnesota has the reporting; now use it. The advisory council and the Attorney General should flag spending that drifts from the evidence-based frameworks the state adopted — publicly, so a county board thinking about a K-9 knows the money is being watched.
Aim the money where the deaths are. A seven-to-one racial disparity is a directive. Direct settlement funds specifically to the American Indian and Black communities bearing the worst of this, through programs those communities design, and measure whether the disparity narrows.
Publish a dashboard everyone can read. Minnesota committed to 100 percent reporting — turn that into a public, searchable dashboard showing every dollar by county and category, so any Minnesotan can see whether the money bought treatment or bought a fume hood. Transparency the public can actually use is what turns a promise into accountability.
And treat the meth signal seriously. Opioid deaths are falling; stimulant deaths are rising. The settlement money is opioid-specific, but the state's broader response can't declare victory on overdose while a different drug fills the gap.
The companies that profited from addiction are finally paying. Minnesota built one of the better systems in the country for tracking that money — which means we have no excuse for letting it drift. Spend it to save lives, in the communities losing the most of them, and show your work.
First the facts. Then the fix.
Sources
Minnesota opioid-settlement figures per the Minnesota Attorney General's office (ag.state.mn.us/opioids) and Minnesota Reformer reporting (Nov. 20, 2025) putting the running Minnesota total at about $633 million: the distributors and Johnson & Johnson (~$300 million over 18 years), Teva/Allergan/Walmart/CVS/Walgreens (~$243 million), Purdue/Sackler (~$59 million), and an eight-manufacturer settlement (~$9 million); the 75-percent-local / 25-percent-state split under the Minnesota opioid memorandum of agreement; the Opiate Epidemic Response Fund and advisory council (Minn. Stat. §§ 256.042 and 256.043). Accountability comparison: Christine Minhee's opioidsettlementtracker as cited by the Reformer, identifying Minnesota as one of about 20 states committed to reporting 100 percent of spending, and KFF reporting that roughly a third of national settlement money is untrackable, that more than $61 million went to law enforcement in 2024, and that more than $240 million went to non-remediation uses. Documented Minnesota spending: Blue Earth/Redwood/Le Sueur counties ($86,156 on police K-9s, 2024), Lakeville ($196,998 on a task-force officer), and Minnetonka ($94,425 on a drug-identification device and fume hood justified by a fentanyl-skin-contact theory that toxicology bodies have debunked). Overdose data from CDC Vital Statistics Rapid Release provisional counts (retrieved via the CDC data API): Minnesota all-drug overdose deaths of 1,392 (2022), 1,341 (2023), 994 (2024, down 26 percent), and 1,025 (2025 provisional), with fentanyl deaths falling from 610 to 576 into 2025 and the total uptick driven by methamphetamine. Racial disparities from the Minnesota Department of Health's overdose race report (2019 data): American Indian Minnesotans roughly seven times and Black Minnesotans roughly twice as likely to die as white Minnesotans. Effective-use guidance from MDH's adoption of the Johns Hopkins/RAND principles, with documented Minnesota examples including naloxone distribution, medication for opioid use disorder, Minneapolis's Turning Point investment, and Clay County detox capacity.
A single authoritative consolidated Minnesota total, post-2019 racial-disparity multiples, and MDH's finalized 2024–2025 counts were not confirmed this pass and are described as provisional or approximate where used. Corrections: campaign@madgettformn.com.