This story is part one of our series, The Black Box: Inside Mississippi’s opioid settlement spending. Explore the series.

Mississippi has received tens of millions of dollars in lawsuit settlement money each year since 2022 from corporations that contributed to the opioid overdose epidemic, a public health crisis that’s killed roughly 10,000 people in the state since 1999.

But a Mississippi Today investigation found that in the three years of receiving the funds, public officials across the state reported spending less than $1 million – or less than 1% of the money received so far – on direct measures to prevent more drug deaths.

The attorney general’s office split the money – expected to total around $421 million through 2040 – between Mississippi’s state and local governments. Attorney General Lynn Fitch’s office and the Legislature oversee most of Mississippi’s opioid settlement dollars, but they’ve only spent money on attorneys’ fees so far. The remaining portion – 15% of Mississippi’s funds – goes to cities, counties and towns.

Management of the local dollars has mostly been a mystery until now. Fitch created a contract with towns, cities and counties that allows them to spend their portion on whatever they see fit – unlike agreements in at least 34 other states. They’re also not required to report what they do with the dollars.

But how Mississippi governments spend money is information that can be requested by anyone. From May to August, Mississippi Today filed public records requests with all 147 towns, cities and counties that have received settlement dollars to find out how much they’ve gotten and how they’ve been using the funds.

The newsroom accounted for about $15.5 million and received responses from almost every city and county receiving settlement shares. It filed an ethics complaint against Mound Bayou, the only local government that didn’t provide any information. Mississippi Today tracked how that money is being spent and analyzed the data to determine how much Mississippi is spending to prevent overdoses, treat addiction and connect people with recovery.

Mississippi Today has published a database for anyone to search how local governments are spending opioid settlement dollars.

Here are some of the biggest takeaways:

• Since September 2022, the 146 towns, cities and counties that responded to Mississippi Today reported receiving roughly $15.5 million. Leaders for those governments have spent about $6.4 million of that.

• Around $945,000 has been used to address addiction with the strategies laid out in one of the opioid settlements, which plaintiffs’ lawyers called “an exemplar.” Most of that money has been used to support drug courts and mental health crisis intervention services. All of the states bordering Mississippi report using at least $4 million each – significantly more than Mississippi both in terms of dollars and percentage of total share – on strategies to address the overdose crisis, and most have committed tens of millions of dollars already.

• The remaining $5.4 million is being used for other purposes. Local officials have deposited $4.2 million directly into accounts for general expenses, often making it impossible to track the dollars. Some expenses not related to addiction include police equipment in Oxford and fiber optic cable installation in Jackson. The city of Vicksburg purchased and firefighter suits and donated to a crisis pregnancy center.

• Over the past three years, 20 of the 147 local governments have spent or finalized plans to spend some or all of their opioid settlement shares to address addiction, officials told Mississippi Today, and 53 governments have not spent or made plans to spend any opioid dollars.

• Just one of the 147 governments, Hattiesburg, indicated it would create opportunities for public input on how to spend its opioid settlement dollars. Mayor Toby Barker initiated his plan after Mississippi Today submitted its public records request in May. 

Public health and legal experts who reviewed Mississippi Today’s data said the pattern of Mississippi’s local spending is a problem, as the money was won from companies that profited while residents struggled with addiction.

Representatives for the towns, cities and counties pointed out to Mississippi Today that Fitch’s contract advised them to spend their dollars for any public purpose. The attorney general has minimized the amount of Mississippi opioid settlement money that must be spent addressing addiction. 

While most states have developed plans that say all opioid settlement money needs to go toward addressing addiction, the Mississippi attorney general’s version says the state can use 30% of its dollars on other purposes, the most allowed by the national lawsuit settlements. Fitch included all of the local dollars in that 30%.

In addition to the attorney general’s directive, some city and county officials said the small amounts they were receiving made it difficult to identify the right addiction-related project. They instead highlighted other efforts they have undertaken to address substance use disorder, like funding local drug courts with other public dollars.

Mississippi Today emailed Fitch a letter with these findings, and she did not answer whether she still believes it was the right decision to allow cities and counties such free rein. Her chief of staff, Michelle Williams, said in a statement that the opioid crisis has cost the country hundreds of billions of dollars, and the settlements allow state and local governments to pay for prior opioid expenses over the past three decades. 

She said the attorney general’s office is working with the Legislature and a new state opioid settlement advisory committee to use the majority of Mississippi’s settlement dollars to prevent more overdoses.

“The Attorney General’s Office is committed to doing everything we can to get the money out to where it is needed quickly,” Williams wrote. 

But the state’s share likely won’t be distributed until July 2026, after the Legislature passes its next budget. Until then, the local dollars are the only Mississippi opioid settlement funds expected to be spent on anything besides lawyers’ fees and administrative expenses. 

Dr. Rahul Gupta, former director of the Office of National Drug Control Policy and an expert witness in several of the lawsuits against opioid companies, said these dollars should be an opportunity to prevent more suffering after the defendant companies’ business models led to an unprecedented number of drug deaths.

He said Mississippi’s local spending reminded him of how states used money from the 1990s tobacco lawsuits — for purposes other than ending a public health catastrophe.

“We should have learned a lot from our tobacco settlement funds,” Gupta said. “It’s disheartening and disappointing to see that.”

‘There was just nothing’

In 2022, when Tricia Christensen established the Appalachian Opioid Remediation project, she created a database to track how 13 states in the region spent their opioid settlement dollars. For the next two years, she led a team that pored through Google alerts, media reports and local public meetings in those states, including Mississippi.

She and her team found opioid settlement spending information in every state, except one.

“In Mississippi, there was just nothing,” said Christensen, now a consultant who advises states on how to spend opioid settlement money. “It was like a black box.”

While a few local governments provided Mississippi Today with spending resolutions passed by city and county officials, most appear to be spending their dollars without any public announcement. Many officials didn’t produce any internal documents that detailed how they were using their money and instead emailed the newsroom a few sentences that outlined their expenses.

Officials with McComb and Charleston said they didn’t know how much opioid settlement money they’d received – despite the fact they were already spending it. Mississippi Today referred clerks for the cities to the management firm in charge of distributing national opioid settlement money so they could determine how much their governments had secured.

When they provided the newsroom with that information and their spending, the records showed each had already spent a large amount of their dollars. McComb used $106,500 of its roughly $151,000 for new police cars, and Charleston had used the roughly $1,000 it received for payroll expenses and police supplies.

Dr. Judith Feinberg, a West Virginia University behavioral medicine and psychiatry professor, helped write a set of best practice guidelines for how states can use these dollars to prevent more overdose deaths. She said she believes state officials who don’t require or even encourage public reporting of opioid settlement spending are prioritizing politics over public health.

“If no one writes anything down, then there’s nothing to investigate,” she said.

Not every government provided Mississippi Today with all the requested information. Officials for Rankin County, which is expected to get the third largest amount of opioid settlement money of any local government, provided Mississippi Today with checks they’ve received but no documents that detail how they’ve been spending nearly $510,000. 

In county attorney Craig Slay’s response, he included a copy of Fitch’s contract with local governments. The sentence that says counties can spend opioid dollars on anything they deem appropriate was highlighted.

Slay did not respond to calls and emails from Mississippi Today about the spending, and he didn’t engage with a reporter for the newsroom at a Rankin County Board of Supervisors meeting in August when he was asked how these dollars were spent. 

“The fact that no one has to report is tragic because you don’t know what the money was spent for,” Feinberg said. “And there’s no accounting. That’s really crazy.”

Thinking about the larger picture

Mississippi’s local governments are expected to accept at least $48 million more in opioid settlement funds over the next 15 years.  

Dr. Cathy Slemp led the West Virginia health department as the state battled the country’s deadliest overdose crisis in the late 2010s. She said the unspent dollars could be an opportunity for local elected officials to begin developing the treatment and recovery resources needed to stop more Mississippi drug deaths.

It’s easy to understand why local governments might want to use the funds to plug budget holes, she said. But she cautioned whether that would be the wisest decision, as many Mississippians struggling with opioid addiction still don’t have access to effective treatment. 

“We can continue to just fill holes, or we can think about it in the larger picture,” she said.

Melody Worsham, a peer support specialist for the Mississippi Recovery Advocacy Project, said she’s hopeful this money can eventually find its ways to groups like hers — organizations that rely on the expertise of those who’ve dealt with addiction and can share which strategies may reach others in similar situations.

But she said the management of the opioid settlement funds mirrors a concerning pattern of how officials in Mississippi spend public dollars. 

“When they get the money, the state figures out, the governments figure out how to spend that money as quietly as possible.”

Editor’s note: Mississippi Today sent almost all of its public records requests in mid-June. Local governments responded on dates that ranged from the same day we sent the request to early September. The settlement administrators sent some payments out throughout July, and governments that wrote back to the newsroom in June have likely received more money since then. We’ve noted the date of when we received the information in our database. Additionally, some towns, cities and counties may have used money or formalized spending plans since they responded. 

When governments provided totals with and without interest, Mississippi Today used the total without interest, as more governments responded in that format. Some checks originally earmarked for towns and cities, especially those set to receive relatively little opioid settlement money, were reallocated to their counties. Because of that, the total these governments expect to get may differ slightly from what they will get. 

Mississippi Today special projects intern Maeve Rigney contributed to the data collection for this story. Andrea López Cruzado contributed to the data analysis.