I think it depends on what someone would want to accomplish. At the most direct level, the city/town council members and county supervisors are the people who decide where the local money goes. If your town, city or county is spending the money without the input of those most impacted by the crisis (which, to our knowledge, is every local government besides Hattiesburg), you could call city hall or the your supervisors and let them know what you think of that and where you think the money should go. Most elected officials’ emails are also publicly available, so contacting them that way could be a good strategy as well. 

The contract Attorney General Lynn Fitch made with the local governments is already finalized, so I don’t believe she can change the unrestricted terms of that spending. But other states’ attorneys general have provided guidance for how local governments should spend their money in overdose prevention, regardless of what their contracts say the cities and counties have to do. North Carolina’s former attorney general wrote extensive FAQs about local settlement spending that experts have brought up to me multiple times. If she wanted to/if her constituents made it known that’s something they want to happen, Fitch’s office could write similar guidelines.

To my knowledge, the only state group that can legally change how the towns, cities and counties spend their opioid settlement money is the Mississippi Legislature. And we’ve seen that happen in other states. Similar to Mississippi, Maine didn’t require its local governments to report what they were spending their settlement money on (although Emily Bader with The Maine Monitor did a remarkable job filling those reporting gaps where she could). Then this spring, state lawmakers passed a simple bill to require that from hereon out. If Mississippi lawmakers hear from their voters that they want a bill like this as well (or others that require the money to be spent on addiction-related purposes), they might look to pass similar legislation during the 2026 regular session. 

In Mississippi, Fitch wrote a contract that says all the settlement money flowing to towns, cities and counties (expected to be around $63 million when all is said and done) can be spent for whatever public purpose their town/city council and Board of Supervisors think is appropriate. The settlements allow for up to 30% of spending to be on things that don’t have to do with addiction; because the local governments are getting 15% of the total Mississippi opioid settlement pie, all of their shares can be spent like any other public dollars. 

While this is technically allowed by the national settlements, the lawyers who wrote the settlements explicitly said they didn’t want that to happen. Most states created arrangements that say all the lawsuit money has to go to something related to addiction (even for purposes that have been criticized by the public). But as of right now, that’s not the case here.

Entirely at the whims of the ones in charge, at least for the local money. But it doesn’t have to be that way. Toby Barker, the mayor of Hattiesburg, created a committee this summer to advise how to spend the city’s settlement money. The committee, made up of locals who have experience addressing addiction, has come up with a few priorities so far, and I heard they’re in the process of moving forward on putting up money for those priorities. 

For questions A and B, it’s going to be hard if the current setup continues. For example, cities and counties have been getting money for three years now, but even those I consider most familiar with the Mississippi overdose crisis (people like James Moore in Hattiesburg) didn’t know anything about the local spending until I requested records and told him about that. But, as you allude to in your next question, anyone can request records from Mississippi governments. And I think we proved that while not ideal, the public record technique is an effective way to bring spending information to light. 

Yep, no problem! First, you need to have an idea about what information you’re looking for and what documents might contain that information. I knew very little about the recordkeeping of these local settlements going into the project, so I asked for “All receipts of dollars received by the [local government name] related to the National Opioids Settlements since June 1,2022,” and “All internal records related to [local government name]’s spending of money received from the National OpioidSettlements since June 1, 2022.”

Here’s one I sent to the city of Hattiesburg, which has all the template information to make sure we get the information as quickly and accessibly as possible. I tried to email them to city/town/chancery clerks, and sometimes added in the county administrator/government attorney. When a local government has a specific city portal or form, like Oxford and Long Beach respectively, I put the same information into those forms. 
I was expecting to receive documents like spending ledgers and city council resolutions from this request, which I sometimes did. But there were tons of other formats clerks and administrators used to provide me the information. I got everything from county budgets mostly unrelated to opioid settlement spending to a handwritten note saying nothing has been spent yet.

Sometimes, helpful public servants would call me to clarify what information I wanted. I nudged some of the clerks a lot, and made sure the Mississippi Ethics Commission knew when the public bodies were breaking state law. It took up most of my summer to do this with all 147 local governments, but I think the importance of this information justifies the work

It’s a very mixed bag from state to state. Like I wrote in this story, every other state has used at least $3 million of opioid settlement money to at least try to address their overdose crises. But that certainly doesn’t mean everything’s sunshine and roses everywhere else. 

Christine Minhee has a better national perspective on the settlement distribution than anyone I’ve met, and she created a state opioid settlement guide last December to give folks baseline information about what’s going on in each state. And the guides show that while there are states effectively using their dollars to prevent more deaths, there’s plenty of opportunities for spending that doesn’t address the opioid epidemic across the country. When I was reporting in West Virginia, I wrote a story about county leaders using nearly half a million settlement dollars for a shooting range. I just saw a story from Hawaii that leaders are using some of the state’s money for waterpark and Chuck E. Cheese vouchers. 

For best practice recommendations, there are a lot of national level resources (like Johns Hopkins University’s guide) that provide broad recommendations for how the settlement money can prevent more deaths.

The settlements themselves have lists of strategies that are proven ways to curb the crisis. But public health professionals repeatedly told me that for any given town, city or county, the people who make up the community whose lives have been touched by the overdose catastrophe are the best people to share what will and won’t work. 

I sent Anna Wolfe this question, and she said the welfare scandal teaches us that when public money intended to assist the state’s most vulnerable residents has so few guardrails, the likelihood it will be squandered is great (whether straight-up stolen or spent on things that have nothing to do with the intended purpose–both of which yield the same result: people don’t receive help and opportunities for better outcomes are lost). I think she’s completely right.

What I would add about the opioid settlement situation in particular is that the State Legislature, the group that will control as much as $300 million when all the payments come in, hasn’t done much to indicate one way or another how it will spend the money it oversees. We’ll know a lot more about what’s to come when the Opioid Settlement Fund Advisory Council presents recommendations for which overdose response efforts lawmakers should fund in December, and when the lawmakers act on those non-binding recommendations in the 2026 regular legislative session. I’ll be keeping eyes on what happens there, and I hope the public does too. 

I think so! I think the Maine bill that requires local spending reporting is a great way to encourage city and county leaders to be responsible stewards of the money. I think there could be a lot of ways states can incentivize spending on preventing more deadly overdoses and a lot of people willing to help develop these incentives. I cite many people with a lot of experience in that department in my stories. 

I won’t pretend to know everything about the health and health care implications of this summer’s federal spending bill. But nearly half of people diagnosed with opioid addiction used Medicaid, the state-federal insurance program for vulnerable Americans. 

So, I would guess that if fewer people have health insurance through Medicaid – which is what I understand the spending bill to incentivize in 2027 – that likely means fewer people can get effective opioid addiction treatment, like the medications buprenorphine and methadone.

This Kaiser Family Foundation article was published before the bill was passed, but I think it does a good job laying out the implications of Medicaid cuts on addressing the opioid epidemic.

I have not come across any audits in my reporting. 

We mostly don’t know right now. Mississippi has received about $125 million as of this summer, but it’s slated to receive another roughly $300 million over the next 15 years. A lot can change in that time, from who’s making the decisions to what the addiction epidemic looks like. 

This graph I made breaks down what’s broadly happened with the $125 million. The biggest chunk of money is with the Legislature, and it’s unspent as of now. That will very likely change after the 2026 Regular Legislative Session, which begins in January and ends in April. I expect lawmakers to make some decisions for these dollars by April, and the public will know more then. 

The $15.5 million controlled by 147 towns, cities and counties can and is being spent on any public purpose their leaders want. This other graph I made digs into whether the local governments are spending the money on addiction, spending it on something else or not spending it yet. 

I don’t know anything about that specific device, so I don’t want to comment on that specifically. But the settlement lawyers list initiatives that prevent more overdoses for inmates and former inmates as acceptable ways to address the crisis. They speak about providing “MAT (medication assisted treatment), recovery support, harm reduction, or other appropriate services” to people involved with the criminal justice system. 

I have not heard of any opportunities for public comment, and I don’t see anything in the law state senators and representatives passed in spring that says there will be public comment opportunities. But lawmakers don’t just make laws — they can also change them! So if Mississippians think public comment opportunities for how these dollars get spent are important, a good way to make that known would be to call/email their state senators and representatives. 

Oh, absolutely. The most common obstacle I came across was staying in contact with whoever handles the public records in any given town, city or county. I filed almost all of my records requests in mid-June, so I started following-up with local governments I hadn’t heard back from in early July. First, I would ask for an email update and often add the town/city/county attorney. For a lot of governments, that was enough. But going into mid-July, there were still dozens of governments that I hadn’t heard back from. 

From there, it branched out into a lot of phone calls to city halls and county boards of supervisors. Mississippi has laws that say public officials have to fully respond to public records requests by at most 14 business days, and it has a state Ethics Commission to enforce them.

So I spent a lot of July reminding city or chancery clerks what the state’s public record act says. My deskmates got a kick out of the number of times I told record keepers I was going to loop in the ethics commissioner Thomas Hood about not receiving these records in a timely manner. But doing that usually worked, so I stand by it. 

For anyone looking to file records requests, feel free to copy and paste the language from my Hattiesburg FOIA where I talk about asking for electronic copies and other things of that nature. I would also recommend reading the public records act I linked above and the state’s model law so they know what you are and aren’t entitled to. If a government is looking to charge 50 cents a page for emailed copies of documents (as happened to me multiple times), that’s a problem. Tom Hood successfully mediated a number of these disagreements between public officials and me. If you run into any issues, you can loop him into the email thread (thood@ethics.state.ms.us), and he might be able to clear up any disagreements. If not, you can file an ethics complaint with his office. 

For the local Mississippi money, no one right now. There’s very few reporting requirements the settlements themselves actually require, and Attorney General Fitch’s agreement with cities and counties doesn’t require it either. But the state Legislature could pass a law to change that, if lawmakers think that’s an important priority. 

For the state’s money, Fitch has designated a small chunk of its share (“small chunk” is relative as it’s still expected to be over $60 million in total) for purposes that don’t have to address addiction. The settlements say the remaining pot of money, set to be around $300 million by 2040, has to be spent on addressing addiction. 

The law the Legislature passed this spring says the Attorney General’s Office is in charge of making sure the money is spent legally. So, unless the Legislature changes something, the person responsible is Fitch or whoever is attorney general in the future. 

For 141 governments, I believe public officials gave me their best estimates of how much money they’ve received and how they’ve been spending the funds. That doesn’t mean I think they got all the information right. For instance, Gulfport wrote me a letter that they hadn’t spent any of their money despite meeting minutes showing that they spent $4,000 for a holiday feeding program in 2023. There could be other governments that did similar things that my editor and I didn’t catch. 

Three governments — Byram, Tunica County and Kosciusko — found some but not all of the payments they’ve received. So their numbers are likely underestimates of the total money they’ve received. 

Moss Point and Rankin County never told me how they’re spending their dollars, and we noted that in the various charts and graphs. Mound Bayou was the only government to provide no information, which led me to file this ethics complaint against the city in August. 

The only reporting requirements I’m familiar with in the settlements is for a chunk of the money that is allowed to be spent for purposes other than addiction. My understanding is this provision was added for tax purposes for the pharmaceutical companies paying the settlements. 

That money is supposed to be reported here. My understanding is that if/when the Legislature spends some of its settlement money without the recommendations of the advisory committee, that spending will have to show up here. But I don’t know if there’s an enforcer of this reporting.

I think reaching out to the local public officials making decisions is a good first step. Now that MT has published our database, there’s hopefully less room for elected officials to say they don’t know what’s going on with the opioid settlements they oversee. I came across many local officials who said they wanted this money to be spent appropriately — they just didn’t exactly know how to do that. So a nudge/recommendation from a helpful constituent could go a long way. 

If that doesn’t work, and state senators and representatives don’t respond to calls and emails, I think going to the media might be a good idea. It’s a story I’d be interested in trying to write, and it looks like Gulf States Newsroom’s Drew Hawkins (whose opioid settlement work I really admire) is looking to produce stories like that as well.  

I’m not sure. The general local spending is allowed by both the law and the settlements (although the lawyers say non-addiction spending is “disfavored”), so it’s not illegal. One of the biggest issues I’ve seen in Mississippi’s opioid settlement distribution is because so little information was made public, most people aren’t familiar with the spending or the settlements themselves. 

At large, it just hasn’t been on the Mississippi media and public’s radar.

I hope that starts to change with this “Black Box” series, but I don’t know what will happen. In my experience, nearly everyone I’ve talked with says overdoses are bad and the government should do whatever it can to prevent them. 

Attorney General Fitch and Jackson Mayor John Horhn held a press conference yesterday to say just that. So, if the public continues to connect those dots to the opioid settlement money, I would hope that decision makers see that spending the money for overdose response and prevention is aligned with their priorities. 

In other states, citizens dismayed by opioid settlement spending on things other than addiction have been able to draw a lot of public attention with protests and editorials. I don’t know if that solves all the problems, but it would certainly make this general spending more visible. 

Because Attorney General Fitch didn’t require local governments to spend the money they oversee on addiction, I found little evidence that there’s been many needs assessments or program evaluation. That could change if Mississippi’s laws and resources change, but for now Hattiesburg is the only government I could find using citizen input to assess how this local money can be spent to best prevent more overdoses.

Anecdotally, I know people who use test strips to verify what’s in their drug supply. But I haven’t asked them if they purchased the strips or were given them by a mutual aid group.