Opioid Settlement Funds in Utah: Where is the Money Going?

In 2021, nationwide settlements were reached to resolve litigation against major pharmaceutical distributors and manufacturers for their role in creating and fueling the opioid epidemic. While no amount of money can bring back the lives lost or undo the profound damage inflicted on families, these settlements provide a critical opportunity to fund life-saving resources.

Utah is expected to receive approximately $543 million in settlement funds over 17 years (through 2039). These funds are split roughly 50-50 between the state and the state’s 29 counties.

But a crucial question remains: How exactly is that money being spent right now, and how can we ensure it goes toward the services that actually save lives?

Here is a breakdown of where Utah’s settlement funds are going in 2026, the mechanisms controlling them, and how the recovery community can demand accountability.

The State Share: The Opioid Litigation Proceeds Restricted Account

The state’s 50% share of the settlement funds is deposited into the Opioid Litigation Proceeds Restricted Account.

In a major shift during the 2025 General Session (via H.B. 10), the Utah Legislature converted this restricted account into a permanent fund. This means that, moving forward, the principal amount is invested, and only the investment earnings (estimated at around $5 million annually, depending on revenues) are available for expenditure. The goal is to create an ongoing, sustainable revenue source indefinitely.

Who Decides Where the Money Goes?

The flow of state funding is a multi-step process:

1. The Blueprint: The Utah Opioid Task Force’s Opioid Settlement Advisory Committee (OSAC)—a group of subject matter experts—created a Utah Opioid Crisis Response Blueprint. This document provides guidance and core principles (like prioritizing treatment, recovery, and harm reduction) but does not have the authority to actually spend the money.
2. The Recommendations: State agencies, primarily the Department of Health and Human Services (DHHS) and the Office of Substance Use and Mental Health (OSUMH), present proposals to the Legislature based on this blueprint.
3. The Final Say: The ultimate power lies with the Utah State Legislature. Specifically, the Social Services Appropriations Subcommittee writes the appropriations into the budget, and the Executive Appropriations Committee makes the final determinations. The funds can only be accessed through legislative appropriation.

Where Did the Money Go in the 2025/2026 Sessions?

Based on recent legislative appropriations, we are seeing state funds directed toward several vital areas, though the amounts vary. Recent funding items from the restricted account (impacting FY 2025 and 2026) include:

• Medication for Opioid Use Disorder (MOUD) in Jails: Ongoing funding to support treatment within county correctional facilities, a critical intervention point.
• Fentanyl Interdiction: Significant funds allocated for personnel and equipment.
• Recovery Community Centers: Appropriations supporting organizations like USARA and other wellness/outreach connections.
• Treatment at Community Health Centers: Funding to expand opioid use disorder treatment access through federally qualified health centers.
• Upstream Prevention: Funding directed toward youth prevention services and epidemiological surveillance.

Note: The Social Services Appropriations Subcommittee has established a process to review these appropriations after three years to ensure they are working as intended.

The Local Share: County-Level Decisions

The other 50% of the settlement goes directly to participating Utah counties. How this money is spent is determined by local county commissions and health departments.

This is where local advocacy is most effective. For example, Grand County recently approved a 60/20/20 split of their opioid settlement funds, directing 20% specifically to USARA/peer-recovery services and the remainder to regional outpatient clinics and wellness collectives.

A 2025 report by the Utah Investigative Journalism Project found that a “majority of counties in the state have spent little to none of the opioid funding they’ve received.” Counties are mandated to spend these funds on “Approved Uses,” which include prevention, harm reduction, treatment, and recovery supports. Crucially, state law dictates that these funds must supplement—not supplant (replace)—existing government funding.

The Advocacy Angle: Demanding Transparency and Peer Support

While it is encouraging to see funds directed toward recovery centers and MOUD in jails, the recovery community must remain vigilant. The historic lack of funding for behavioral health means there is immense pressure to use these new dollars to plug old holes in the budget, rather than funding innovative, community-based solutions.

Friends of Recovery Utah is advocating for the following priorities regarding settlement spending:

1. Fund Peer Support: We demand that a significant portion of both state and county funds be dedicated to expanding Certified Peer Support Specialist (CPSS) programs, particularly in emergency departments and rural areas.
2. Saving Lives is Non-Negotiable: Settlement funds must be used to expand access to naloxone, fentanyl test strips, and other evidence-based harm reduction strategies that save lives.
3. Total Transparency: We support the OSAC’s recommendation for rigorous reporting and outcome measurements. The public deserves to know exactly which programs are receiving funding and what the tangible results are.

Take Action

The decisions being made by the Social Services Appropriations Subcommittee and your local county commissioners will shape Utah’s behavioral health landscape for the next decade.

You can track how the legislature is utilizing these funds via the Utah State Legislature’s Funding Item Follow Up Report.