How Minnesota communities are spending millions of dollars from opioid settlement

Minneapolis bought a mobile medical unit. Clay County added beds at a new detox facility. St. Louis County is fixing up a triplex to house people who were incarcerated. Several greater Minnesota counties are funding D.A.R.E. programs.

The massive sums flowing into the state from opioid settlements are starting to be spent.

Minnesota expects to see more than $633 million over many years, paid by opioid manufacturers, pharmaceutical distributors and pharmacy chains. And the total continues to grow, with the Minnesota Attorney General Office’s recently announcing another round of settlements that would bring roughly $9 million more to the state.

Three-quarters of the money is going to cities and counties, which have broad discretion in how to spend it. Those local governments started using more of the money last year, with recently released data showing they spent $17.4 million in settlement funds in 2024 to combat the deadly opioid crisis.

“There’s so much unstable in the world of health and human services at the state and federal level,” said Association of Minnesota Counties Executive Director Julie Ring. “Having this funding committed to going out to local government to address the needs of their community feels more important than ever.”

While there are vastly different needs and ideas for using the money, common themes have emerged in how 70 counties and 19 cities have spent the cash over the past few years.

Key trends so far:

Cities and counties reported significant portions of their settlement spending targeted those communities.

Hennepin County, for example, said it served those populations with money it passed along to the Native American Community Clinic in south Minneapolis and NorthPoint Health and Wellness Center in north Minneapolis. Some of the other groups governments reportedly focused on include people involved in the criminal justice system, those who are homeless and youth.

Many counties and cities identified spending projects that were aimed toward certain communities, such as the $106,000 Mille Lacs County used for its co-responders. That program sends people, such as social workers, on behavioral health calls with law enforcement. The county identified it as serving a dozen different populations, from racial and ethnic groups to youth and pregnant or postpartum women.

About half of the city and county money was identified as going to evidence-based practices. The Minnesota Management and Budget department reviews reports about services and assesses whether they qualify as evidence-based practices or if they are theory-based and “may benefit from rigorous evaluation.”

In Minneapolis, the purchase of a mobile medical unit — the city’s first vehicle that will provide mobile basic health services and connect people with opioid addiction treatment — was among those identified as theory-based.

“Doing so would limit innovation and the development of promising new approaches,” Hogan said in a statement. “Since work within the substance use field is ever-evolving and transforming, it is important to fund innovation and discovery as well as evidence-based practices.”

Minnesota’s 87 counties and cities with populations greater than 30,000 that are participating in the litigation get portions of the settlement funds, with larger communities receiving larger shares.

Local governments first reported using the money in 2022. They went from about $540,000 in spending that year to $5.5 million in 2023 — a fraction of the tens of millions cities and counties received during those years. However, local government officials said that was predictable as cities and counties first strategized about how best to use the dollars and set up systems to distribute the money.

After the slow start, cities and counties spent more of the money — $17.4 million — in 2024.

Last year about three-quarters of Minnesota counties spent some settlement funds, Ring said. She noted the latest reports don’t show the full picture of what governments are doing with the money, because they don’t include dollars that have been committed for certain purposes but not yet gone out the door.

Minnesota cities and counties reported using settlement funds for 520 different services or projects over the past few years. Hennepin County had the two biggest single expenditures: $934,000 for the medical examiner and $924,000 for “admin costs” last year. It also spent $585,000 on administrative costs the prior year.

Overdose deaths have increased the medical examiner’s workload and settlement dollars have helped add staff in that office, including hiring another forensic pathologist to look into causes of death, county spokeswoman Carolyn Marinan said. She noted toxicology reports have discovered drug trends appearing on the streets.

Hennepin County has been distributing settlement funding through contracts with local organizations, and Marinan said administrative expenses have gone toward setting up the infrastructure to spend the money and oversee it.

The overdose-reversing drug naloxone, often referred to by the brand name Narcan, came up again and again in spending data.

Over the past couple years, dozens of communities spent some money distributing the drug or training people how to use it.

Many communities focused some of their spending on youth, but with different approaches to address substance abuse within that group.

Several greater Minnesota counties spent settlement dollars on D.A.R.E. programs. The “just say no” drug education program that was ubiquitous in the 1980s through the early 2000s had fallen out of favor in many communities as studies showed it was largely ineffective. The program has since been relaunched with a new “keepin’ it REAL” curriculum.

Meanwhile, Ramsey County used some money to train people at Gordon Parks High School on opioid health education and administering naloxone.