Maryland’s Opioid Settlements

This Community Guide will describe how Maryland is spending its opioid settlements and whether Maryland is working to ensure community access to opioid settlement funds. Last revised September 1, 2024.

Total Funds

$653 million[1]

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[1] Total is rounded. See The Official Opioid Settlement Tracker Tally. Accessed September 1, 2024.

Allocation

70% to local governments and 30% to the state[2]

Mechanism

State-Local Agreements (State-Subdivision Agreement Between the State of Maryland and Local Governments on Proceeds Relating to the Settlement of Opioids Litigation and State-Subdivision Agreement Between the State of Maryland and Participating Local Governments on Proceeds From Settlement of Opioids Litigation Against Teva, Allergan, Walmart, and Walgreens); Legislation (Md. State Finance and Procurement Code Ann. Sec. 7-331, Md. Health - General Code Ann. Secs. 7.5-901 to 7.5-905); Executive Order (Executive Order 01.01.2023.21)

	45% Targeted Abatement Grants	25% Local Share	15% State Share	15% State Discretionary Abatement Fund
Ultimate Decisionmaker	Local officials for counties, cities, and towns	Local officials for counties, cities, and towns	The “State” (Maryland Department of Health)	Maryland Department of Health
Decision-making Process	Qualifying charter counties decide autonomously Other localities receive funds via a Maryland Department of Health targeted abatement grant program after approval of a local abatement plan	Localities decide autonomously after receiving non-binding recommendations from the state and consulting other localities in their county	The Maryland Department of Health distributes funds after considering recommendations from the Opioid Restitution Fund Advisory Council	The Maryland Department of Health distributes funds through a competitive grant program after considering recommendations from the Opioid Restitution Fund Advisory Council
Supplantation	Prohibited	Not prohibited	Prohibited	Prohibited
Grant Funding	Up to each locality (availability and processes will vary)	Up to each locality (availability and processes will vary)	Yes. See Maryland’s Office of Overdose Response’s Grants and ORF Advisory Council pages.	Yes. See Maryland’s Office of Overdose Response’s Grants and ORF Advisory Council pages.
Public Input	Up to each locality (not required)	Up to each locality (not required)	Depends on future programming (recurring opportunities not required)	Depends on future programming (recurring opportunities not required)
Advisory Body	Up to each locality (not required)	Up to each locality (not required)	Yes (required). See the Opioid Restitution Fund Advisory Council. The Council is required to include member(s) with lived and/or living experience.	Yes (required). See the Opioid Restitution Fund Advisory Council. The Council is required to include member(s) with lived and/or living experience.
Expenditures	Public reporting required. View annual public reports here.	Neither public nor intrastate reporting required	Public reporting required. View annual public reports here.	Public reporting required. View annual public reports here.
Updates	For updates on the Targeted Abatement Grants share, a good starting point is to check the websites for your county council, city council, or local health department. You can also refer to the Maryland Association of Counties’ various opioid settlement-related articles on its Opioids page. See also Opioid Restitution Fund Advisory Council (Maryland’s Office of Overdose Response).	For updates on the local share, a good starting point is to check the websites for your county council, city council, or local health department. You can also refer to the Maryland Association of Counties’ various opioid settlement-related articles on its Opioids page.	For updates on the state share, visit the Opioid Restitution Fund Advisory Council’s website and join Maryland’s Office of Overdose Response mailing list.	For updates on the State Discretionary Abatement Fund share, visit the Opioid Restitution Fund Advisory Council’s website and join Maryland’s Office of Overdose Response mailing list.

[2] The 70% to local governments includes the 45% Targeted Abatement Grants share and 25% Local Share.