Reexamining New Jersey’s Opioid Settlement Fund Allocation: Progress and Challenges.

December 2024

By Nikki Tierney, JD, LPC, LCADC, CPRS
NCAAR Policy Analyst

According to the Official Opioid Settlement Tracker Tally, the official sum of settlements reached between U.S. state and local governments and the 16 major pharmaceutical opioid manufacturers, marketers, distributors, and retailers is $55.2 billion, with New Jersey having already received slightly over $1.2 billion, with an additional $5.2 billion expected. ¹ New Jersey was one of twelve states that committed to publicly report expenditures of their funds in a way that an average person could find and understand. In the most recent analysis of states’ progress, New Jersey was determined to have fulfilled its commitment and publicly reported 100% of the expenditures with clarity. ² According to Norman Litchfield, a psychiatrist and Director of Addiction Medicine at St. Luke’s Health System in Idaho, by fulfilling this commitment, New Jersey and other states could potentially “help get the message out that treatment works and treatment is available.” ³ This kind of transparency helps to decrease stigma and provide hope, and New Jersey has been a leader in this movement.

While there has been no official analysis of how New Jersey’s subdivisions, in this case, counties and municipalities, are complying with the transparency and plain English commitment, our informal examination reveals mixed results. Notably, New Jersey is one of the few states that requires local governments to complete reports on how they use the funding. ⁴ One of the more discouraging observations from comparing the 2023 and 2024 Annual Opioid Abatement Reports was the lack of follow-through or action on previously reported intentions, the failure of subdivisions to solicit input from the community, assess community needs, and draft strategic plans that include a detailed process for awarding funds.  Many subdivisions outlined evidence-based responses in their respective 2023 reports, and yet in the more recent report, they either have completely revised plans or taken no further action.

One example of a municipality that did not follow through on a promising idea is Harrison. In its previous report, it stated its plans to spend $30,000 to facilitate access to treatment for residents in need and $13,500 to create a welcoming “Drop-In Center” to support residents in “treatment and recovery.” However, according to the 2024 Opioid Abatement Report they filed, they received $259,302.38 since distributions commenced in 2022, and $241,704.63 remains unspent and/or uncommitted. Specifically, the funds that were allocated were spent on existing programs like the ‘Junior Police Academy.’  As for their efforts to engage the community, Harrison stated that they have not engaged the public but “plan to in the future.”

Perhaps fortunately, the Town of Clinton did not follow through on its 2023 plans to spend $26,000 to purchase equipment for officers to safely identify unknown drug substances. The program’s target population was projected at thirteen people (presumably this target population consists of 13 law enforcement officers who do not have opioid use disorder or are at risk for the same). Instead, Clinton has tentatively decided to join forces with the county once the county develops its plan. When asked if they engaged the public, the report indicated, “We did have a couple of members from the public attend a Council meeting and express their desires for the use of the money, but this was not the purpose of the meeting.”

A final example of a municipality that did not follow through with its plans set forth in the 2023 report is Marlboro. The municipality never funded education for police as outlined in the 2023 report and instead redirected resources to provide scholarships for treatment.  According to their report, they have spent $80,000 to support treatment and/or transportation for residents with substance use disorders.  This is another example where the lack of follow-through led to a more valuable use of funds, but delays in investment delay their potential impact.

As of 2023, several towns did not provide a report in 2024, including Weehawken and Elmwood Park. In its 2023 report, Weehawken reported receipt of $11,876.30 as of June 30, 2023, and in response to the question if New Jersey could post their strategic plan online, Weehawken responded “Not yet. Please, we are still fine-tuning it.”  One year later, they have no strategic plan and no report.  Several subdivisions provided reports that contained no significant information.  Specifically, Wall Township reported it received $207,882.06 since distributions commenced in 2022, and $207,882.06 remains unspent and/or uncommitted.  Almost every question is answered with, ‘No, but we plan to’.  Hudson County similarly provided a two-page report lacking any substantive information, reporting that despite receiving $1,195,295.30 since distribution commenced in 2022, $1,179,065.63 remains unspent and/or uncommitted.  This, despite Hudson County having the fourth highest Naloxone administration totals in the state in the 3rd quarter (See DMI Table).  In total, only five subdivisions created a strategic plan.  There is voluminous, free, evidence-based assistance to subdivisions in New Jersey to assist in maximizing their respective opioid settlement funds, and, tragically, so many subdivisions have not availed themselves to that support. ⁵

Conversely, some counties and municipalities have taken impressive actions and allocated their funds toward significant initiatives.  For example, Montclair reports that it received $272,516.53 since distribution began in 2022, and a mere $30,955.36 remains unspent and/or uncommitted as of their 2024 report.  Montclair reported that it decided how to use the funds based on strategies provided by their local EMT and from an online survey to all the Township’s social media sites and local online newspapers. Their investments include programs to “[e]ducate and train the general public, school-aged children and various work groups that tend to have high opioid abuse rates (restaurant employees, construction, etc.)  on how to properly administer Narcan,” connecting residents to treatment and providing “giveaway bags containing fentanyl and xylazine test strips, Narcan, CPR mask and other educational materials related to opioids. We distributed these bags at special events within the Township.”

Similarly, Maplewood used its funds for salary and wages for a Crisis Intervention Social Work Program (CISW) and reported that “[i]n 2023, the CISWs addressed 175 cases, with 44 co-responses with police dept. From Jan.- June 2024, the CISWs addressed 80 cases with 32 co-response and 16 clinical social work cases.”  Jersey City has also allocated funds to evidence-based and public health responses.  Particularly, Jersey City reported it received $1,135,372.85 since distribution commenced in 2022 and only $561,772.85 remains unspent and/or uncommitted.  Their report detailed a “Harm Reduction Kiosk in our Ward with increased issues which provides access to Narcan and various testing strips such as fentanyl, xylazine, and GHB” and a Peer Intervention Program.  Jersey City reported engaging the public through a survey to address community needs.

As reviewed in NCAAR’s first newsletter on this matter in October 2023, some of the allocations by subdivisions are not evidence-based and it is questionable if they fall within the clear terms of the settlement agreements.  First, Hamilton Township reported it received $170,615.34 since distribution commenced in 2022 and $168,490.34 remains unspent and/or uncommitted.  The $2,125 that was allocated was used to purchase a K-9 Police dog: “Through demonstrations and outreach programs, our K-9 unit helps to educate the public, especially young people, about the importance of safety, the role of law enforcement, and the value of responsible pet ownership. These educational initiatives foster trust and cooperation between the police and the community, promoting a shared commitment to public safety.” Similarly, the Township of Mahwah purchased a K9 dog as they indicated in their 2023 report.  Interestingly, they reported allocating $23,000 to fund their municipal alliance, but that budget includes care and training for the K9, stating that continued training and care of the K-9 in the amount of $11,222.62 is allocated/expended.

The Borough of Ramsey obtained the narcotics detection dog, named “Jack,” for $8,500 that according to the report has not only detected and seized drugs but “has been utilized not only by the police for prevention but also at numerous community events, such as weekly Farmers Market, Ramsey Day and other educational events to increase awareness.”  That appears to be the only money they have spent.  The town further reported that “K9 Jack is an essential member of our community engagement team as he attracts many people who may otherwise be reluctant to interact to come see him and interact and engage in conversation they normally would not have.” While dogs are wonderful companions and therapy dogs are evidence-based care for people with opioid use disorder, it is without question that criminal and punitive responses have not decreased the deaths and harm from opioids, but in fact, exacerbated it.  A 2021 study demonstrated that when law enforcement disrupts local drug markets, through the seizure of drugs, hypothetically detected by a K9 dog, there was a doubling of drug-related deaths, due to people being forced to find a new source to obtain substances. ⁶

Mantua Township made good on its promise to spend its money to “Increase Police Department Staff.”  They received $ $85,799.65 and $8,262.64 remains unspent and/or uncommitted. Per the report, Mantua Township states, “Funds help offset police budget to assist with the opioid crisis and the day-to-day response in combatting the number of overdose calls and intervention to save lives.”  The outcome they aim to achieve is a “[r]eduction in response from opioid and addiction calls.”

The Borough of Collingswood received $166,429.68 and spent $5,600 again in 2024 on an Employee Assistance Program for 130 Township Employees and their families.  In response to the question “What is the anticipated number of unduplicated clients this program will reach annually,” the municipality answered fifty.  In contrast, their 2024 report indicated that $2,867.97 was spent on education and awareness programs to benefit members of the public.  In response to the question “What is the anticipated number of unduplicated clients this program will reach annually,” the municipality answered 11,000.  Finally, in 2023, $12,252,15 was spent on EMS Ambulance Repairs/Supplies.  New Jersey and its subdivisions are not alone in addressing the use of opioid settlement funds, whether to replace funding for existing programs or to allocate resources toward law enforcement initiatives.  Many state and local government entities are grappling with these very issues.

The remaining question is whether the use—or failure to use—these funds has had any impact on overdose death rates.  As noted earlier, while drug-related deaths (which notably are not the only metric used to measure harm from the opioid epidemic) have decreased in New Jersey and nationwide, there are certain areas in the country- and counties in New Jersey, where deaths have increased.  Moreover, while deaths have fallen overall, certain groups have not seen decreases.  As KFF Health News reported, “opioid death rates varied widely by race, ethnicity, age, and sex. In the second half of 2023, White people saw the largest decline (-14%) while declines in other racial and ethnic groups were much smaller. Opioid deaths increased for people 65 and over while falling in all other age groups.” ⁷  The inequities at the national level are occurring here in New Jersey as well.  New Jersey Department of Health Commissioner, Dr. Kaitlin Batson explained that “as we’ve seen the numbers drop off for White New Jerseyans, we’ve actually seen them continue to rise in the Black and Brown communities in our state, which is unacceptable. And we’re seeing disproportionate numbers of people affected in rural areas and staggering numbers in the elderly population. And so, I say all this not to be depressing, but to say we have work to do, and that is why we are here.” ⁸