Opioid overdoses have killed thousands of Mississippians in the last decade, and Attorney General Lynn Fitch and the state Legislature have said the crisis requires effective, bipartisan solutions.

But three years into managing money intended to address this crisis, state and local leaders have committed less opioid settlement money to prevent overdoses than every other state in the country — both in total dollars and as a percentage of settlement shares.

Elected officials have reported using less than $1 million of the over $124 million in opioid settlement funds they manage for direct measures to combat addiction, according to public records Mississippi Today requested. The other 49 states, including ones receiving significantly less money, have allocated at least $3 million each from the lawsuits to address the public health problem.

About $109 million of Mississippi’s money has been sent to the state government, according to a public record requested from Fitch’s office. The state has used roughly $20 million of that to pay the Ridgeland law firm of John Davidson, the attorney general’s outside counsel for the opioid lawsuits.

The state Legislature controls the remaining $89 million. But lawmakers only this year created the Mississippi Opioid Settlement Fund Advisory Council, which is tasked with making recommendations about how to spend the funds to address the overdose crisis. The recommendations the Legislature approves are expected to be allocated in July 2026, when the next state budget goes into effect.

The rest of the money is with Mississippi’s towns, cities and counties. The localities have received over $15.5 million of opioid settlement money, according to a Mississippi Today investigation. Officials have spent $945,000 on strategies the settlement’s plaintiff lawyers recommend for curbing the crisis.

They spent about $5.4 million on a variety of purposes not related to fighting addiction, such as routine government expenses, police body cameras and new city vehicles.

Fitch — unlike attorneys general in at least 34 other states — did not require any of the money local governments receive to be spent on addiction-related purposes, and she also did not require localities to report their expenses.

Elected officials and Davidson expressed more urgency when arguing for this money in court. When the state filed a lawsuit in 2018 against companies that flooded towns with addictive and deadly opioid prescription painkillers, then-Attorney General Jim Hood and Davidson wrote that these dollars were necessary to respond to the “public health epidemic that these Defendants have created.” That lawsuit and other similar ones are expected to pay Mississippi around $421 million through 2040.

The public health crisis has ramped up in the roughly seven years since the lawyers wrote that. More people are dying of overdoses in Mississippi and the U.S. than in 2018, and there have been over 1,300 Mississippi drug deaths since the national settlement managers wired Fitch’s office the first payment in September 2022, according to the Mississippi State Department of Health and the Centers for Disease Control and Prevention.

The state Health Department has counted more than 4,600 non-fatal overdoses in the first six months of 2025 alone. And Mississippians still have trouble finding resources. Many in the state with opioid use disorder aren’t treated with the gold-standard medications and can’t find safe sober-living options, according to recent studies.

“There’s been three years now that people have been dying for no reason,” said Melody Worsham, a Harrison County peer support specialist for the Mississippi Recovery Advocacy Project. “They’re sitting on money while people die.”

After being presented with these findings in a letter, Fitch did not answer a question about whether she and the Legislature have done enough with the settlement dollars to prevent Mississippians from overdosing.

Her chief of staff, Michelle Williams, said in a statement the public health crisis has cost hundreds of billions of dollars, and the lawsuits themselves allow for some of the settlement money to pay for prior expenses made to address the epidemic.

She added that Fitch’s office was pleased the Legislature passed a law in the spring to start distributing most of the dollars with recommendations from the settlement advisory council. She said the office is looking forward to working with the committee’s members.

Lt. Gov. Delbert Hosemann and Speaker of the House Jason White did not respond to emails asking if the Legislature had done enough to address addiction with these dollars over the past three years. Davidson didn’t respond to a similar email.

Lt. Gov. Delbert Hosemann, a Republican, right, speaks with reporters, Wednesday, Dec. 6, 2023, after a meeting of the Joint Legislative Budget Committee in Jackson, Miss., while former House Speaker Philip Gunn, R-Clinton, center and Speaker Jason White, R-West, left, listen. (AP Photo/Rogelio V. Solis)

One factor that could have delayed Mississippi’s opioid settlement spending is that state elected officials altered the distribution plan as they were receiving the dollars. In 2021, Fitch and local government leaders agreed to a plan that would send 70% of the settlement funds to the University of Mississippi Medical Center for a new addiction medicine center.

But the Legislature overrode Fitch’s contract. Lawmakers passed a bill this spring to create the advisory council that makes recommendations about which private and public addiction response projects the dollars should go toward — recommendations lawmakers can approve or reject.

Dr. Caleb Alexander, a Johns Hopkins University Bloomberg School of Public Health epidemiologist who studies drug safety, said it’s a better plan for states to use the settlements for multiple addiction response strategies.

“No one in their right mind, I think, would argue that the money should all be dumped in a single bolus,” he said.

But he also said overdose deaths continue to be an urgent health crisis requiring swift action. While he expects states to take time to thoughtfully set up their distribution processes, he was surprised more Mississippi money hasn’t been used to address the emergency.

“I think three years and less than 1% represents a problem,” he said.

Another reason so little money has been spent to address addiction has been Fitch’s communications with cities and counties controlling opioid settlement dollars, according to public health experts. Representatives for the attorney general’s office have repeatedly told the local governments they don’t have to document their spending or use the money to address addiction in letters, emails and legal opinions.

Attorneys general in states such as Utah and North Carolina provided detailed guides for local governments on how to prevent more overdoses with the funds.

Dr. Rahul Gupta, the former Office of National Drug Control Policy director, served as an expert witness for the plaintiffs in many of the opioid settlement lawsuits. He said the local payouts weren’t meant to be spent secretly or for plugging budget holes. Rather, they were supposed to address addiction issues facing specific communities, while the state dollars could focus more on issues that impact large swaths of Mississippi.

Dr. Rahul Gupta was the former Office of National Drug Control Policy director, a position also known as the country’s “Drug Czar.” Credit: Courtesy of West Virginia University

“The whole goal of 100% of the funds is to use them in unison,” he said.

After her son died while struggling with addiction in 2019, Pine Belt resident Jane Clair Tyner has worked to make Mississippi addiction response resources more accessible. Her goal is to prevent more of the type of irreparable harm done to her family.

She said she sees public service announcements throughout the state claiming that help is available for anyone with substance use disorder. But that wasn’t the experience she had with her son, at least for options that were affordable.

Tyner said she wants Fitch and local government leaders to show a commitment and urgency to preventing more overdoses, and she wants them to be good stewards of this money.

“That is not at all what is being done,” Tyner said. “It’s being squandered.”

Andrea López Cruzado contributed to the data analysis of this story.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Read original article by clicking here.

‘They’re sitting on money while people die’: Mississippi is years behind other states in using opioid settlements to address addiction

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