Opioid Restitution Fund

Overview 

Banner for the "City of Baltimore" with the text "Opioid Restitution Fund" in bold white letters over a purple-tinted cityscape. The city's seal is at the top left.

Opioid overdoses have been one of the most deadly public health epidemics in our nation's history, leading to more than 80,000 deaths annually in the United States. In the last two decades, Baltimore has been disproportionately impacted, with more than half a billion opioid pills permeating the Baltimore area between 2006 and 2019, driving an increase in overdose deaths. Public health experts have estimated that more than 80% of Baltimore’s opioid use disorder cases between 2010 and 2021 began with prescription opioids, leading residents to turn to illicit drugs.

Baltimore City makes up 9% of Maryland’s population but, now through the first seven months of 2024, represents 44% of Maryland’s overdose deaths. Annually, Baltimore has an average of more than 2 overdose deaths per day.

In response, in 2018, Baltimore City initiated legal action against various pharmaceutical manufacturers and distributors for their role in creating the opioid epidemic in Baltimore City by failing to take reasonable steps to prevent the diversion of their highly addictive prescription opioids. The City then opted out of the global settlement that would have provided the City with much less restitution money than it deserved, and decided instead to pursue its litigation against some of the largest pharmaceutical companies in the world.

That decision has paid off. As of September 10, 2024, the City has reached settlement agreements with Allergan, Cardinal Health, CVS, Walgreens, and Teva, totaling $402.5 million and already eclipsing the amount the City would have received under the global settlement.

The City anticipates additional recoveries through settlement or trial in pending cases against the manufacturers and distributors that caused and perpetuated the opioid epidemic. This page will be updated regularly to reflect additional victories.

The recoveries from these cases will be used to create the Baltimore City Opioid Restitution Fund.

 

Executive Order Issued By Mayor Scott

On August 29, 2024, Mayor Scott released an Executive Order establishing the City’s approach to managing the restitution funds received, including provisions that:  

  1. Establish a separate Baltimore City Opioid Restitution Fund 
  2. Establish a trust fund that will sustain the impact of these funds for at least 15 years 
  3. Create positions in the Mayor’s Office including an Executive Director of Overdose Response and an Opioid Restitution Program Manager 
  4. Establish a Restitution Advisory Board 
  5. Outline key documents that the City will publish for accountability and transparency 

For more details, you can read the full Executive Order, or read the overview of the Executive Order.

The application period for the Restitution Advisory Board has closed. Submitted applications are being scored, and finalists will be contacted in November for a formal interview.

If you have comments or questions on the Executive Order, please email overdoseresponse@baltimorecity.gov.

 

Community Engagement

In the Executive Order, the Mayor detailed the process and procedures of the Opioid Restitution Fund governance and financial structure. As part of that effort, the City of Baltimore plans to engage in robust community engagement meetings across the city to hear from individuals and groups impacted by the overdose crisis.

The City’s proposed community engagement process will include: 

  • Community Listening Sessions 
  • Focus Groups
  • Online Public Feedback Form

More details on the community engagement plan and schedule of events will come soon.

 

Next Steps

Steps for Administering Opioid Restitution Funds

Flowchart outlines 10 steps for managing Opioid Settlement Funds in Baltimore City. Steps include governance setup, Executive Order, hiring key roles, forming an advisory board, community engagement, setting priorities, and selecting programs to fund.

Image Description: A vertical flowchart titled "Steps for Administering Opioid Restitution Funds" with ten sequential steps, each in a blue box connected by arrows. The steps are as follows:

  1. Establish Governance and Finance Structure for Restitution Funds

  2. Mayor Scott Announces Executive Order: Administration of Funds from Restitution Funds 

  3. Hire Executive Director of Overdose Response and Opioid Restitution Program Manager - We are Here

  4. Establish Restitution Advisory Board - We are Here

  5. Conduct Community Engagement and Needs Assessment - We are Here

  6. Publish City-wide Overdose Response Plan

  7. Set Annual Funding Priorities

  8. Release Notice of Funding Availability

  9. Select Programs to Fund

  10. Distribute Funds for FY26

 

Additional Resources:

 

Funding Opportunities

Organizations seeking funding through the Opioid Restitution Fund should sign up for City updates and check back in the Spring to find more information on this site. To learn more, you can view the Mayor’s Executive Order. We anticipate releasing applications for funding in Spring 2025. 

 

Additional Funding Opportunities

 

How to Get Involved

  • The Restitution Advisory Board Application closed on September 30th . Check back here for more updates on how to get involved. 

 

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