Opioid Restitution Fund
Overview
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 November 2024, the City has reached settlements and jury awards totaling more than $668.5 million, which is more than six times the amount the City would have received under the global settlement. Of that amount, the City has received $115 million to date ($71.6 million after legal fees and repayment of litigation costs), with the balance expected by the end of 2025.
- Allergan: $45 million
- Cardinal Health: $152.5 million
- CVS: $45 million
- Walgreens: $80 million
- Teva: $80 million
- Johnson & Johnson: Settled, amount to be announced
- Cencora (formerly AmerisourceBergen) and McKesson: $266 million jury award, pending litigation
The City entered abatement proceedings in December 2024. All recoveries from these cases will go to 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:
- Establish a separate Baltimore City Opioid Restitution Fund
- Establish a trust fund that will sustain the impact of these funds for at least 15 years
- Create positions in the Mayor’s Office including an Executive Director of Overdose Response and an Opioid Restitution Program Manager
- Establish a Restitution Advisory Board
- Outline key documents that the City will publish for accountability and transparency
Read the full Executive Order or view the Executive Order Overview. For comments about the Executive Order, email overdoseresponse@baltimorecity.gov.
Share Your Ideas
We want to hear from you! Help improve Baltimore’s response to the opioid crisis by sharing your ideas:
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Give feedback on the draft Community Engagement Plan by March 15, 2025.
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Share your thoughts about the draft Transparency and Accountability Plan by March 15, 2025.
Restitution Advisory Board
As of February 12, 2025, the Mayor announced the Restitution Advisory Board. Read more about the board here.
Community Engagement
Part of the Mayor’s Executive Order charged the city government with developing a City Overdose Response Strategy to guide the efforts to address the opioid and overdose epidemic through programs, interventions, and funding.
On December 17, 2024, the City published a draft community engagement plan per the executive order. The Community Engagement Plan outlines a two-step approach to ensure the City’s Overdose Response Strategy reflects the current needs and gaps in services.
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Submit your comments on the City's draft Community Engagement Plan by March 15, 2025.
As part of this engagement, the City will host four Community Listening Sessions in early 2025 to hear directly from residents about the overdose crisis and their recommendations for addressing it. Details, including dates, times, and locations, will be shared in early 2025.
Public Transparency and Accountability Plan
Included in the Mayor’s Executive Order, the City must publish a plan for transparency and accountability of the restitution funds.
Next Steps
Steps for Administering Opioid Restitution Funds
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:
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Establish Governance and Finance Structure for Restitution Funds
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Mayor Scott Announces Executive Order: Administration of Funds from Restitution Funds
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Hire Executive Director of Overdose Response and Opioid Restitution Program Manager
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Establish Restitution Advisory Board
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Conduct Community Engagement and Needs Assessment - We are Here
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Publish City-wide Overdose Response Plan - We are Here
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Set Annual Funding Priorities - We are Here
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Release Notice of Funding Availability
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Select Programs to Fund
- Distribute Funds for FY26
Additional Resources:
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Look up and connect with community resources in Baltimore City through Charm Care
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Need immediate emotional support? Call 988 to connect to a counselor who can help
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Learn about Baltimore City Health Department's Substance Use services and resources
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Access the Baltimore City Health Department Overdose Dashboard
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Access the Maryland Department Health’s Overdose Dashboard
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Request The Baltimore City Health Department's Naloxone Training
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Sign up for Baltimore City Health Department’s Virtual Naloxone training
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Learn more about the resources and information of the Maryland Syringe Services Programs
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Get free Naloxone, Fentanyl Test Strips, and Xylazine Test Strips
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 2025.
Additional Funding Opportunities
How to Get Involved
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Attend a community listening session in early 2025
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Give feedback on the draft Community Engagement Plan by March 15, 2025
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Share your thoughts about the draft Transparency and Accountability Plan by March 15, 2025
Contact Us