West Virginia Shifts Opioid Settlement Funds to Direct State and Local Control

West Virginia Attorney General J.B. McCuskey announced Tuesday a significant shift in how future opioid settlement dollars will be distributed, moving away from the established West Virginia First Foundation model to direct funding for state and local government entities.

The change, outlined in a Tuesday afternoon press release, redirects future settlement recoveries to the West Virginia Legislature at the state level and to mayors and county commissioners at the local level. The decision marks a departure from the distribution model established in 2023 when former Attorney General Patrick Morrisey, now the state's governor, helped create the private non-profit foundation through a memorandum of understanding with all 55 counties and more than 220 cities.

The New Distribution Framework

Under the previous West Virginia First memorandum of understanding, opioid settlement funds were divided with 24.5% going to cities and counties, 3% to the Attorney General's Office, and 72.5% flowing to the West Virginia First Foundation. Major pharmacy chains and manufacturers—including Johnson and Johnson, Teva, Walgreens, CVS, Kroger, Walmart, Allergan, and Rite Aid—agreed to a $940 million settlement for their roles in manufacturing and distributing prescription opioids in the state.

McCuskey emphasized that the Foundation, which has already begun spending the nearly $800 million it will receive from earlier settlements, now has sufficient resources to continue its mission. "Now is the time to allow the State and local government to do the same," McCuskey stated.

Rationale for the Change

The Attorney General's office indicated that the new distribution model would reduce the share of recoveries paid to third parties and attorneys' fees, ensuring that a higher percentage of opioid settlement funds reaches intended beneficiaries. McCuskey, a former State Auditor and legislator, expressed confidence in the legislature and local governments' ability to understand their communities' needs.

"I have worked with both the legislature and our local governments and am confident that they know best what their communities need," McCuskey said. "I am excited to see the thoughtful and effective ways that my friends in both local governments and the Legislature use this increased funding to better the lives of their constituents."

Current Financial Status

According to the West Virginia First Foundation's financial report for fiscal year 2026, which ended June 30, the foundation has received more than $336 million in opioid settlement funds to date, along with over $25 million in investment earnings. As of the end of June, the foundation has distributed nearly $26 million in grants and direct funds.

A spokesperson for the Attorney General's Office clarified that the change will not affect any opioid settlement funds the West Virginia First Foundation currently manages or current grant programs administered by the foundation.

Context of the Opioid Crisis

West Virginia has been among the states hardest hit by the opioid epidemic, with some of the highest overdose death rates in the nation. The settlement funds represent a critical resource for addressing substance use disorders, expanding treatment access, and supporting communities devastated by the crisis.

The shift to direct government control raises important questions about accountability, transparency, and the most effective use of these funds. Local governments will now have greater discretion in determining how settlement dollars are spent within their jurisdictions, potentially allowing for more tailored approaches to addressing the opioid crisis at the community level.

For individuals seeking help with opioid addiction, the change could mean more direct pathways to funding for local treatment programs and support services as communities gain greater control over settlement resources.