Arizona's September Naloxone Shipments Help, But They're Sized for a Crisis That's Shrinking Everywhere Except Here

This month, Arizona’s Attorney General’s office is taking delivery of two separate naloxone shipments that were locked in months ago and have nothing to do with each other except the reason they exist: courts made drug companies pay for the opioid crisis, and part of the payment is free overdose medicine. Under the Hikma settlement agreement, Arizona placed an order by the March 24, 2026 deadline for 6,599 units of naloxone, arriving in September. Under a separate deal with Amneal, the state is getting the first installment of a four-year allotment totaling 33,714 units, paid out at 8,428 units a year, also landing this month. A “unit,” in settlement language, is a box of two nasal naloxone doses — the same spray-up-the-nose kit any bystander, not just a paramedic, can use in under a minute to reverse an opioid overdose. No training course, no needle.

Free overdose medicine that reverses a fatal event in under a minute is unambiguously good, and it is still not enough medicine for how many Arizonans are dying.

Here is what a settlement agreement actually is, stripped of the legal wrapper: when states sued opioid manufacturers, distributors, and pharmacies for their role in flooding communities with pain pills, the companies agreed to pay out over time rather than fight in court forever. Some of those deals let a company hand over medicine instead of cash for part of the bill — which is why a pharmaceutical company, not a public health agency, is the one shipping boxes to Arizona this week. Arizona’s full opioid settlement haul across every company that has settled runs to $1.215 billion paid out over 18 years, split 56 percent to counties, cities, and towns and 44 percent to the state under the One Arizona distribution agreement. Maricopa County alone booked a $4.7 million first settlement payment, and a separate Teva-settlement round already put more than 55,000 naloxone units into county health departments statewide.

Now put the September numbers next to the death count. Arizona logged an estimated 2,988 overdose deaths in 2025, up 18 percent from 2,531 the year before — a spike happening while national overdose deaths were falling, according to the Arizona Public Health Association. Fentanyl is now involved in roughly six of every ten drug deaths in the state. Arizona also ranks near the bottom nationally, 50th of 51 jurisdictions, for adult access to mental health and behavioral health care, per Mental Health America. Read more Arizona overdose and policy coverage in our Arizona Watch archive.

Divide 6,599 units across 15 counties, a few dozen sheriff’s offices, and every syringe service program and rural clinic asking for a share, and a county health department is left rationing a few hundred boxes until the next settlement check clears — in a state burying close to eight people a day to overdose. The Amneal shipment helps more precisely because it repeats every year for four years, which is what a health department actually needs to plan a program instead of scrambling. A one-time truckload is a gift. A four-year schedule is infrastructure. Arizona has both landing in the same month, and only one of them is built to last.