Louisiana Gave Sheriffs 20 Cents of Every Opioid Settlement Dollar. Nobody Made Them Prove It Saved Anyone.

Danny Bolner Jr. keeps overdose reversal medication in his car. He hands it out at schools, at hospitals, in bars, wherever someone might need it before an ambulance can get there. He has been in recovery for more than two decades. His 28-year-old son died of a fentanyl overdose in 2016, and Bolner is now raising his son’s 14-year-old daughter. None of this is his job. He does it anyway, on his own schedule, with his own gas money, because the state agency built to fund exactly this kind of work has not gotten around to it.

“What’s happening here is they have a lot of money, and they want to distribute it to all the wrong places,” Bolner told KFF Health News, which published its investigation into Louisiana’s opioid settlement spending on August 27 in partnership with Verité News, WWNO, and WRKF. “This money is what we have to save lives.”

Louisiana built a public-health windfall with no mechanism to check whether it does any public health, and the sheriffs know it.

Opioid settlement money is not a grant and it is not a gift. It is court-ordered restitution — money the companies that made and sold OxyContin, the distributors that shipped it by the truckload, and the pharmacies that filled the prescriptions were forced to pay after lawsuits found they had helped fuel the overdose crisis, paid out in installments like a court-ordered allowance rather than a lump sum. Louisiana is the only state in the country that hands sheriffs one dollar in five of that allowance — the largest law enforcement carve-out of any state settlement structure in the country, according to the National Academy for State Health Policy’s settlement tracker. It’s roughly $600 million into the state over 18 years under a 2021 allocation agreement, split 80-20 between parish governments and sheriffs’ offices, with payments that began arriving in 2023 and will keep landing through 2038.

Of the 64 sheriffs’ offices in Louisiana, only 38 reported their spending to the reviewers KFF Health News commissioned. Those 38 accounted for $8.1 million. The reviewers — a panel that included addiction medicine physician and former West Virginia drug czar Stephen Loyd, and public health policy analyst Tricia Christensen — found that $5.4 million of it, 66%, was spent on things they considered inappropriate for opioid abatement money: evidence safes, narcotics scanners, automated license-plate readers, body cameras. Sixty percent of the reported total landed on items that other states, the ones that bothered to write an unallowable-expenditure list, would have blocked outright. Twenty sheriffs’ offices did not respond to a single inquiry. Their share of the money — an estimated $10.7 million — is simply not accounted for anywhere a member of the public can see it.

Why nobody has to say no

The reason this can happen in Louisiana and not, say, Ohio, is structural, and it is worth sitting with because it explains why “spend it on public health” turned into “spend it on Flock cameras” without anyone technically breaking a rule. Louisiana’s sheriffs are independently elected constitutional officers. They are not subordinate to a mayor, a parish president, or a city council, and they run their own budgets. When the state carved out 20% of its settlement money for them in the 2021 allocation agreement, it created a class of recipient answerable to almost no one between elections — no unallowable list, no mandatory public reporting, no clawback provision if the money goes somewhere the settlement was never meant to fund.

Terrebonne Parish’s sheriff’s office put $465,000 of its share into Flock cameras — the automated license-plate readers now common in local law enforcement, which read every passing car whether or not anyone in it has ever touched an opioid. Bossier Parish bought 130 body cameras and 50 dash cameras. East Baton Rouge’s sheriff’s office bought a narcotics scanner and an evidence safe; a spokesperson there, Casey Rayborn Hicks, told reporters that “while treatment and recovery services are indispensable… law enforcement has a different, but equally essential, responsibility.” Kevin Cobb, executive director of the Louisiana Sheriffs’ Association, put it more plainly: “Our budgets are overloaded.” That may well be true. It is also not what a settlement paid by opioid manufacturers, meant to abate an opioid crisis, is supposed to underwrite.

It is also not what a settlement paid by opioid manufacturers, meant to abate an opioid crisis, is supposed to underwrite.

That gap between what opioid settlement money is legally required to fund and what it can, in practice, be spent on is not unique to Louisiana — it is just more visible there because Louisiana is the only state that handed sheriffs this much of it with this little oversight attached. Set against that is Acadia Parish, whose sheriff, K.P. Gibson, put the entirety of his office’s allocation into jail-based addiction treatment. “I want people back into society, being productive,” Gibson said. St. Martin Parish spent nothing — not one dollar — on enforcement; instead it built a team that connects people leaving custody directly to treatment. “We’re not clinicians,” the office’s chief legal counsel, Chester Cedars, told reporters, describing the office’s approach as acting as “a broker” between the justice system and care, “not using one penny for any enforcement activity.” Two sheriffs, working from the exact same 2021 statute, made opposite choices about what the money was for. That gap is the whole story: nothing in the law forced either of them, and nothing will force the next one.

The country has run this experiment before, and we already know the ending

If this sounds familiar, it should. In 1998, 46 states signed the Tobacco Master Settlement Agreement, a $246 billion deal with the major cigarette makers explicitly framed around funding smoking-cessation and youth-prevention programs. States spent the money on roads, budget gaps, and unrelated tax cuts instead — watchdog groups have spent two decades documenting how little of the $246 billion ever reached a smoking-cessation program, and researchers have since found that states receiving larger MSA payments actually developed weaker tobacco-control policy over time — the money substituted for public health investment instead of funding it. Hawaii is the textbook case: lawmakers there originally dedicated 25% of the state’s annual tobacco payments to a prevention trust fund, then quietly whittled that share down over successive budget cycles until it sat at roughly 6.5%, a few million dollars a year, a fraction of what was promised when the ink was still wet.

Harvard’s own public health researchers pointed to exactly this history while the opioid settlements were still being negotiated, warning states not to repeat it. Louisiana’s 20% sheriff carve-out is that warning, ignored in real time, with a shorter accounting cycle: it took the tobacco money over a decade to fully reveal itself as diverted, one budget cycle at a time, state by state, until researchers could measure the pattern nationally. Louisiana sheriffs got there in the first reporting cycle, in a single year, in public view, because a newsroom went looking before the money had time to disappear quietly the way Hawaii’s did.

If you have ever waited for a system that told you it existed to help you, you already understand what it feels like to watch that gap open up in real time — the promise on one side, the invoice for something else entirely on the other.

Someone is trying to close it, and the clock is short

Louisiana state senator Brach Myers, a Republican, co-authored Senate Concurrent Resolution 22 in May, directing the Louisiana Legislative Auditor to review every parish and sheriff’s opioid settlement spending and report to the legislature’s health and welfare committees by December 31, 2026 — before the 2027 regular session. Myers told reporters he would “absolutely” introduce bills to tighten how the money can be spent once the audit lands. It is a real deadline with real teeth: Louisiana’s legislative auditor already has statutory authority to compel the records, and a 2025 audit found that 21 sheriffs’ offices didn’t even bother responding to that survey. Whether a majority-Republican legislature moves to restrict a Republican-aligned constituency of elected sheriffs, four months before its own members are back in Baton Rouge, is the actual test of whether this resolution changes anything or becomes the second report gathering dust next to the first.

Myers told reporters he would “absolutely” introduce bills to tighten how the money can be spent once the audit lands.

Tricia Christensen, who sat on the review panel, framed the stakes in exactly the terms that should worry anyone watching settlement money nationally, not just in Louisiana: “The impetus of this opioid settlement money is to spend on innovative ways to not let this happen again,” she said. “How could we use this to reinvest in the community, not just build up our office?” She added a line that doubles as a warning to every other state watching its own settlement rollout: “You’re keeping them on the track when you tell them what they can’t use it for.” Louisiana never told anyone what they couldn’t use it for. Now it is trying to find out, after the fact, what they did.

Six other states wrote that unallowable list before spending a dollar. If your program is one of the hundreds nationally now applying for county or parish settlement funding, the do-this-week version of this story is simple: ask whoever controls your local allocation whether an unallowable-expenditure list exists at all, and ask to see it before you build a budget around money that a sheriff’s office down the road might also be counting on. Louisiana’s answer, for four years, was that no such list existed. That is now a case study your funder’s board has probably already read.

The overdose numbers that made this money exist in the first place are, nationally, still moving in the right direction, if slower than anyone would like — provisional CDC data reported in January showed drug overdose deaths down nearly 21% over the prior twelve months, a decline Rize covered in more recent detail last week as the fentanyl supply itself shifts under a slowing but still-fragile trend line. None of that progress is self-executing. It is bought, county by county, with exactly the kind of settlement dollars Louisiana cannot currently account for.

Danny Bolner isn’t waiting on the audit. He wasn’t waiting on the 2021 statute, either. Every naloxone kit he hands out at a school gym or a Baton Rouge bar is a settlement dollar’s worth of work happening on his own dime while $10.7 million sits somewhere nobody has to itemize. “If I save one life,” he said, “it’s accomplished.” That’s a lower bar than the state has set for itself, and he’s already clearing it — this week, on his own, before anyone audits anything.