GREENVILLE, N.C. (WNCT) — Money from recent national opioid settlements is flowing into North Carolina, and Attorney General Josh Stein wants counties and municipalities to be purposeful and transparent in how they spend those funds.

All of North Carolina’s municipalities have received their first payments from one of those settlements, a $26 billion agreement with drug distributors Cardinal, McKesson and AmerisourceBergen. North Carolina’s share of that settlement is $750 million, according to Stein’s office, and 85% of that allocation is being distributed to local governments “to support treatment, recovery, harm reduction and prevention strategies to address the opioid epidemic.” The rest will go to the state government for the same purposes.

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“When I got into office, I asked myself, ‘How did we get into this terrible place with the opioid epidemic?’ And we did an investigation, and I concluded that the drug companies were the primary ones who created this crisis,” Stein said. “And so I wanted to hold them accountable.

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“We put together a national bipartisan coalition of nearly every attorney general in the country to take these drug companies to court, and frankly we are winning,” Stein added. “We’ve won $26 billion in the national opioid settlement against three distributors and one manufacturer, and we have another $8 million in settlements in settlements in principle with three other manufacturers.”

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Settlement payments will be made over an 18-year period ending in 2038. Local governments must choose an opioid mitigation strategy before spending their settlement funds.

Click the link below to see how much each North Carolina’s state and local governments will receive from the $26 billion settlement.


The North Carolina Department of Health and Human Services says more than 28,000 North Carolinians died of drug overdoses from 2000 to 2020. The agency says the opioid epidemic is “overwhelming medical providers and is straining prevention and treatment efforts.”

The rate of overdose deaths among North Carolina residents in 2021 was 35.8 per 100,000 residents, according to NCDHHS data. That includes deaths involving opioids, including those that are commonly prescribed, heroin and synthetic narcotics; stimulants like cocaine and methamphetamine; benzodiazepines and other drugs.

Of the 3,759 overdose deaths in North Carolina in 2021, 2,994 (78.3%) involved illicit opioids. That percentage has been quickly increasing since falling to 18.2% in 2011.

The state says opioid-related overdose deaths involving pain medications such as oxycodone and hydrocodone have typically been the leading causes of overdose deaths, but illicit substances such as heroin, fentanyl and fentanyl analogs are becoming more prevalent in overdose deaths.

“The opioid crisis has fallen somewhat from the news, but it rages worse than ever,” Stein said. “We’re actually at the deadliest moment in what is the deadliest drug epidemic in American history. And the consequences are devastating. There are 3,000 overdose deaths in North Carolina.

“Tens of thousands of North Carolinians are struggling with terrible addiction. And it doesn’t only affect them. It affects their parents, their siblings, their friends, their neighbors, their loved ones. There’s hardly any community in this state that is untouched.”


Stein emphasized transparency when talking about how local governments can spend their opioid settlement funds.

“There were a couple principles that were really important to us when we negotiated this deal,” Stein said. “One of them was that the money actually go to save lives, and not go to fill potholes, or give companies big tax breaks. We wanted to attack the problem. So the money has to go to prevention, treatment, recovery or harm reduction strategies.

“The other thing is we wanted that money to be spent effectively. So we have a portal at, where every government, whether it’s local government or the state, has to report on how they spent their money. Who did they give it to? How much did they give? And what were the impacts? What were the outcomes of that investment? Because it’s all about saving lives.”

Stein said more legal action is on the way.

“The opioid crisis wasn’t created by a single company,” Stein said. “Purdue Pharma and the Sackler Family probably were the most responsible, but other companies also played a role. Manufacturers; the distributors who take the pills from the manufacturers to the drugstores; some of the national drugstore chains. They all played a role, and they all profited from this epidemic because there were more pills being sold. So my objective, my imperative, is to make sure that every company that played a role in creating this crisis, fueling this crisis pays to be held accountable. They need to help clean it up.”