Maryland’s Office of Overdose Response has released a new Opioid Restitution Fund Primer to help explain how opioid settlement funds are used statewide.
The Maryland Office of Overdose Response’s (MOOR) Opioid Restitution Fund (ORF) Primer helps counties, partners, and the public better understand how settlement dollars from opioid litigation are being managed and distributed across the state.
The Primer offers a comprehensive, plain-language overview of the state’s opioid restitution structure, tracing the origins of settlements with manufacturers and distributors to the creation of Maryland’s Opioid Restitution Fund (ORF) in 2019. It explains how funds flow from national and state-level agreements, outlines allowable uses, and details the roles of state and local governments in administering the funds.
As previously covered by MACo, counties receive opioid settlement funds through several channels, each with distinct allocations and oversight structures:
- Opioid Restitution Fund (ORF): 15% for state use.
- Targeted Abatement Subfund (TAS):
- 15% for state use (competitive grants).
- 45% for local governments (non-competitive grants).
- Local Allocation: 25% for local use.
From the Primer:
Based on current projections, a total of $670,823,954.48 will be received by Maryland and its subdivisions over the next 18 years. Of this, $160,093,417 will be distributed directly to local subdivisions, $284,763,252.13 will be distributed to local subdivisions through TAG distributions, $122,014,862.59 will be designated for the State Allocation, and $100,490,400.97 will be designated for State Discretionary Abatement Fund grants.
As of August 2025, Maryland has received payments from eight settlements, with more expected through 2038. Under Maryland’s 2022 and 2023 State-Subdivision Agreement, 70 percent of the funds in this agreement are distributed to local subdivisions for prevention, treatment, recovery, and other opioid abatement activities, while 30 percent supports state-level initiatives and competitive grant programs.
The Primer highlights new tools for transparency, including an upcoming public dashboard that will display state and local expenditures, as required by legislation passed this year. Read MACo’s testimony on SB 589. These efforts build on MOOR’s commitment that every settlement dollar contributes meaningfully to opioid remediation and recovery in communities hardest hit by the epidemic.
To walk through the new document and answer questions, MOOR will host a public webinar on Thursday, November 20, at 1:00 pm. Submit questions in advance by November 14 using this form.
Stay tuned to Conduit Street for more information.
