Overview
Opioid overdoses have been one of the most deadly public health epidemics in our nation's history, leading to more than 80,000 deaths annually in the United States. In the last two decades, Baltimore has been disproportionately impacted, with more than half a billion opioid pills permeating the Baltimore area between 2006 and 2019, driving an increase in overdose deaths. Public health experts have estimated that more than 80% of Baltimore’s opioid use disorder cases between 2010 and 2021 began with prescription opioids, leading residents to turn to illicit drugs.
Baltimore City makes up 9% of Maryland’s population but, now through the first seven months of 2024, represents 44% of Maryland’s overdose deaths. Annually, Baltimore has an average of more than 2 overdose deaths per day.
In response, in 2018, Baltimore City initiated legal action against various pharmaceutical manufacturers and distributors for their role in creating the opioid epidemic in Baltimore City by failing to take reasonable steps to prevent the diversion of their highly addictive prescription opioids. The City then opted out of the global settlement that would have provided the City with much less restitution money than it deserved, and decided instead to pursue its litigation against some of the largest pharmaceutical companies in the world.
That decision has paid off. As of September 10, 2024, the City has reached settlement agreements with Allergan, Cardinal Health, CVS, Walgreens, and Teva, totaling $402.5 million and already eclipsing the amount the City would have received under the global settlement.
The City anticipates additional recoveries through settlement or trial in pending cases against the manufacturers and distributors that caused and perpetuated the opioid epidemic. This page will be updated regularly to reflect additional victories.
The recoveries from these cases will be used to create the Baltimore City Opioid Restitution Fund.
Below are the values for each settlement agreement the city has reached, as well as the pending cases:
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Executive Order Issued By Mayor Scott
On August 29, 2024, Mayor Scott released an Executive Order establishing the City’s approach to managing the restitution funds received, including provisions that:
| 1 - Establish a separate Baltimore City Opioid Restitution Fund |
| 2 - Establish a trust fund that will sustain the impact of these funds for at least 15 years |
| 3 - Create positions in the Mayor’s Office including an Executive Director of Overdose Response and an Opioid Restitution Program Manager |
| 4 - Establish a Restitution Advisory Board |
| 5 - Outline key documents that the City will publish for accountability and transparency |
For more details about the Executive Order, you can read the full executive order, or check the overview of the executive order. If you have comments or questions on the Executive Order, please email overdoseresponse@baltimorecity.gov.
Community Engagement
In the Executive Order, the Mayor detailed the process and procedures of the Opioid Restitution Fund governance and financial structure. As part of that effort, the City of Baltimore plans to engage in robust community engagement meetings across the city to hear from individuals and groups impacted by the overdose crisis.
The City’s proposed community engagement process will include:
- Community Listening Sessions
- Focus Groups
- Online Public Feedback Form
More details on the community engagement plan and schedule of events will come soon.
Steps for Administering Opioid Restitution Funds
The process involves these steps:
- Establish Governance and Finance Structure for Restitution Funds
- Mayor Scott Announces Executive Order: Administration of Funds from Restitution Funds
- Hire Executive Director of Overdose Response and Opioid Restitution Program Manager
- Establish a Restitution Advisory Board
- Conduct Community Engagement and Needs Assessment
- Publish a City-wide Overdose Response Plan
- Set Annual Funding Priorities
- Release Notice of Funding Availability
- Select Programs to Fund
- Distribute Funds for FY26
We are now in the steps of hiring the Executive Director of Overdose Response and Opioid Restitution Program Manager, setting up the Restitution Advisory Board, and gathering input from the community.
Substance Use and Overdose Resources
Resources
Baltimore City Health Department's Substance Use services and resources
Substance abuse services and resourcesCommunity Resources and Programs
Community Resources
Find and connect with community resources in Baltimore City through Charm Care. Get help with food, health, education, jobs, and more!
Visit Charm CareMaryland Syringe Services Programs
Learn more about the resources and information of the Maryland Syringe Services Programs
See Maryland Syringe Services ProgramsNaloxone and Training
Request Training
Request The Baltimore City Health Department's Naloxone Training
Training Request FormNaloxone and Test Strips
Get free Naloxone, Fentanyl Test Strips, and Xylazine Test Strips
Get Naloxone and Test StripsCounseling Resources
Immediate Support and Counseling
Need immediate emotional support? Call 988 to connect to a counselor who can help
Visit 988 HelplineFunding Opportunities
Stay Updated on Fund Opportunities
If your organization is interested in funding from the Opioid Restitution Fund, sign up for City updates and check this website in the spring for details. We expect to open funding applications in spring 2025.
Sign Up for Updates
| To learn more about the Baltimore City Opioid Restitution Funds, read the Mayor's Executive Order. |
Additional Funding Opportunities |
Get Involved
The Restitution Advisory Board Application closed on September 30th. Submitted applications are being scored, and finalists will be contacted in November for a formal interview. Check back for more updates on how to get involved.