Wisconsin is set to receive more than $780 million in opioid settlement funding through 2038 to address the public health crisis created by pharmaceutical companies’ deceptive promotion of opioids. As communities implement these funds, policymakers are drawing lessons from the 1998 Tobacco Master Settlement Agreement—particularly cautionary ones about how settlement dollars can be redirected away from their intended purpose.
Tobacco settlement spending fell short
The MSA required four major tobacco companies to settle dozens of lawsuits, with more than 45 tobacco companies eventually joining. States were encouraged to use annual payments to fund tobacco cessation programs and prevention efforts. However, an estimated 3.4% of tobacco settlement dollars and tobacco taxes across the country were allocated toward tobacco prevention and cessation in fiscal year 2026, according to the Campaign for Tobacco-Free Kids. Maine is the only state that reaches CDC-established benchmarks for recommended spending.
Wisconsin directed to spend $57.5 million annually but spent only $7.4 million in fiscal year 2026—12.9% of the CDC recommendation and 8% of the state’s tobacco settlement payment of $91.6 million in 2025. Notoriously, some states used tobacco settlement dollars to fill potholes and subsidize tobacco farmers, according to NPR reporting featuring former Mississippi attorney general Mike Moore.
The MSA lacked binding restrictions, allowing states to allocate money to general funding needs rather than abatement, according to Stacey McKenna of the R Street Institute.
Opioid settlements include stronger guardrails
The two largest opioid settlement agreements require at least 85% of distributions to support opioid abatement—a structural difference from tobacco settlements. Opioid settlements are set to pay out closer to $50 billion total, compared to over $200 billion already paid by tobacco companies.
Six northwest Wisconsin counties—Ashland, Barron, Bayfield, Price, Sawyer and Washburn—will receive combined millions over the next decade. Statewide opioid overdose deaths fell sharply in 2024, with data from 2025 suggesting the trend continued, according to CDC data. Wisconsin reported a 44% decrease in overdose deaths in 2024, among the largest reductions nationally, according to KFF Health News.
Kristen Pendergrass of Shatterproof noted that fewer restrictions on opioid settlement dollars allow communities to create hyperlocal solutions. Dr. Elizabeth Salisbury-Afshar, medical director of harm reduction services for Wisconsin’s DHS Division of Public Health, emphasized that settlement funds can fill gaps federal and state dollars cannot address, giving communities flexibility to try new approaches.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.apg-wi.com/rice_lake_chronotype/news/tobacco-settlement-past-looms-large-in-opioid-settlement-future/article_044d6408-54bb-4b84-a201-efb2c843bca7.html