Minnesota cities and counties have spent just a fraction of the more than $50 million they received from initial rounds of opioid settlements, new data shows, and many have not yet used any of the money to combat the crisis.

Local leaders say the slow start was expected as they strategize and distribute dollars they hope will help permanently curb the opioid epidemic that has lasted two decades.

Last year was the first full year for communities to start using the cash. While more than 40% did not use any settlement dollars, data published this month show a wide variety of uses among those that spend part of it. Some distributed the overdose-reversing drug naloxone to community members or first responders. Several embedded a social worker or mental health professional with their police departments. Many paid for meetings to discuss how to use the money.

"We need to take the time to understand what works rather than just pushing money out the door quickly into things that are quick and easy to do but might not have the longest-term impact," said Association of Minnesota Counties Executive Director Julie Ring. "We want to bend the curve, and that's going to take planning."

Minnesota expects to see $535 million land in state and local coffers in waves over 18 years after the Minnesota Attorney General's Office joined multistate settlements with opioid manufacturers, pharmaceutical distributors and retail pharmacy chains. Three-quarters of the money will go to local governments with the state government responsible for the remaining quarter.

Every county in the state and 33 cities, primarily those with populations larger than 30,000, started receiving portions of the money in fall 2022.

How much they get varies, with data from the Attorney General's Office showing many cities and smaller counties got less than $100,000 from the various rounds of payment that went out the past two years, while Hennepin County netted about $10 million.

Communities must report how they spend the money every year. Very few cities or counties spent any of it in 2022, when they had a tight time frame. Last year, 61 places — including a couple of multi-county organizations — used some of the money.

Tracking the spending

Minnesota created a dashboard where people can track settlement dollars, as well as other federal and state funding to address the crisis. Compared to other states, Minnesota has a transparent system to follow the money. However, details of how the dollars are being spent aren't always clear.

The single largest expenditure was nearly $585,000 by Hennepin County. Data available through the state's spending dashboard says only that the money went to "administrative expenses."

Clay County had the second largest expenditure — about $409,000 to construct a detox facility that will double available beds. St. Louis County followed with its $263,000 purchase and renovation of a triplex to house people after incarceration.

Hennepin County reported spending about a quarter of the settlement money it got in 2022 and 2023. Julie Bauch, the county's opioid response coordinator, said she has been working with community partners and county departments for six years. They knew how to prioritize the money and could get it out faster than many other places, she said, noting the county quickly distributed a chunk of money to community organizations focused on American Indian, African American and East African populations and people who are homeless.

Local government officials said they are trying to balance a desire to make the best use of the money with the desperate need to curb what Bauch called the "biggest public health crisis we're going to see in our lifetimes."

"In Hennepin County, there are one or more people dying of an opioid-related overdose every day," she said. When it comes to available dollars, "We have to act fast. It's not an option."

Across Minnesota, more than 100 people died monthly from drug overdoses last year, according to preliminary figures from the state Department of Health.

Communities want to prevent those deaths, but the settlement money also allows them to play "the long game" of preventing people from becoming addicted, including spending some of it to support young people, said Wright County Public Health Director Sarah Grosshuesch.

"If all we do is save lives for 18 years and then the money is gone, you know, we're not going to be in any better place," Grosshuesch said. "We're just now going to be without the funds to buy Narcan and fund treatment systems. We also need to do that prevention work at the same time."

Prevention over time

Setting up prevention efforts can take a while, leaders said. Ring, with the Association of Minnesota Counties, also noted that some communities have gone through the process of granting settlement dollars, but that doesn't show up in the data because organizations receiving the money haven't necessarily spent it.

"It isn't that surprising that we don't see the money going out as soon as it comes in," said Patricia Beety, the League of Minnesota Cities general counsel who has been working with cities on opioid dollars.

Cities had to learn how to use the money and understand reporting requirements, she said, and many communities that are getting relatively small sums have been figuring out how to partner with counties and pool resources in hopes of making a bigger impact.

"We're just at a space where those decisions will be made. And I think I would be surprised next year if we see that type of percentage" of more than 40% of municipalities not spending funds, she said. "I think you will see actual usage in this coming year."