Wisconsin is celebrating an overdose decline it didn’t pay for.
Wisconsin just recorded one of the steepest drops in overdose deaths in its history. Opioid overdose deaths fell 42.5% from 2023 to 2024, from 1,422 to 817, according to the state Department of Health Services. State officials greeted the news warmly. Attorney General Josh Kaul said the work being done with opioid settlement funds is having a real impact. DHS Secretary Kirsten Johnson said the funding has saved lives.
The decline is real and worth celebrating. But the explanation deserves more caution because most of the settlement money has not been spent. As of September 2025, the state had received about $90 million of its share and reported spending roughly $35 million. Local governments, which receive the larger share, had taken in more than $160 million by the end of 2025, and most of it was still sitting in the bank: Just eight of the 87 local governments had spent more than half of their funds, and 16 had spent nothing at all. Much of the money arrived only recently, and grants take time to become services. A pot of money that remains mostly in public accounts cannot fully explain a decline that had already happened.
The deeper problem with crediting Wisconsin’s spending is that the same decline is appearing almost everywhere. Nationally, overdose deaths fell nearly 14% in 2025, the third straight annual drop, with decreases in almost every state, according to the U.S. Centers for Disease Control. The year before, Wisconsin was among the states with the largest declines. Deaths are falling even in places that have barely touched their settlement dollars. Menominee County, which has long recorded the state’s highest overdose death rate, received about 0.08% of local settlement funds. Yet overdose deaths in the Menominee Indian Tribe of Wisconsin community within the county fell from nine in 2023 to one in 2024.
None of this means the money is useless or that naloxone and treatment do not help. They plainly do, and some settlement dollars have paid for them. But naloxone, the overdose reversal drug most often credited, became available over the counter in 2023 and reaches people through pharmacies and many state and federal programs, not chiefly these local accounts. The timing and the geography do not fit a story in which Wisconsin’s settlement spending drove the drop. The dollars are mostly unspent, and the same downward trend appears across the country, including where little was spent. A single state’s fund cannot claim a nationwide decline as its own.
This is good news. And precisely because it is good news, it should not become a reason to relax oversight. Right now, the state’s reporting tells us how much money has gone out the door, not what it bought or whether it reached the communities hit hardest. Wisconsin can do better. It can build a single, searchable statewide dashboard of settlement spending, similar to what Minnesota and Indiana already offer. That work is being done instead by a nonprofit newsroom: Wisconsin Watch built a searchable database of local spending reports because the state left them as PDFs on a legislative committee’s website. It can require recipients to report what the money actually funded and whom it served, not just dollar totals, instead of relying on local governments to voluntarily disclose that information in inconsistent ways. And it can measure progress by a simple test: Do these dollars reach high-burden places like Menominee and turn into services people can use?
The accountability gap runs in both directions. The executive branch should not claim a victory it cannot yet prove. The Legislature’s finance committee should not let local spending reports sit in formats few residents can search.
Wisconsin has cashed out a public health windfall before. In 2002 the state sold the rights to decades of its tobacco settlement payments for about $1.3 billion up front, then spent the entire amount within a single budget cycle. About $681 million went straight into the general fund, and most of the rest covered routine payments to counties and cities. Little was set aside for the tobacco prevention programs the settlement was meant to support. By the state’s own later accounting, the deal returned only about 60 cents for every dollar of tobacco money it gave up. The temptation has returned. In Arizona, the Legislature moved $115 million in opioid settlement money to the state prison system, and the state attorney general went to court to stop it and lost.
The lesson is not that settlement money fails. It is that good headlines are exactly when the public tends to stop watching. A real decline in overdose deaths should be the moment Wisconsin holds this money to a higher standard, not a reason to look away.
Jiyue Wang lives in New Brunswick, New Jersey. He completed this research as part of his master’s degree in economics at the University of Wisconsin-Milwaukee. He will begin a Ph.D. in political science at Rutgers University in September 2026.
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