Ohio recorded 5,144 opioid related deaths in 2023, a mortality rate of 41.6 per 100,000 people. The state has ranked in the top 10 in the country for opioid related deaths over the last 10 years. In light of this fact, Ohio District Attorneys united with others across the country to sue pharmaceutical companies for their role in producing and distributing opioid painkillers. 

The result: Ohio’s state government and municipalities are set to receive about $2 billion in opioid lawsuit settlement funds from pharmaceutical companies such as Cardinal Health, McKesson, AmerisourceBergen, Teva, Allergan, CVS, Walgreens, Johnson & Johnson, Janssen Pharmaceuticals and McKinsey & Co.  

Smaller cities and rural counties, however, will receive only a fraction of what major metropolitan areas receive—like Cuyahoga County’s $137 million, according to signalceleveland.org—forcing them to carefully consider how to stretch limited resources. 

Noble County, with a population just shy of 15,000, has received just over $100,000 in settlement funds from the lawsuits. While the amount falls far short of what larger cities can use to build facilities or hire specialized staff, it is a rare opportunity to address lasting harm. 

Noble County Commissioner Allen Fraley is one of the people tasked with distributing the funds. He aims for a “positive and supportive” approach. 

“When Judge [Arnold] approached me with the ability to acquire funds to address and assist with current and future problems, the Commissioners were all in,” Fraley says. “We stressed that others—Sheriff, Probation, School SRO, Judges and Counselors—take the lead on best use of these funds.” 

A breakdown of expenditures notes the impact of the funds, including ankle monitors, anti-drug promotional materials, a mental health room for Caldwell Schools, and other items for the Sheriff’s Department like car wraps and a mobile anti-drug educational trailer. 

“That is why you will see the largest cumulative expenditures in ankle monitors (to keep people out of jail), school programs and the EMS,” Judge Arnold says, taking the lead in day to day distribution of funds in Region 12, covering larger Noble County. 

With $57,600 remaining at the time of writing, Fraley finds these purchases instrumental in drug education and the eradication of perpetual drug use and dependency. 

According to the Commissioner’s accounts, the above disbursements are all in compliance with the OneOhio Recovery Foundation’s initiative. OneOhio is a private non-profit created at the direction of Ohio’s leadership to “distribute 55 percent of the funds our state will receive from the pharmaceutical industry as a consequence of its role in the national opioid epidemic,” according to their website. 

“By taking a collaborative approach, OneOhio is working not only to respond to the current opioid crisis but also to help prevent future substance use epidemics and build healthier, more resilient communities across Ohio,” Alisha Nelson, Executive Director of OneOhio says.  

Leveraging the state’s settlement money has been no easy feat. According to censusreporter.org, 10.6% of Noble County residents live below the poverty line, making access to resources even harder.  

“As a Commissioner, I am concerned with the health and wellbeing of my county’s residents, all of them. Voters and non-voters, elderly and youth, employed or unemployed … each one deserves the best options available to succeed in their chosen area of life,” Fraley says. 

To address accessibility concerns, the team managing Noble County’s settlement expenditures have considered how to make widespread preventative and remedial measures to those not within Caldwell schools or under probation, for example. 

“We even created a group, Noble County CARES, as a multi-agency task force to address all addictions in any form,” Fraley says.  

CARES stands for Community, Access, Resources, Education, Services—providing resources such as a crisis prevention line and links to behavioral health services to expand accessibility separate from settlement funds.  

Other counties also take a collaborative approach . In Knox County, leaders formed focus groups that include schools, law enforcement and healthcare providers to guide spending decisions and ensure that settlement dollars address real gaps in services. 

Sustainability is a key concern, as settlement funds are temporary. Local leaders stress that the money cannot support programs that would later require general fund dollars to maintain. 

Low-cost measures such as fentanyl testing strips, naloxone or care packages for people in recovery can reduce harm and support stability. 

“Drug addiction has never offered anyone a positive step in reaching their goals,” Fraley says. Ohio’s leaders are collaboratively doing what they can to give that boost.  

“Looking ahead, OneOhio will continue its work to expand prevention, treatment, and recovery support initiatives across the state. By taking a collaborative approach, OneOhio is working to help prevent future substance use epidemics and build healthier, more resilient communities across Ohio,” Nelson says.