A new report from Utah State University’s Utah Women & Leadership Project should be a wake-up call for every policymaker and county official in the Beehive State. It shows not only that Utah lost 591 people to overdoses in 2024 but also that among women entering treatment last year, opioids outpaced all other drugs as the leading primary substance at intake. These realities underscore how entrenched this crisis remains in our state, even after years of public education and improved prescribing practices.
This moment carries added weight because Utah is slated to receive more than $520 million from opioid settlements over the coming years — resources that represent both an extraordinary opportunity and a solemn responsibility. These funds were secured to address one of the most devastating public health crises in modern American history. As such, they should not be taken lightly, and they certainly should not be reduced to a hidden line item in a general budget bill. Ensuring that this money is used wisely is not simply smart governance; it should be a matter of moral stewardship.
With my involvement in the Utah Attorney General’s office, I witnessed how state attorneys general from across the country worked together to enforce Big Tobacco’s Master Settlement Agreement, which required some 45 companies to make annual payments to offset the damages caused to individuals and taxpayers by tobacco-related products. Those funds and other large settlements of this kind may be squandered when they are not specifically earmarked and used judiciously. Having served as a member of the Utah House of Representatives, I also understand the temptation and pull of using such funds to fill in budget gaps, pay down debt or fund unrelated political priorities. But Utah cannot afford to make those mistakes with opioid funds. Far too many lives are at stake.
To its credit, Utah’s opioid settlement directs half of the funds to the counties, acknowledging that local governments are closest to the ground and well positioned to understand community needs. But the current structure also leaves substantial wiggle room without true accountability. Counties vary widely in how they report spending, how much detail they disclose and how quickly they move funds into real programs. Some counties have acted quickly and responsibly. Others, according to recent reporting, have yet to spend any of the money at all. That does not necessarily imply mismanagement, but it does underscore the importance of clear expectations and transparent reporting with oversight.
There are bright spots worth highlighting. Weber County’s installation of Narcan vending machines will likely save lives. Such community resources, combined with education and substance abuse programs, will give individuals who might otherwise be lost a chance for treatment and eventual recovery. Other counties could benefit from similarly straightforward, life-saving investments — whether mobile outreach teams, expanded access to medication-assisted treatment, partnerships with community nonprofits or crisis response programs that help law enforcement divert people suffering from addiction into rehabilitative care rather than custody or worse.
Still, the risks of misuse, delay or drift are real. As outlined by national data and notwithstanding millions of dollars spent on education, fentanyl abuse continues to be “the single deadliest drug threat our nation has ever encountered.” This fact may become more pressing as synthetic opioids and new chemical variants continue to evolve. Utah must therefore ensure that every dollar meant to combat this crisis is effective, i.e., traceable, transparent and tied to a measurable positive impact.
Thoughtful statewide guardrails — a uniform reporting structure, transparency and defined categories for allowable expenditures that still leave ample room for local innovation would be a good start. It may also be prudent to consider a mechanism for reallocating funds that go unspent for long periods into other critical, drug-related priorities, ensuring that dollars do not sit idle while urgent needs grow.
Ultimately, the question before Utah today is one of stewardship. The opioid settlement is not a windfall, but compensation paid forward to prevent future trauma, loss and tragedy. With every single dollar representing a chance to prevent another family from suffering the same fate, we should require it be used with the serious attention to detail commensurate with the stewardship. At this time I encourage Utah leaders to take the lead and show others across our nation how a caring state can use such funds to eradicate a major problem and save precious lives.