New York City’s Health Department published a fresh accounting of how it spends money won from the opioid industry in late March 2026, showing tens of millions of dollars flowing each year to syringe service programs, naloxone and overdose prevention as the city’s settlement payouts climb.

The Opioid Settlement Funds Report, dated March 25, 2026, came from the Department of Health and Mental Hygiene and laid out both past spending and planned dispensing. The city plans to dispense roughly $41 million of opioid settlement funds in fiscal year 2025, $48 million in FY 2026 and $50 million in FY 2027 — an upward trajectory as more settlement money arrives.

Where the money has gone

The report’s line items point to a harm-reduction-heavy strategy. DOHMH spent about $8.44 million on syringe service programs — run by OnPoint NYC — in each of FY 2023 and FY 2024, and allocated $2.2 million for naloxone, the overdose-reversal medication, in FY 2024. The city said it would continue expanding wraparound services at syringe service programs, which distribute sterile syringes and naloxone and connect drug users to treatment and other services, with an added $4.1 million in FY 2026.

Those syringe programs include the overdose prevention centers OnPoint operates — the first publicly recognized supervised consumption sites in the United States. Between July 2024 and April 2025, syringe service programs operating overdose prevention centers provided more than 38,000 harm-reduction services to roughly 6,600 participants, the city reported, reducing overdose and infection risk and steering people toward treatment.

The settlements behind the spending

The money traces to a wave of legal settlements with opioid manufacturers, distributors and pharmacies. Statewide, Attorney General Letitia James has secured billions: a $7.4 billion settlement with Purdue Pharma and the Sackler family announced in January 2025, with up to $250 million directed to opioid treatment, prevention and recovery in New York; up to $523 million from Teva over 18 years; and up to $458.2 million combined from CVS and Walgreens. The city itself has separately moved to recover roughly $48 million from an opioid manufacturer in ongoing litigation.

Across the state, counties have taken in more than $330 million from opioid settlements over four years. Much of what counties receive is unrestricted, allowing broader spending than the abatement-focused city allocations — a flexibility that watchdogs have flagged as a transparency concern.

Transparency rules tighten

That concern is partly why the report exists in the form it does. Under the FY 2025–2026 state budget, all local subdivisions receiving opioid settlement funds must annually publish how those funds are used — a disclosure mandate intended to keep the money tied to addiction services rather than absorbed into general budgets. DOHMH’s March 2026 report is the city’s compliance with that expectation.

Against a backdrop of falling deaths

The spending plan lands at a notable moment for the overdose crisis. The city has reported its first substantial decline in overdose deaths in nearly a decade — 2,192 deaths in 2024, down about 28% from 2023 — a drop officials have partly credited to wider naloxone distribution, expanded access to medications for opioid use disorder, and the harm-reduction network the settlement dollars help fund.

The challenge for the Mamdani administration, which inherited the funds and the strategy on Jan. 1, 2026, is to sustain that progress. With $48 million slated for FY 2026 and $50 million for FY 2027, the city has committed money; the open question is whether the harm-reduction approach it bankrolls keeps overdose deaths on their downward path.

Verification

Frequently Asked Questions

How much opioid settlement money is NYC spending?
The city plans to dispense roughly $41 million in fiscal year 2025, $48 million in FY 2026 and $50 million in FY 2027 from opioid settlement funds, per the Health Department.
What does the money pay for?
Programs including syringe service programs, naloxone distribution, and wraparound services at overdose prevention sites. DOHMH spent about $8.4 million on syringe service programs in each of FY 2023 and FY 2024 and $2.2 million for naloxone in FY 2024, with an added $4.1 million for syringe-program services in FY 2026.
Where does the settlement money come from?
From legal settlements with opioid manufacturers, distributors and pharmacies. Statewide deals secured by Attorney General Letitia James include a $7.4 billion Purdue Pharma/Sackler settlement announced in January 2025, plus settlements with Teva, CVS and Walgreens.
Is there a public accounting requirement?
Yes. Under the FY 2025–2026 state budget, all local subdivisions receiving opioid settlement funds must annually publish how those funds are used. DOHMH published its latest report March 25, 2026.