South Dakota counties and cities that received the first $9.6 million of national opioid settlement money have spent less than half of it, according to Department of Social Services spending reports through the end of 2025.
While 41 South Dakotans died from opioid overdoses last year – up from 39 in 2024 – some officials from those 53 counties and 13 cities said they haven’t yet made plans on how to use the distributions, which began in late 2022.
In 2021, a combined nearly $50 billion in settlements from opioid manufacturers, distributors and pharmaceutical companies began distributing funds to all 50 states, as part of the national settlement agreement.
South Dakota was allocated just under $99 million to be distributed through 2038. Funding to each state was determined based on a formula including the number of overdose deaths, number of opioids shipped to the state and number of people with opioid use disorder in the state.
The vast majority of South Dakota’s settlement funds will come from the distributor settlement, which includes major drug distributors McKesson, Cardinal Health and Amerisource Bergen.
Of South Dakota’s funding, 70% is directed to the state through the Department of Social Services. The other 30%, or around $29 million, will be divided among local governments in the state: the 53 counties and 13 towns and cities that signed a memorandum of agreement to spend those dollars on specific approved uses.
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For smaller counties receiving lower settlement amounts, drawing knowledge and resources from statewide networks like Face It Together and the charity Emily’s Hope, which provides naloxone boxes and substance abuse support across the state, could make all the difference, Colwell said.
“What’s out there? What can be brought in? What’s an easy lift? What’s low hanging fruit?” she asked. “Just understanding the addiction programs that are out there. We’re getting better at being less siloed in South Dakota, but the silos are still there.”