The Opioid Ledger · Live National Data
$14 billion is sitting in state bank accounts.
Drug companies pledged $54 billion to fight the opioid crisis. States have spent only 25 cents on the dollar. The Ledger tracks where every cent goes, and what it earns sitting still.
Interest accruing now
$63,724,481.00
+$1.42 / second · nationally
Promised over 18 years
$54,000,000,000
$54 B cumulative
Cumulative payments, 2022-2039 · modeled trajectory
Source: National Opioids Settlement aggregate, 2022-2039 payment schedule
Estimated sitting unspent
$14,000,000,000
$14 B cumulative
Unspent balance, modeled trajectory
Modeled from 24% blended deployment across nine verified states
Verified interest earned · 9 states
$63,724,481
$63.7 M cumulative
Cumulative monthly accrual, 2022-2025 · modeled between known endpoints
Verified from primary-source filings across NC, TX, OH, WV, TN, SC, CA, MT. National total estimated $300-600M.
9 States · 2022-2025
Verified, primary-source, replicable.
Every figure below is pulled from an audited financial filing, council report, or state ACFR. Click any card to open the underlying ledger.
Texas
TX
$17,383,304
FY 2024
State trust 1202
North Carolina
NC
$16,799,588
FY21-22 through FY24-25
114 local jurisdictions
Ohio
OH
$10,421,832
2 years
OneOhio Foundation 990
West Virginia
WV
$9,000,000+
2023
First Foundation audit
Tennessee
TN
$7,652,733
FY22-24
Opioid Abatement Council
South Carolina
SC
$1,294,614
2022-2023
SCORF audited financials
California
CA
$686,183
FY22-23
DHCS LDF report
Montana
MT
$244,142
2023
MOAT Form 990
Figure 02
What restricted interest looks like in dollars.
Interest earned by state, cumulative verified.
Figure 01
A national map of deployment.
Each state colored by the share of received settlement funds it has actually spent on abatement. Crimson states are deploying below the national average. Click any verified state to open its ledger.
8 states verified · 43 pending
Deployment rate
- <22%1 state
- 22-25%5 states
- 25-28%2 states
- >28%0 states
- No data43 pending
Fastest deployers
- West Virginia27.3%
- Ohio26.0%
- South Carolina24.5%
Slowest deployers
- Montana21.3%
- Texas23.0%
- North Carolina23.0%
Figure 03 · Counterfactual
What $14 billion would actually fund.
The unspent balance translated into units of opioid abatement, at industry-standard unit costs. Each figure is computed from the same data module that powers this site.
440,875
bed-years
Residential recovery beds
NASADAD 2023 cost survey
2,333,333
patient-years
Buprenorphine (MAT) treatment
SAMHSA TIP 63 cost guidance
350,000,000
kits
Naloxone kits distributed
CDC overdose prevention cost guidance, 2024
560,000,000
hours
Peer support specialist hours
CMS peer support service rate benchmarks
What the Ledger found
Three findings from the first national audit.
01
24 cents on the dollar.
24% deployed76% idle
Across nine verified states, settlement dollars are being deployed at an average rate of 23.6%. The other three-quarters sits in treasury accounts.
02
Texas earned $17.4 M in a single year.
$17.4 MTX
$10.4 MOH
$686 KCA
Interest on undeployed settlement funds is itself locked into opioid-only spending. Texas, Ohio, and California lead the unspent-balance interest table.
03
7 N.C. counties earned more in interest than they spent.
7 / 114 N.C. jurisdictions
An analysis of 114 North Carolina county filings shows interest revenue exceeded abatement spending in 7 jurisdictions in FY24-25.
From the analysis"The interest alone, idle in state treasuries, would fund every recovery housing bed in the country for two years."
$63.7 M
Verified interest
÷
$87
Per bed / night
÷
365
Nights / year
=
~2,000
Bed-years
≈ 2,000 BED-YEARS of recovery housing covered by sitting interest alone.
Wire · Latest filings