ORF Resources
General Resources
Opioid Restitution Fund Primer - PDF - 608.5 KB
This document provides a high-level overview of prescription opioid settlement funds in Maryland, including finalized settlements, how funding is distributed, and a summary of funds received to date.
State-Subdivision Agreement (January 2022 – Janssen) - PDF
This document is an agreement between the State of Maryland and all local governments that joined the state’s prescription opioid lawsuits. It describes how funds will be shared between state and local partners. In Maryland, 70% of funds are distributed at the local level.
State-Subdivision Agreement (April 2023 – Teva, Allergan, & Walmart) - PDF - 55.45 KB
The State-Subdivision Agreement was updated in 2023 to include additional settlements that have been finalized since the original agreement.
Statutory Mandate (updated in 2024 with Senate Bill 751)
State Finance and Procurement Article §7–331 was first established in 2019 and was last updated in 2024. It establishes the Opioid Restitution Fund and outlines the allowable uses for settlement funds received by the state.
Janssen Settlement – Exhibit E (allowable uses) - PDF - 1.42 MB
This document identifies allowable uses for funds under National Settlement Agreements.
Fiscal Year 2025 State Discretionary Abatement Fund Awards Summary - PDF - 190.74 KB
In Fiscal Year 2025, Maryland awarded 28 grants, collectively totaling $12.4 million. These awards were made using the 15 percent of the proceeds that are designated for use through competitive funding opportunities for opioid remediation purposes (State Discretionary Abatement Fund).
Opioid Restitution Fund (ORF) Advisory Council
Maryland’s ORF Advisory Council was established in 2022 to provide recommendations regarding the use of prescription opioid-related legal settlement funds. As specified by state statute (Maryland Health General Article §7.5–903), the council consists of 12 members who serve for two years.
Resources for Local Partners
ORF Policy Bulletin Naloxone & Drug Test Strips Purchasing - PDF - 388.5 KB
This bulletin describes the state’s policy toward using Opioid Restitution Funds (ORF) to purchase naloxone or drug testing strips, which is considered an unallowable expenditure under state statute. All local subdivisions receiving ORF dollars should instead become certified as Overdose Response Programs to access these materials instead of using settlement funds to purchase them.
2026 MOOR Recommendations for Local Spending - PDF - 526.65 KB
Pursuant to Maryland’s State-Subdivision Agreement, Maryland’s Special Secretary of Overdose Response is required to provide non-binding recommendations to local governments for using settlement funds annually.
Settlement Funds by Subdivision Spreadsheet - XLSX - 158.35 KB
(Use this link to download the file. Once downloaded, click “enable editing.”)
This spreadsheet provides the total projected award amounts for all participating local subdivisions in Maryland. Use this link to download the file. Once downloaded, click “enable editing.”
Bulletin: Municipality TAG Reversion to County - PDF - 360.01 KB
Pursuant to Maryland’s State-Subdivision Agreement, funds that are not utilized by local subdivisions may revert to the county in which they reside. This memo was issued in 2025 to advise local subdivisions of this requirement.
Opioid Restitution Fund Policy Bulletin: Allowable Spending - PDF - 388.15 KB
This document provides an overview of spending parameters for settlement funds as specified in National Settlement Agreements and state statute.
Opioid Restitution Fund Policy Bulletin: Expenditure Reporting Requirements - PDF - 379.93 KB
This document details annual reporting requirements related to settlement fund use by all recipients.
National Guidance for Utilizing Prescription Opioid Settlement Funds
This page provides a wide variety of resources to assist local governments in their efforts to utilize the funds they receive through national prescription opioid legal settlements. These resources include guiding principles for using funds, evidence-based practices across the continuum of care, evaluation and decision-making tools, and more.
Note: Please consult your local legal counsel when making spending decisions. Refer also to Exhibit E - PDF to help identify allowable uses under Maryland law.
Making Opioid Settlement Dollars Count: Evidence-Informed Priorities for Maryland - PDF - 622.68 KB
Led by the American Institutes for Research® (AIR®) and in collaboration with the National Academy for State Health Policy (NASHP) and the O’Neill Institute’s Center on Addiction and Public Policy at Georgetown University Law Center, the Measurements for Accountability to All People in Policy Solutions (MAAPPS) initiative provides practical, evidence-informed recommendations for opioid settlement investments in Maryland by combining empirical evidence with direct input from community members with relevant lived/living experience and subject matter expertise.
Partnership to End Addiction: Guidance for Investing the Opioid Settlement Funds in Primary Prevention - PDF
This guide by the Partnership to End Addiction identifies and recommends several primary prevention strategies that can be supported with settlement funds.
Legal Action Center: Evidence-Based Strategies for Abatement of Harms from the Opioid Epidemic
This resource center from the Legal Action Center provides various evidence-based interventions across the continuum of care as well as fact sheets summarizing findings from each chapter of the main guide.
Johns Hopkins Bloomberg School of Public Health: The Principles for the Use of Funds from the Opioid Settlements
This guide from the Johns Hopkins Bloomberg School of Public Health provides five guiding principles for local jurisdictions to utilize settlement funds: spend the money to save lives; use evidence to guide spending; invest in youth prevention; focus on racial equity; and develop a fair and transparent process for deciding where to spend the funding.
Johns Hopkins Bloomberg School of Public Health: Tools to Implement Principles
This page provides a variety of tools and resources to assist jurisdictions in promoting readiness in implementing the Johns Hopkins Bloomberg School of Public Health’s five principles for utilizing settlement funds.
Brandeis Opioid Resource Connector
Brandeis Opioid Policy Research Collaborative’s Opioid Resource Connector provides a curated collection of community-focused programs, tools, and resources to help stakeholders choose, design, and implement interventions for reducing overdoses.
SAMHSA Evidence-Based Practices Resource Center
This library from the Substance Abuse and Mental Health Services Administration provides extensive peer-reviewed and evidence-based resources for reducing overdoses across the continuum of care.
ASPPH: Report and Recommendations from the ASPPH Task Force on Public Health Initiatives to Address the Opioid Crisis - PDF
This resource from the Association of Schools and Programs of Public Health presents findings and recommendations for reducing overdoses utilizing public health approaches and legislative reforms.
NACO Opioid Solutions Center
This resource center from the National Association of Counties provides several strategy briefs for utilizing settlement funds across the continuum of care.
RAND: Strategies for Effectively Allocating Opioid Settlement Funds
This resource from RAND provides guiding principles for utilizing settlement funds and recommendations for addressing the root causes of overdose deaths. It also identifies lessons learned and recommendations to avoid pitfalls when utilizing funds.
Big Cities Health Coalition: Supporting local decision makers managing opioid settlement funds: A public health approach
This guide from the Big Cities Health Coalition provides decision-making resources for local administrators of settlement funds, including guiding principles and evaluation tools.