Governments across North Carolina are set to receive about $145 million from OxyContin manufacturer Purdue Pharma and its former owners as part of a nationwide settlement that was signed Monday.
“We’re now up to $1.6 billion that will be coming to North Carolina. The vast majority of it will be hitting in the next three years, and the vast majority of that is designed by the terms of the agreement to go downstream into local communities to help fight addiction and break the cycle of addiction,” N.C. Attorney General Jeff Jackson, a Democrat, told the N.C. Newsroom.
Jackson was referring to opioid settlements the N.C. Department of Justice secured under now-Governor Josh Stein. Those settlements spanned a wide range of pharmaceutical and related companies, addressing not only opioid manufacturers but also how the pain pills were marketed and sold.
Purdue is perhaps the most well-known of all those companies. Beginning in the mid-90s, the company started manufacturing OxyContin and branding it as a less-addictive alternative to other pain medications. That was false, with pain pills triggering the first wave of an opioid epidemic that would soon include heroin and then fentanyl.
Jackson called the settlements a “classic case of the effect of accountability,” noting that not only have the Sacklers and Purdue Pharma been held to account, but also middlemen who helped the drugs reach consumers like some of the nation’s largest pharmacies.
“It has sent a really strong message about the fact that you will be held accountable if you participate in this widespread social harm,” Jackson said.
Between 2000 and 2023, more than 41,500 people died from an overdose in North Carolina, according to N.C. Department of Health and Human Services data. That is similar to the populations of Fuquay-Varina, Holly Springs or Rocky Mount.
In April 2025, there were a suspected 266 overdose deaths in the state, according to preliminary data.
The state’s rate of overdose deaths climbed in the mid-2010s, declining slightly in the latter half of the decade before shooting back up after 2020. In 2019, the overdose death rate was 22.4 per 100,000 people, climbing to 31.6 per 100,000 by 2020 and then 41 overdose deaths per 100,000 people in 2023.
DHHS estimates that more than 3,000 people died from an overdose in 2024, a rate of 29.7 per 100,000 North Carolinians.
Per the bankruptcy agreement, the Sackler family will not be able to control Purdue and will be banned from selling opioids in the United States.
“They are never allowed to do any of this ever again. They are now permanently and forever restricted from the manner in which they can participate in the manufacturing of pharmaceuticals,” Jackson said.
A federal bankruptcy court in New York still needs to sign off on the final arrangement, but Jackson expressed optimism that would be a formality.
“This is actually going to happen. It is pretty much set in stone at this point,” Jackson said.
Previous deal struck down
The U.S. Supreme Court last year struck down a previously agreed settlement between states, Purdue and the Sackler family. Under that arrangement, the Sacklers would have provided Purdue $4.3 billion to help pay the settlement and, in return, been shielded from ongoing and any potential new civil lawsuits.
The Supreme Court ruled that the Sacklers could not receive civil immunity as part of the Purdue bankruptcy case because the family was a third party. Those who have sued the family also are not party to the bankruptcy case, justices ruled in the 5-4 decision.
Civil claims against the Sackler family will be allowed to move forward under terms of the new settlement. Individuals will also have the option to join the agreement, with about $850 million set aside to settle their claims.
The new agreement increases the amount the Sackler family must pay to $6.5 billion, with Purdue Pharma contributing an additional $900 million.
When the court signs off on the settlement, the family will contribute $1.5 billion, and the company will pay $900 million. The rest of the family’s payments will be spread over the next 15 years.
About 85% of the funds North Carolina receives will be funneled to county and municipal governments, while the state will control the rest.
“Counties are on the front lines of the opioid overdose epidemic — and leading the way toward recovery. Local governments, especially counties, are best positioned to help communities prevent, treat, and recover from opioid use disorders,” Tare “T” Davis, a Warren County Commissioner who is president of the N.C. Association of County Commissioners, said in a press release.
There is an element of finality to the agreement, Jackson said, in part because the 16 attorney generals offices involved in the negotiations focused on addressing the problems identified in previous decisions.
“We’re highly confident this will stand up to judicial scrutiny,” Jackson said.
How NC has used opioid settlement funds
Monday’s agreement is the latest in a series related to the opioid epidemic.
North Carolina has secured:
- $10.8 million in an October 2020 settlement with pharmaceutical company Mallinckrodt
- More than $753 million as part of a $26 billion nationwide 2022 settlement with Johnson & Johnson, as well as drug distributors Amerisource Bergen, Cardinal and McKesson
- $10.2 million in an August 2022 settlement with opioid manufacturer Endo International
- $87.8 million as part of a 2022 settlement with retail giant Walmart due to the distribution of opioids at its pharmacies
- $521 million as part of a 2023 settlement with CVS, Walgreens and drug manufacturers Allergan and Teva — the pharmacies also agreed to monitor for and report suspicious opioid use as part of the settlement
- $40.3 million as part of a 2024 settlement with grocery chain Kroger due to its pharmacies’ role in pill distribution
Settlement funds are being used to battle the opioid epidemic in an array of efforts across North Carolina. Those include treatment programs in local jails, distribution of overdose reversal drug naloxone and housing for people in treatment.
For example, Cumberland County is using about $66,000 in settlement funds to support its Law Enforcement Assisted Diversion program, following up with people who have overdosed to provide overdose reversal drugs and offer further care.
In New Hanover County, part of the funds provide $1.4 million to a nonprofit to help pregnant women who have opioid use disorder with preventative treatment and parenting support services.
Narcan nasal spray. Narcan, or naloxone, reverses the effects of an opioid overdose.
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Jason deBruyn
Annie Vasquez, a former opioid user who now works as a substance use service coordinator for Forsyth County, praised the agreement. Vasquez is in charge of overseeing the county’s opioid settlement funds.
“Whether it’s funds to expand the addiction workforce, treat opioid use disorder, fund peer support specialists or support our harm reduction organization, we are able to help residents tackle their own individual challenges head on,” Vasquez said in a press release.
Forsyth County has allocated $500,000 in settlement funds to purchase medication to help treat opioid addiction and $60,000 to a local treatment facility to help take people without transportation to treatment, among other efforts.
Soon, local governments will be asked to join the Purdue agreement. It is important, Jackson said, that they sign on.
“In order to make sure that North Carolina gets its full share of the settlement, we have to make sure that we have widespread participation by counties and towns and cities,” Jackson said.
Jackson expressed optimism that North Carolina would have 100% participation, helping the state receive the full $145 million.
