Louisiana Sent a Fifth of Its Opioid Settlement to Sheriffs. The Results Were Predictable.

In September 2023, we warned that opioid settlement dollars were arriving in a state that was not ready to steward them, and pointed to a bribery investigation in Lafayette as an early sign of how this public money can be captured. Three years of reporting has confirmed the concern and clarified its cause.

The settlements, more than $50 billion nationwide from the companies that manufactured and distributed prescription opioids, were won as a remedy for a crisis that killed more than 800,000 people in the United States between 1999 and 2023. Many call the money ‘blood money’ and expect it to be spent abating the crisis. Louisiana instead directed 20% of its share to elected sheriffs, the largest law enforcement carve-out of any state, and imposed no requirement to report how they spend it. That decision placed public health money inside a justice system built to keep people who use drugs in jail rather than in treatment. The money flowed like water down the path of least resistance and, too often, of least benefit to the people who need it.

Because sheriffs in Louisiana are elected and hold independent budgets, reporters from KFF Health News, The Current, Gulf States Newsroom, and Verite News had to build the first detailed accounting themselves, contacting all 64 sheriffs over five months and filing public records requests. What they found: 38 offices reported spending roughly $8.1 million, much of it on surveillance cameras and drug-detection gear. A three-person review panel, made up of an addiction-medicine physician, a public health policy analyst, and a Jefferson Parish resident in recovery who lost his son to a fentanyl overdose, judged $5.4 million, about 66%, an inappropriate use of the funds. A separate analysis found that $4.7 million, nearly 60%, went to items that six states with published "unallowable" lists say should not be bought with opioid cash. Terrebonne Parish spent its entire $465,000 on Flock license-plate readers. Twelve parishes spent a combined $1.3 million on defibrillators, which do not reverse opioid overdoses.

The panel measured appropriateness, not legality. Most of this spending was legal under a memorandum of understanding whose approved-use language is broad enough to cover almost any law enforcement expenditure that could conceivably be considered related to the epidemic. The breadth of that language is the problem. Nine sheriffs spent well, directing roughly $1.8 million to in-jail treatment, overdose-response training, and public awareness, all of it approved by the panel. But 20 offices provided nothing at all, leaving about $10.7 million hidden from public view. The Jefferson Parish Sheriff's Office, allotted the most at nearly $4 million through 2025, did not respond to more than a dozen calls and emails.

A system built to keep beds full

None of this is an accident. It is what a carceral economy does when handed public health money without conditions. More than half of the people in Louisiana's state custody, about 53%, serve their time in local jails rather than state prisons, the highest rate in the country. The arrangement dates to the 1970s. After a federal court capped the population at the Angola state penitentiary in 1975, Louisiana found it cheaper to pay sheriffs to hold the overflow than to build new prisons, and sheriffs came to treat state prisoners as a revenue source, expanding their jails to hold more. Between 1999 and 2019 the state added roughly 14,000 jail beds.

The state pays a per-diem to keep those beds full, and in 2024 those payments totaled $177 million. Sheriffs will receive an estimated $124 million from the opioid settlement over 21 years. In a single year, Louisiana pays its sheriffs more to hold prisoners than they will collect from the settlement over two decades.

That arrangement shapes behavior. Smaller parishes built jails larger than their local need and now depend on state prisoners to fill them; when the population fell after 2017, some turned to federal immigration detainees to keep the revenue flowing. As Sarah Omojola of the Vera Institute put it, Louisiana law enforcement agencies are "uniquely invested in incarceration" because they "financially benefit from people who are being held in their jails." The people held there fare worse for it. They recidivate at higher rates than people released from state prisons, 43.3% against 35.3% among those released in 2017, and jails offer fewer of the treatment and education programs that lower the odds of returning. Louisiana's overall incarceration rate, 1,067 per 100,000, is higher than that of any independent democratic country.

Louisiana had proof that the opposite approach works. A 2017 bipartisan reform package cut the nonviolent prison population by more than half between 2012 and 2021, ended the state's run as the most incarcerated in the nation, and reinvested $153 million in savings into the reentry and recidivism-reduction work the settlement is now meant to expand. Governor Jeff Landry ran on crime, and the concern was real: violent crime surged after 2020, and in 2022 New Orleans had the highest homicide rate of any major American city. But the 2017 reforms had cut sentences for nonviolent offenses, not violent crime, and the surge was already reversing. New Orleans homicides fell for two straight years, down 35% in 2024, a turnaround that predated the special session and that analysts credited to policing and community efforts.

Landry reversed the reforms anyway. His 2024 special session abolished parole for nearly everyone convicted going forward and required most people to serve 85% of their sentences. The escalation continued into 2026: on August 1, a new law made cannabis possession within 2,000 feet of a school a felony carrying up to a year at hard labor, which Landry publicized for football tailgates just as the sheriff investigation became public. Because sheriffs are paid by the bed, more arrests and longer sentences mean more revenue for the offices now receiving settlement money. The settlement was meant to help empty these jails. The state is refilling them.

Corruption confirmed, oversight absent

The specific risk this blog flagged in 2023 has produced federal convictions. The Lafayette pretrial-diversion scheme, in which a prosecutor funneled arrestees into the program in exchange for kickbacks from its vendors, ended with former assistant district attorney Gary Haynes sentenced to seven years and a $200,000 fine in December 2025, and contractor Dusty Guidry, who admitted roughly $800,000 in kickbacks, sentenced to four.

The guardrails that might catch the next scheme are thin. Parish governments must file annual reports on their settlement spending; sheriffs are not required to. In the first round of reporting, only two of 64 sheriffs' offices filed voluntarily. The state's Opioid Abatement Task Force can advise but not compel, and a 2025 legislative auditor reportfound it has no power to enforce its recommendations. Curtis Nelson, executive counsel to the body that supports the task force, has been direct about the intent: "This funding is not for law enforcement strategies." The Lafayette convictions show how public money moves through this justice system when accountability is weak. Opioid settlement dollars are now flowing to sheriffs on much the same terms.

What the money is supposed to reach

From the standpoint of patient access, enforcement spending fails a specific test. Syringe services, naloxone distribution, medications for opioid use disorder, and street outreach are the frontline of HIV and hepatitis C prevention, and often the point of contact where people who use drugs and are not otherwise in care get tested and linked to treatment. Enforcement equipment does not reach those settings, and enforcement itself drives people away from them. Medications for opioid use disorder reduce the risk of overdose death by 50% or more, and research shows that arrests can worsen the crisis: people who use drugs avoid calling 911 or seeking treatment when contact carries the risk of arrest.

Two states show the alternative. Virginia awarded $12.3 million this year through a competitive process, renewable only on documented progress, to harm reduction, treatment in corrections, naloxone, and campus recovery. Connecticut put more than $4 million into mobile methadone units that reach rural areas where the nearest clinic can be a long drive or a three-hour bus trip. In eastern Connecticut, the town of Windham recorded 62.9 overdose deaths per 100,000 in 2024, four times the national rate. "We're going to bring it to people instead of having them come to us and struggle," said Kevin Laymon, the recovery specialist who drives one of the vans.

Some Louisiana sheriffs reached the same place on their own. Acadia Parish Sheriff K.P. Gibson put all of his settlement money into treatment inside his jail. "I want people back into society, being productive," he said. But that was his choice, not a rule. In Louisiana, whether the money reaches treatment depends on who happens to be elected sheriff and what they decide it is for. Virginia and Connecticut built systems so it would not.

What Louisiana should do now

The state can still steer the coming decades of payments. Advocates, public health officials, and policymakers should press for four changes.

First, enact an enforceable statewide unallowable list, as California, Indiana, Kansas, Michigan, South Carolina, and Virginia have done, barring enforcement equipment, defibrillators, and budget backfill. The task force is exploring one, but guidance without statutory force has already failed. Second, require sheriffs to report on the same schedule as parish governments. Third, fund forensic audits with authority to withhold future payments where money is misused, and point the legislative auditor's pre-2027 review toward binding rules. Fourth, build allocation on the model Ryan White has used to steer HIV funding for decades: a process led by public health experts, with people who have lived experience holding real decision-making power, prioritizing medications for opioid use disorder, naloxone, syringe services, and reentry.

The counterargument from sheriffs is that their budgets are stretched and that seizing drugs saves lives. Budgets may be stretched. But this money is finite, and it was won as a remedy for a health crisis, not a subsidy for the system that criminalized it. Danny Bolner Jr., who reviewed the spending and lost his son to an overdose in 2016, named the stakes: "This money is what we have to save lives." Spent well, it moves Louisiana toward ending its overdose crisis and advances the state's part in ending the HIV epidemic and eliminating hepatitis C. Spent on cameras and empty jail beds, it will be gone, and the people it was meant to reach will still be dying.