Are Drug Disposal Initiatives an Effective Use of Opioid Settlement Funds?

By Tricia Christensen & Abby Winiker

States and local jurisdictions have been receiving and spending opioid settlement funds since 2022. Since then, millions of dollars of opioid settlement money have gone towards drug disposal initiatives, including take-back days and drug deactivation products. These items and activities are being marketed as lifesaving prevention strategies. But there has been limited evidence disseminated to support this claim, leaving those allocating settlement funds to wonder whether they are actually an effective use of opioid settlement funds. Specifically, do these investments meaningfully reduce overdose deaths?  

To answer this question, we reviewed existing research on drug disposal initiatives and developed a Frequently Asked Questions guide. We find that no research to date has directly examined the link between the use of disposal initiatives and the outcome of lives saved. Some studies show that people who receive education or a disposal product are more likely to say they disposed of medications, but this is not linked to measuring changes in overdose events. The FAQ highlights several lifesaving interventions which do merit settlement fund investment. 

This does not mean that safe medication disposal has no place in public health. People should have safe ways to dispose of unwanted medications. Fortunately, the FDA and DEA already provide guidance and infrastructure for this disposal, including via thousands of authorized collection sites nationwide.  

At a time when communities are still losing tens of thousands of people each year to overdose, communities must not waste funding on strategies that are unproven or outdated. Settlement funds represent a rare, time-limited opportunity to meaningfully shift the trajectory of the overdose crisis and should be used to invest in the many solutions that are proven to save lives.

Abigail Winiker, PhD, MSPH, is an Assistant Scientist in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and the Program Director for the Bloomberg Overdose Prevention Initiative. Her work and training in harm reduction and health education inform her public health practice, and she strives to conduct research with direct translational implications to improve outcomes for at-risk populations.

Tricia Christensen, MPP is an independent consultant specializing in harm reduction and drug policy. Her work bridges the gap between policy and practice, and she has over a decade of experience facilitating collaboration among government and community partners and standing up programs for low-barrier access to life-saving supplies and broader support systems. As a national opioid settlement expert, she advocates directing funds toward evidence-based, locally led interventions to save lives and heal communities from decades of regressive policies. Tricia is an alumna of Johns Hopkins Bloomberg School of Public Health, earning her MPP in 2017.