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Tribal Principles: Guidance for Tribes Receiving Opioid Litigation Settlements

In February 2022, news media announced that federally recognized Tribes within the US had reached a $590 Million opioid settlement with Johnson & Johnson and the United States’ three largest drug distributors. This settlement was the result of many years of advocacy led by Tribes and their legal teams. Since then, additional settlements have been added and Tribes are slated to receive over $1.5 billion throughout the next 15 years.  

Following this announcement, a core Tribal Principles Project Team was brought together at the Johns Hopkins Bloomberg School of Public Health, through funding from the Bloomberg Philanthropies as a part of the Bloomberg Overdose Prevention Initiative. This team developed the Tribal Principles through: collaborative discussions with an expert Indigenous Advisory Committee; a series of listening sessions with Indigenous and allied researchers, tribal leaders, service providers, and tribal community members throughout the United States; and scholarship and the practice experiences of the core Tribal Principles Project Team of Indigenous researchers ( and  

The Tribal Principles are: 

  1. Culture First: Support Cultural and Traditional Healing in Your Community 
  2. Invest in Opportunities for Reciprocal Learning and Partnerships Across Tribes 
  3. Healing Support for Families: Invest in Parent, Caregiver and Elder Resources 
  4. Sustain and Enhance Substance Use Services for Youth 
  5. Create Opportunities for Holistic Well-Being 

The Tribal Principles complement  The Principles for the Use of Funds from the Opioid Litigation, which provide planning and process level guidance for state and local policymakers on how to effectively spend money from the opioid settlements”.  

For further information, please see or email with any questions.