Science
In California, opioid settlement money helps fund lifesaving drugs and police projects
Sonja Verdugo lost her husband to an opioid overdose last year. She regularly delivers medical supplies to people using drugs who are living — and dying — on the streets of Los Angeles. And she advocates at Los Angeles City Hall for policies to address addiction and homelessness.
Yet Verdugo didn’t know that hundreds of millions of dollars annually are flowing to California communities to combat the opioid crisis, a payout that began in 2022 and continues through 2038.
The money comes from pharmaceutical companies that made, distributed or sold prescription opioid painkillers and which agreed to pay about $50 billion nationwide to settle lawsuits over their role in the overdose epidemic. Even though a recent Supreme Court decision upended a settlement with OxyContin maker Purdue Pharma, many other companies have already begun paying out and will continue doing so for years.
California, the most populous state, is in line for more than $4 billion.
“You can walk down the street and you see someone addicted on every corner — I mean it’s just everywhere,” Verdugo said. “And I’ve never even heard of the funds. And to me, that’s crazy.”
Across the nation, much of this windfall has been shrouded in secrecy, with many jurisdictions offering little transparency on how they’re spending the money, despite repeated queries from people in recovery and families who lost loved ones to addiction.
Meanwhile, there’s plenty of jockeying over how the money should be used. Companies are lobbying for spending on products that range from medication bottles that lock to full-body scanners to screen people entering jails. Local officials are often advocating for the fields they represent, whether it’s treatment, prevention, or harm reduction. And some governments are using it to plug budget gaps.
In California, local governments must report how they spend settlement funds to the state’s Department of Health Care Services, but there’s no requirement that the reports be made public.
KFF Health News obtained copies of the documents via a public records request and is now making available for the first time 265 spending reports from local governments for fiscal year 2022-23, the most recent reports filed.
The reports provide a snapshot of the early spending priorities, and tensions.
Naloxone an early winner
As of June 2023, the bulk of opioid settlement funds controlled by California cities and counties — more than $200 million — had yet to be spent, the reports show. It’s a theme echoed nationwide as officials take time to deliberate.
The city and county of Los Angeles accounted for nearly one-fifth of that unspent total, nearly $39 million, though officials say that since the report was filed they’ve begun allocating the money to recovery housing and programs to connect people who are homeless with residential addiction treatment.
Among local governments that did use the cash in the first fiscal year, the most popular object of spending was naloxone, a medication that reverses opioid overdoses and is often known by the brand name Narcan. The medication accounted for more than $2 million in spending across 19 projects.
One of those projects was in Union City, in the San Francisco Bay Area. The community of about 72,000 residents had five suspected fentanyl overdoses, two of them fatal, within 24 hours in September.
The opioid settlement money “was invaluable,” Corina Hahn, the city’s director of community and recreation services, said in her report. “Having these resources available helped educate, train and distribute the Narcan kits to parents, youth and school staff.”
Union City bought 500 kits, each containing two doses of naloxone. The kits cost about $13,500, with an additional $56,000 set aside for similar projects, including backpacks containing Narcan kits and training materials for high school students.
Union City also plans to expand its outreach to homeless people to fund drug education and recovery services, including addiction counseling.
Those are the sorts of lifesaving services that Verdugo, the Los Angeles advocate, said are desperately needed as deaths of people living on the streets pile up.
She lost her 46-year-old husband, Jesse Baumgartner, in June 2023 to an addiction that started after he was prescribed pain medications for a high school wrestling injury. He tried kicking his habit for six years using methadone, but each time prescribers lowered his dosage the cravings drove him back to illicit drugs.
“It was just this horrible roller coaster of him not being able to get off of it,” Verdugo said.
Sonja Verdugo lost her 46-year-old husband, Jesse Baumgartner, in June 2023 to complications from an opioid addiction. She’s now a community organizer for Ground Game LA.
(Arlene Mejorado / For KFF Health News)
By then the couple had survived 4½ years of being homeless and had been in stable housing for about two years.
Fentanyl use, particularly among homeless people, “is just rampant,” she said. People sometimes are initially exposed to the cheap, highly addictive substance unknowingly when it is mixed with something else.
“Once they start using it, it’s like they just can’t backtrack,” said Verdugo, who works as a community organizer for Ground Game LA.
So she leaves boxes of naloxone at homeless encampments in the hope of saving lives.
“They definitely use it, because it’s needed right then — they can’t wait for an ambulance to come out,” she said.
Cities backtrack on spending for law enforcement
By contrast, the cities of Irvine and Riverside listed plans to prioritize law enforcement by buying portable drug analyzers, though neither city did so in the first fiscal year, 2022-23. Their inclination mirrored patterns elsewhere in the country, with millions in settlement funds flowing to police departments and jails.
But such uses of the money have stirred controversy, and both cities backed away from the drug analyzer purchase after the Department of Health Care Services issued rules that opioid settlement funds may not be used for certain law enforcement efforts. The rules specifically excluded “equipment for the purpose of evidence gathering for prosecution, such as the TruNarc Handheld Narcotics Analyzer.”
In Hawthorne the police department had already spent about $25,000 of settlement funds on an initial installment to buy 80 BolaWraps, devices that shoot Kevlar tethers to wrap around a person’s limbs or torso.
After the state said BolaWraps were not an allowable expense, the city said it would find other funding sources to pay the remaining installments.
Santa Rosa, in California’s wine country, spent nearly $30,000 on police officer wellness and support.
The funds allowed the police department to boost its contracted wellness coordinator from a part-time to a full-time position, and to buy a mobile machine to measure electrical activity in the brain, said Sgt. Patricia Seffens, a spokesperson.
The goal is to use the technology on police officers to help “assess the traumatic impact of responding to the increasing overdose calls,” Seffens said in an email.
In Dublin, east of San Francisco, officials are using part of their $62,000 settlement for a DARE program.
DARE, which stands for Drug Abuse Resistance Education, is a series of classes taught by police officers in schools to encourage students to avoid drugs. It was initially developed during the “Just Say No” campaign in the 1980s.
Studies have found inconsistent results from the program and no long-term effects on drug use, leading many researchers to dismiss it as “ineffective.”
But on its website, DARE cites studies since the program was updated in 2009, which found “a positive effect” on fifth- graders and “statistically significant reductions” in drinking and smoking about four months after completing the program.
“The DARE program when it first came out looks a lot, lot different than what it looks like right now,” said Nate Schmidt, the Dublin police chief.
Schmidt said that additional settlement money will be used to distribute naloxone to residents and to stock it at schools and city facilities.
Other local governments in California spent modest sums on a wide range of addiction-related measures. Ukiah, in Mendocino County, north of San Francisco, spent $11,000 for a new heating and air conditioning system for a local drug treatment center. Orange and San Mateo counties spent settlement funds in part on medication-assisted treatment for people incarcerated in their jails. The city of Oceanside spent $16,000 to showcase drug prevention art and videos made by middle school students in local movie theaters, public spaces, and on buses and taxis.
The Department of Health Care Services said it plans to release a statewide report on how the funds were spent, as well as the individual city and county reports, by year’s end.
Science
Pacifica pier cracks, another coastal casualty as seas continue to rise
The Pacifica Municipal Pier was shut down and taped off Thursday after city workers noticed cracks running through the landmark structure and concrete chunks falling into the ocean.
It’s just one of many coastal California structures that have recently crumbled under pressure from a rising and relentless ocean.
Officials from the small, beach city south of San Francisco said the pier was closed due to “cracking, separation, and displacement of the concrete walkway and structural elements.”
It will stay closed while structural engineers asses its safety.
Photos taken by city employees show a wide crack that runs from top to bottom and across the structure as well. Other photos show a large horizontal crack under the foundation of a small restaurant on the pier, the Chit Chat Cafe.
The cafe was also shut down.
This is not the first time the 53-year-old pier has shown signs of stress. In 2021, part of it was shut down after handrails along the edge collapsed. And in 2023, after a series of storms pummeled the Central California coast, damaging parts of the pier, the structure was partially closed for more than year.
Those same storms caused extensive damage in Aptos and Capitola, 70 miles south, where piers and waterfront infrastructure were swept away or damaged.
In 2024, a 150- to 180- foot section of the Santa Cruz wharf was ripped off by powerful waves.
At least 10 of the state’s dozens of coastal public piers were closed for part or all of 2024 due to structural damage sustained in winter storms since 2022. At least five others have longer-term upgrades planned to address structural issues.
“These things are costly to maintain,” said Zach Plopper, senior environmental director at Surfrider. “They are a part of our California coastal culture in many ways, but we’re going to need to reckon with, one, the state that they’re in, and two, the continuous and worsening threats they’re going to experience,”
He said most of the piers were constructed in the early 1900s, and they weren’t built to withstand decades of rough seas, storms and rising sea level.
“With this incoming El Niño, which is forecasted to be significant, and this marine heat wave we’re in the midst of, we’re kind of in uncharted waters as far as what this winter could bring in terms of storms and swells to the California coast, and we’re likely going to see a lot more damage,” he said. “Not just piers, but roads and other coastal infrastructure up and down the state.”
There was no storm in Pacifica earlier this week, so no single event could be blamed for the destruction.
However, a 2025 report from an outside engineering firm, GHD, found that several sections of the pier were in “poor” or “serious” condition, and they recommended closure before anticipated storms or events that could “subject the piles to high winds, swells and large waves.”
The firm found several areas of the pier where concrete was missing and rebar was exposed and corroding.
“The pier has continued to experience high winds and large waves in a harsh marine environment,” the engineers wrote in the report, noting that continuous exposure to seawater or marine spray was “detrimental” to the structure.
A 2023 city report estimated it would cost $19 million to repair.
That same year, a state law was enacted to require local governments along the California coast to plan for sea level rise in the coming decades.
Sea level has risen some 8 inches, on average, along the coast in the past 150 years, Plopper said, and researchers anticipate another foot in the next 25 years.
“We’re going to see profound shifts on our coastline, none that we have ever experienced before, and building static structures on the coast just doesn’t work all that well,” he said. “We’re going to have to make some really hard decisions.”
Science
L.A. region begins the year with the smoggiest first 5 months in a decade
The first five months of 2026 in Southern California have been the smoggiest — with the highest number of unhealtful air days — in more than a decade, according to statewide air monitoring.
So far this year, the South Coast air basin, which includes Los Angeles, Orange, Riverside and San Bernardino counties, has seen 39 days when the concentration of lung-irritating ozone (commonly known as smog) exceeded the federal standard, according to preliminary state air quality data.
That’s even worse than the infamously hot and hazy 2017, when Greater Los Angeles had 36 unhealthful air days by June 4 and ultimately saw 145.
Many of the roughly 18 million people who live in the air basin have been subjected to unhealthful levels of ozone, a highly corrosive gas that triggers asthma attacks and a wide range of respiratory illnesses. This has taken many by surprise since successive days of smog more commonly happen in summer, when heat waves and intense sunlight convert man-made pollution into ozone.
“If we have this many violations by this time, this could be a really awful year for air quality,” said Adrian Martinez, director of Earthjustice’s Right to Zero campaign, an initiative calling for the transition away from fossil fuels. “We’re already the worst place in the country for summertime smog pollution. So it could be one of the worst years in one of the worst places in the country.”
The pollution has been especially severe in valleys. On April 18, an air monitor in Reseda in the San Fernando Valley measured the second highest spike in hourly ozone levels in the last decade.
Greater Los Angeles has seen more high-smog days so far in 2026 than any other year in the past decade.
(Courtesy of South Coast Air Quality Management District)
The South Coast Air Quality Management District says the high ozone levels are due to early heat waves. Officials said they were not aware of any increase in the pollutants — most of them from different kinds of exhaust — that lead to ozone formation.
Local temperatures have been well above normal, climbing into the mid-80s and high 90s between January and April, breaking several daily high temperature records, according to the National Weather Service.
March in particular was the warmest on record in California. Riverside had an unprecedented 13 days of temperatures above 90 degrees, the weather service said.
“It was really that heat wave — conditions we typically see in July or August, we saw them in March,” said Sarah Rees, deputy executive officer of the air district. “That put us ahead of the curve in terms of how much ozone we got.”
Air district officials urged residents to monitor pollution levels on the agency’s website and mobile app, and spend only limited time outdoors when smog levels are high.
“People generally know when there’s a wildfire, because you see the smoke and smell it,” said Scott Epstein, the air district’s manager of planning and rules. “Then, it’s like, I’ve got to take precautions. Ozone, you can’t really tell.”
Southern California has been particularly susceptible to smog formation because of its millions of gas-powered cars releasing tons of tailpipe emissions each day. The region’s sunshine acts as a catalyst for smog formation. Then the mountains trap this pollution over densely populated communities.
For nearly half a century, state and local air regulators have made rules designed to alleviate this pollution, enacting the nation’s first tailpipe emission standards in 1966 and requiring catalytic converters in 1975.
Smog-forming pollution has been dramatically reduced over the last two decades, but the region still does not meet federal air quality standards for ozone.
At an air district meeting Friday in Diamond Bar, the governing board held a moment of silence for William Burke, a former longtime chair. During his tenure, the agency enacted nearly 270 rules that are credited with reducing smog-forming pollution by hundreds of tons per day. Burke, who also founded the Los Angeles Marathon, died in May at 87.
“Those are just emission reductions,” air district Chair Michael Cacciotti said at the Friday meeting. “But what it doesn’t tell you is how many kids, families, seniors were prevented from going to the hospital from an asthma attack, didn’t get cancer or other respiratory problems.”
Several residents from the Inland Empire, which suffers some of the worst smog pollution, expressed their appreciation for the air district’s efforts. But they also stressed the need for more progress.
“I’m old enough to remember growing up in the ‘70s and ‘80s … and not being able to see the mountains for weeks and months at a time,” said Erik Morden, one of several residents who spoke at the meeting.” I know things have improved, and I want to thank all of you for all the hard work that you’re doing. But there’s a lot of invisible stuff that you don’t see, that’s still out there — a lot of particulates in the ozone and chemicals that are causing a lot of problems.”
Martinez, the Earthjustice attorney, said the abnormally early outbreak of smog should be a wake-up call to government regulators that there’s work to be done, including offering more incentives to help residents and businesses transition to zero-emission appliances.
“We shouldn’t over-complicate it. We’ve got a lot of heat, we’ve got a lot of pollution,” Martinez said. “Our contention is, this agency can’t control the weather. But the one thing it can control is the pollution.”
Science
A flesh-eating worm from the 1960s is re-invading the U.S. Are CA cattle at risk?
Federal agricultural inspectors detected a case of New World screwworm larvae — maggots that burrow into the flesh of living animals and sometimes humans — on a 3-week-old calf in south Texas, near the U.S.-Mexico border. Officials anticipated the arrival of screwworm in the United States and say they’re prepared to contain it.
New World screwworm, also known as Cochliomyia hominivorax, is starkly different from the average maggot that feeds on decaying organic matter such as garbage, rotting food or dead animals, said Tom Talbot, veterinarian and member of the California Cattlemen’s Assn.
That’s because a screwworm larva “attacks living flesh,” Talbot said.
On Thursday, the U.S. Department of Agriculture confirmed the detection of New World screwworm in the umbilical area of a bovine in Zavala County, Texas, more than 60 miles from the northern Mexico border.
As of Friday morning, there have been no additional cases of infected animals reported.
Screwworm is endemic in South America and parts of the Caribbean, according to the Centers for Disease Control and Prevention. However, the parasitic fly has been steadily moving north from Central America to Mexico since 2023.
The USDA says it has actively monitored the fly’s movement. Last month, the USDA was aware of more than 200 active screwworm infestation cases in the border states of Nuevo León and Tamaulipas, according to Mexico’s Secretary of Agriculture and Rural Development dashboard. There are currently more than 2,000 active cases throughout Mexico.
It was believed that the New World screwworm would enter the U.S. in 2025, “however, thanks to the hard work across the entire Trump administration and our industry, state, and local partners, we were able to buy time for this moment,” said Dudley Hoskins, undersecretary for Marketing and Regulatory Programs for the USDA, in a statement.
The potential economic impact of New World screwworm on the cattle industry due to import restrictions, reduced productivity and animal loss is substantial, said Sally DeNotta, director of the University of Florida’s Equine Performance Laboratory.
Last year, 175 key agricultural organizations signed a letter urging additional federal funding for screwworm-control measures, emphasizing USDA estimates that a New World screwworm outbreak in the U.S. could cost producers $4.3 billion annually and cause economic losses of more than $10.6 billion across the southern United States.
“While the fly does not survive at temperatures at or below freezing, infected animals could carry the parasite northward and spread infection during the summer months, and the temperate climate of Southern California could certainly support year-round New World screwworm populations,” DeNotta said.
Talbot said from the federal to the local level, everyone in the ranching community has been talking about the arrival of screwworm and how to combat it.
“My expectation is that there will be a minimal number of cases of [New World screwworm] in California,” he said.
That’s because there are several stations on the border in Southern California, he said, that are collecting data, monitoring for any incidents of the parasitic fly and trapping them.
Talbot says he’s confident that the proactive measures on behalf of the federal government will mitigate the screwworm’s reach and therefore not impact the beef supply locally or nationally.
How screwworm infection spreads
Female screwworm flies are attracted to the smell of wounds — that can be as small as a tick bite — and body openings such as the nose, eyes, ears and mouth where they can lay eggs, according to the CDC.
A female screwworm fly can lay 200 to 300 eggs at a time and may lay up to 3,000 eggs during her 10 to 30-day lifespan.
When the eggs hatch into maggots, the maggots eat live tissue, causing a worsening, often painful and foul-smelling wound, according to the CDC.
Screwworm has hit the United States before
There was a screwworm outbreak in the southwestern region of the United States in 1965 that prompted Mexican and U.S. livestock producers to sign a declaration to establish a joint program for the eradication of the screwworm from the states on either side of the Mexico-U.S. border, according to the National Agricultural Library.
By 1966, the United States had eradicated screwworms, but livestock remained vulnerable to reinfestation from screwworms migrating from Mexico.
Eradication was possible through the sterile insect technique, which uses gamma radiation to irradiate screwworm pupae and create sterile male flies.
The U.S. Department of Agriculture’s Animal and Plant Health Inspection Service maintains a screwworm pupae sterilization facility in North America and is currently building a new center in southern Texas.
When produced and released in large numbers, sterile male flies mate with wild female flies, which then lay unfertilized eggs, according to the USDA.
“Since female screwworm flies normally mate only once, the population progressively reduces and is, ultimately, eradicated,” according to USDA officials.
Last year, the Trump administration cut thousands of grants and programs from the U.S. Agency for International Development, which includes U.S.-funded animal disease monitoring projects operated by the United Nations Food and Agriculture Organization, Argi-Pulse Communications reported. Among the slashed programs were some dedicated to monitoring and containing New World screwworm in Central America.
Today, screwworm infestations aren’t a regular occurrence in the U.S., but cases have occurred in travelers returning from areas where the flies are present, according to the CDC.
Can infected animals be treated?
Infected wounds are cleaned and debrided to remove any screwworm larvae, after which the animal is treated with an approved insecticide, DeNotta said.
Last month, the U.S. Food and Drug Administration issued an emergency use authorization for several insecticides known to be effective against screwworm.
There are approved systemic and topical options for a variety of species, including cattle, horses, small ruminants, cats and dogs, DeNotta said.
“Multiple days of treatment are often required, and antibiotics and analgesics may also be administered to treat secondary infection and control pain,” she said.
If left untreated, the tissue destruction caused by flesh-eating larvae can be extensive and severe, often resulting in debilitation and eventual death of the host, DeNotta said.
“Animals that survive may suffer weight loss, poor growth and reduced productivity as a result of pain and discomfort,” she said.
Screwworm can infect humans
Human infection is rare, DeNotta said, but it can happen.
Humans are at risk of being infected by screwworms if they travel to an area where the flies are present, such as South America and the Caribbean, according to the CDC.
CDC officials said your risk of screwworm infection increases when you:
- Spend a lot of time outdoors during the day, especially if sleeping or unable to keep the flies at bay.
- Have any open wounds. A small break in the skin, including from a scratch, insect bite or recent surgery, may attract screwworm flies.
- Have a medical condition that causes bleeding or open sores, such as from skin or sinus cancer, or from treatments that can create breaks in the skin.
- Live, work or spend an extended amount of time with or near, livestock or other warm-blooded animals in areas where screwworm flies are present.
The symptoms humans experience when infected by screwworm
The following are symptoms of screwworm according to the CDC:
- Feeling maggots move or seeing maggots within a skin wound, sore or body opening.
- Painful skin wounds or sores that worsen within a few days.
- Foul-smelling odor from the site of the infestation.
- Bleeding from open sores.
Bacteria can also infect wounds where screwworm maggots are present and may cause an infection that can lead to symptoms like fever or chills.
To treat a screwworm infection, DeNotta said, people undergo the same combination of wound debridement and insecticides used in animals.
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