Becky Corbin: A New Year’s resolution for opioid accountability

Pennsylvania is entering a consequential new phase in its response to the opioid epidemic. With most major opioid lawsuits now settled, almost $2 billion in settlement funds are expected to flow into the Commonwealth over the next two decades. That scale of investment brings real opportunity and real responsibility. 

Recent reporting has justifiably drawn attention to how these dollars are being allocated and the  safeguards in place to ensure they serve their intended purpose. The good news is that compared with previous large settlements — think tobacco and asbestos — the state has moved deliberately toward greater transparency and expanded public input with regard to the use of these funds. Dedicated websites now track county spending, advisory councils have been created, and public listening sessions have begun. Those steps matter. They reflect an understanding that stewardship of these dollars must be earned through openness and accountability. 

But, as we head into 2026, meaningful limitations remain on transparency and public participation in the grantmaking process, as well as on guidance as to how these funds should be spent. Addressing these issues now will determine whether the opioid settlement ultimately delivers strong public trust and measurable results. 

Regarding transparency, public visibility into settlement spending remains fragmented. While dashboards and reporting portals have improved visibility into local spending, funds distributed through accounts controlled by state lawmakers have proven more difficult for the public to track in a consistent way. At the same time, the state’s Opioid Trust is shielded from Pennsylvania’s open records law, allowing members to review local spending decisions in secret meetings before making recommendations for the full board to consider. This may warrant reconsideration over time if the goal is to maximize public confidence and independent oversight. Transparency is not only about publishing data; it is about ensuring that citizens, researchers, and policymakers can readily understand how and why decisions are made and how dollars flow through the  system. 

Public participation presents a similar challenge. As a matter of course, Pennsylvania’s opioid trust does not regularly allow public comment at its meetings. While a promising step forward was taken this past summer when the Trust held its first public listening session, public engagement should not be treated as a periodic procedural formality. These funds exist because members of the public and their communities suffered real harm. The structure of its meetings should be changed to consistently invite input from those most impacted by the crisis — not simply to air grievances, but to strengthen legitimacy, provide local insight, and build shared ownership of solutions. 

Perhaps the most complex issue is the guidance provided at the local level regarding settlement fund related expenditures. County officials and municipal leaders continue to wrestle with uncertainty over what qualifies as appropriate opioid-related spending. In fact, researchers affiliated with Penn State recently found that many local officials looked to the Trust for guidance but did not feel they were receiving the clarity they needed. In a system of this  magnitude, ambiguity inevitably creates friction. 

That vague instruction has also produced disputes over proposed programs that appear only  loosely connected to opioid mitigation. Some counties and cities have challenged Trust decisions in court after certain projects were rejected — including proposals tied to outdoor youth programming, newsletters, home repairs, and small business support. These cases underscore a broader governance problem rather than simply a policy disagreement. When guidance is unclear, expectations diverge, and the system becomes vulnerable to both mission drift and legal conflict. 

None of this diminishes the progress Pennsylvania has already made. Building governance structures for nearly two billion dollars in settlement funding is inherently complex. Early investments in transparency infrastructure and public outreach demonstrate good faith and institutional seriousness. But stewardship is not static. It requires continuous refinement as real world challenges emerge. 

As a former legislator who served on the House Health Committee, I learned that public trust is built not only on good intentions, but on robust systems that invite scrutiny, encourage participation, and provide clarity to those charged with implementation. Therefore, 2026 should be the year Pennsylvania strengthens the foundations it has already laid for accountability with regards to opioid settlement spending. 

The opportunity is enormous, but so is the risk of fragmentation if governance does not keep pace with funding. If we get the governance right, these funds can deliver lasting benefits for families and communities across the Commonwealth. If we allow ambiguity and opacity to linger, even well-intended investments may fall short of their promise. The next phase of this effort will determine which path Pennsylvania ultimately takes. 

Becky Corbin was a member of the Pennsylvania House of Representatives from 2013-2018 and served on the Health Committee. Her professional background and training is in the field of chemistry.