Earlier this month, the Office of Mayor Brett Smiley released the 2025 Opioid Settlement Fund Report. According to the report, Providence invested over $1.2 million over the course of the year in community-led opioid abatement initiatives that served over 3,000 people.
Through the funds, the City trained over 635 people in overdose response and narcan administration, connected over 625 people to housing support and housing-related services and conducted numerous collaborations with community projects and organizations.
This is the first annual report on how the city is distributing the funds from various settlements with major opioid distributors accused of fueling the national opioid crisis. Between the lawsuits, Rhode Island secured more than $300 million in funds directed towards opioid abatement over the next 18 years.
While 80% of these funds are designated for the state, the remaining 20% is allocated towards individual cities and towns within Rhode Island. Providence will receive 21% of this share — about $10 million over the 18 year period.
“Providence has put in the work to ensure these resources directly support our residents, strengthen the organizations providing critical services and connect people with the care they need,” Carl Austin Miller Grondin MPA’24, Smiley’s press secretary, wrote in an email to The Herald.
Grondin added that Smiley believes the funds represent an “important opportunity” to address the impact of the opioid crisis on Providence residents.
According to data from the U.S. Centers for Disease Control, over 800,000 people nationwide died from an opioid overdose from 1999 to 2023. The crisis peaked in 2022 with an estimated 84,181 opioid-related deaths.
“The overdose crisis in Rhode Island has mirrored national and regional trends,” Brandon David Lewis Marshall, a professor of epidemiology and chair of the Rhode Island Opioid Settlement Advisory Committee, wrote in an email to The Herald.
According to Marshall, Providence has been particularly affected by the crisis. The city had the second highest per capita rate of fatal overdoses in Rhode Island, behind only Woonsocket.
Over 4,000 Rhode Islanders died from an opioid overdose between 2014 and 2025, according to the Governor’s Overdose Prevention and Intervention Task Force.
According to Marshall, the “deaths started to increase in 2014, primarily due to the introduction of fentanyl into the illicit opioid supply.” Fatalities then “spiked to unprecedented levels” in 2022, with 436 overdose-related deaths that year, he added.
But since then, overdose deaths have decreased by nearly 50% — in 2025, there were 219 fatal overdoses. Marshall wrote that provisional data from the CDC shows that, between April 2025 and April 2026, overdose deaths in Rhode Island had decreased by 36%, one of the largest decreases in the country.
“While a 50% decrease in overdose deaths is a major public health success story, even one death is too many, and so we have much more work to do,” Marshall wrote.
“Providence should be commended for taking a comprehensive approach to spending their opioid settlement funds,” Brendan Saloner, professor of alcohol and addiction studies, wrote in an email to The Herald.
Saloner, whose research focuses on improving access to opioid use disorder medications, said that the city is “stretching a relatively small pot of money out to try to reach many different groups who need help.”
“The city knows funding alone is not enough, which is why we are continuing to build long-term solutions that go further in preventing overdoses, expanding access to treatment and supporting recovery,” Grondin wrote.
The state-sanctioned Providence Overdose Prevention Center, the first of its kind in the nation, was established using funds from the settlement. Over 2025, the center received 8,680 visits and conducted 182 overdose or overamping interventions, according to the settlement report.
“The key idea in the crisis is no wrong door — ensuring that wherever people engage with the system they can get to the services that help them, including medications, safer use supplies, and naloxone,” Saloner added.
“The city expects that the 2026 Annual Report will demonstrate an even greater impact than 2025,” Grondin wrote. “All 2026 projects are already underway, some of which are new and some of which continue successful initiatives from 2025.”
Maxwell Silver is a senior staff writer covering health and environment.
