Georgia will receive a total of $638 million as part of a $26 billion multistate settlement with companies that made or distributed prescription painkillers tied to the deadly opioid crisis, according to an analysis by KFF Health News.

As part of that settlement, Atlanta and Georgia’s four largest counties — Cobb, DeKalb, Fulton and Gwinnett — already have been designated to receive about $7 million and are set to get more than $26 million in future payouts, the analysis shows.

Additional funds could flow into Georgia, as settlements with other pharmaceutical companies are pending.

Fulton Commissioner Bob Ellis welcomed the news, saying it “will be needed for a long period of time to deal with the aftermath.” He added he knows people who have been tragically impacted by the epidemic.

“It’s hard, probably, for anyone not to know someone who has been personally impacted by it because it has had such broad tentacles. And it is still going,” he said.

KFF Health News, a nonprofit news service that covers health care policy, gathered figures through March 4 from BrownGreer, the court-appointed firm administering the settlement. The funds are being paid by four companies: AmerisourceBergen, now called Cencora; Cardinal Health; McKesson; and Janssen, now known as Johnson & Johnson Innovative Medicine.

BrownGreer is distributing the money to each state based on a number of factors, including amounts of opioids shipped to them, numbers of opioid-related deaths that have happened within their borders and how many of their residents are suffering from opioid addiction.

The settlement requires 85% of the money be spent on fighting the crisis through treatment, education and prevention programs. BrownGreer says it has paid more than $2.6 billion from the settlement to 3,402 states and local governments so far.

In Georgia, state officials are set to announce Monday the creation of the Opioid Crisis Abatement Trust, which will receive $479 million from the settlement. Of that, $159 million will be distributed to local governments. Georgia Department of Behavioral Health & Developmental Disabilities Commissioner Kevin Tanner will serve as the trustee.

“With these funds, critical treatment, prevention and recovery services will be more accessible to Georgians who are desperately in need of help,” said Georgia Attorney General Chris Carr, who announced in January of 2022 that the state had signed onto the $26 billion settlement.

Prescription opioids can be used to treat pain effectively. But they also can be misused, leading to addiction and fatal consequences. From 1999 to 2021, nearly 280,000 people died in the United States from overdoses involving prescription opioids, according to the U.S. Centers for Disease Control and Prevention. The number of overdose deaths involving prescription opioids in 2021, the CDC said, was nearly five times the number in 1999.

Estimates of the epidemic’s financial toll vary. The White House’s Council of Economic Advisers estimated the economic cost for 2015 at $504 billion. The Society of Actuaries said the cost was at least $631 billion for the four years between 2015 to 2018.

In 2017, Fulton County leaders assembled in their downtown Atlanta auditorium to announce their county would become the first in Georgia to sue the opioid industry for damages stemming from the epidemic.

Since then, dozens of other Georgia cities and counties have filed similar lawsuits, seeking to recoup taxpayer expenses for health care, law enforcement and other costs tied to the epidemic.

Each year in Cobb, for example, fire officials respond to about 1,000 opioid-related calls, costing hundreds of thousands of dollars. As many as a third of the cases handled by the county’s Medical Examiner Office in recent years have involved opioid overdoses, costing an estimated $175,000 annually. The crisis has also increased costs for the county’s Sheriff’s Office, jail and court system.

“The county is eager to use these funds to recuperate some of the ongoing costs of this epidemic and, more importantly, to fund programs to save lives in the future,” Cobb spokesman Ross Cavitt said of the settlement money.

DeKalb CEO Michael Thurmond said the opioid crisis has “had a devastating effect on the county, the state and the nation during the past few years and many lives have been destroyed. This settlement will allow us to go forward with prevention initiatives that hopefully reverse the trends we are seeing and restore broken families and lives.”