Opioid overdoses have been one of the most deadly public health epidemics in our nation's history, leading to more than 80,000 deaths annually in the United States. In the last two decades, Baltimore has been disproportionately impacted, with more than half a billion opioid pills permeating the Baltimore area between 2006 and 2019, driving an increase in overdose deaths. Public health experts have estimated that more than 80% of Baltimore’s opioid use disorder cases between 2010 and 2021 began with prescription opioids, leading residents to turn to illicit drugs.
Baltimore City makes up 9% of Maryland’s population but, now through the first seven months of 2024, represents 44% of Maryland’s overdose deaths. Annually, Baltimore has an average of more than 2 overdose deaths per day.
In response, in 2018, Baltimore City initiated legal action against various pharmaceutical manufacturers and distributors for their role in creating the opioid epidemic in Baltimore City by failing to take reasonable steps to prevent the diversion of their highly addictive prescription opioids. The City then opted out of the global settlement that would have provided the City with much less restitution money than it deserved, and decided instead to pursue its litigation against some of the largest pharmaceutical companies in the world.
That decision has paid off. As of September 2025, the City has reached settlements and awards totaling $579.9 million (before legal fees and repayment of litigation costs).
On August 29, 2024, Mayor Scott released an Executive Order establishing the City’s approach to managing the restitution funds received, including provisions that:
Read the full Executive Order or view the Executive Order Overview. For comments about the Executive Order, email overdoseresponse@baltimorecity.gov.
Under the leadership of Mayor Brandon M. Scott, as outlined in the Executive Order, BCMOOR was charged with creating a coordinated, city-wide response to address the overdose crisis in Baltimore City.
The strategy is grounded in a comprehensive needs assessment that analyzes both quantitative (statistics and numbers) and qualitative (stories and voices) data. Quantitative data from over 16 data sources were included and over 300 stakeholders—including people who actively use drugs, people who were in treatment, family and friends of people who use drugs, providers, and city staff—contributed insights.
The Overdose Response Strategic Plan is a living document—open to ongoing community feedback. Residents are encouraged to contribute their voices to ensure Baltimore’s response reflects the needs and aspirations of every neighborhood. Please submit comments on the Public Feedback Form by August 29, 2025 or attend a community listening session in July.
As of February 12, 2025, the Mayor announced the Restitution Advisory Board. Read more about the Restitution Advisory Board here.
The Baltimore City Mayor’s Office of Overdose Response is currently reviewing applications to serve on the Restitution Advisory Board in 2026. Applicants will be hearing about next steps in the consideration process in the coming weeks.
Meetings are be held on the last Wednesday of each month.
Upcoming Meetings
*Due to ongoing weather conditions, this meeting will be held virtually*
Date: January 28, 2026
Location: Virtual
Online Meeting Information:
Join Virtual Meeting
Agenda: View Agenda | Download Agenda
Past Meetings
Looking for past meetings of the restitution advisory board? You can view agendas and meeting minutes from previous sessions.
Click here to view Past Meetings
Part of the Mayor’s Executive Order charged the city government with developing a City Overdose Response Strategy to guide the efforts to address the opioid and overdose epidemic through programs, interventions, and funding.
On December 17, 2024, the City published a draft Community Engagement Plan per the executive order. The Community Engagement Plan outlines a two-step approach to ensure the City’s Overdose Response Strategy reflects the current needs and gaps in services. The City also opened a public feedback period to gather input on the draft. That feedback period closed on March 15, 2025. Public feedback was incorporated into an updated version of the Community Engagement Plan, which was approved by the Restitution Advisory Board on July 30, 2025. View the final Community Engagement Plan
As part of this engagement, the City hosted four Community Listening Sessions in July and August of 2025 to hear directly from residents about the overdose crisis and their recommendations for addressing it. These Community Listening Sessions took place in Cherry Hill, Penn North, Park Heights, and East Baltimore. See the presentation slides from these Community Listening sessions.
To ensure that the public could readily access information about the use of the ORF, Mayor Scott’s Executive Order also called for the City to release a Transparency and Accountability Plan. The Mayor’s Office of Overdose Response prepared a draft of this plan, which was released on December 17, 2024 and was open for public comment until March 15, 2025. With input and support from the Restitution Advisory Board, the Transparency and Accountability Plan was finalized and adopted on July 30, 2025. It includes expectations for information the City should include as part of its annual reporting on the use of the Opioid Restitution Fund.
Steps for Administering Opioid Restitution Funds
Image Description: A vertical flowchart titled "Steps for Administering Opioid Restitution Funds" with ten sequential steps, each in a blue box connected by arrows.
The steps are as follows:
Establish Governance and Finance Structure for Restitution Funds
Mayor Scott Announces Executive Order: Administration of Funds from Restitution Funds
Hire Executive Director of Overdose Response and Opioid Restitution Program Manager
Establish Restitution Advisory Board
Conduct Community Engagement and Needs Assessment - We are Here
Publish City-wide Overdose Response Plan - We are Here
Set Annual Funding Priorities - We are Here
Release Notice of Funding Availability
Select Programs to Fund
Look up and connect with community resources in Baltimore City through Charm Care
Need immediate emotional support? Call 988 to connect to a counselor who can help
Learn about Baltimore City Health Department's Substance Use services and resources
Access the Baltimore City Health Department Overdose Dashboard
Access the Maryland Department Health’s Overdose Dashboard
Request The Baltimore City Health Department's Naloxone Training
Sign up for Baltimore City Health Department’s Virtual Naloxone training
Learn more about the resources and information of the Maryland Syringe Services Programs
Get free Naloxone, Fentanyl Test Strips, and Xylazine Test Strips
The application for Fiscal Year 2026 Opioid Restitution Fund Community Grants is now open. For more information on how to apply, including detailed application instructions and a timeline for the stages of applying, please visit the Mayor’s Office of Recovery Programs website. Proposals are due on November 23 at 11:59PM EST.
Attend a community listening session in 2025
