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Opioid settlement funds could support programs for older adults raising grandchildren
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EDITOR'S NOTE: This story was co-written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and The Silver Century Foundation.
Laurel Exner’s 16-year-old son, Adam Whited, didn’t want medication when diagnosed with multiple sclerosis but, by age 20, he needed pain relief. His dosage climbed from 10mg to 60mg oxycodone as he edged toward addiction.
When his prescription ran out, he begged a friend for help. But instead of oxycodone, Whited found fentanyl, an opioid that’s up to 100 times as powerful. He overdosed in April 2022, leaving behind a wife and two children.
But that wouldn’t be the family’s only tragedy. Exner’s daughter, Deanna, developed substance use disorder while trying to self-medicate with crack cocaine and heroin for anxiety and depression. She was raped and gave birth to a son in 2020 as COVID-19 raged.
“The baby has been in our lives since Day 1,” Laurel Exner says. “I cut his cord; I was there with her the whole time that she was in labor.”
Deanna Exner accumulated nine months of sobriety, but her brother’s death led Deanna to relapse. She died in 2023 by fentanyl overdose in the same house where she, her parents, and almost-3-year-old son lived.
Laurel Exner didn’t want her grandson to go into the foster care system, even for a night. So she became Mom, leaving any notions of grandparent life to daydreams.
Exner of Naples, Fla., is one of 300,000 grandparents nationwide who are raising their grandchildren, saving the child welfare system $10.5 billion annually. Increasingly, families have found themselves in this position due to the opioid epidemic. From 2011 to 2021, 321,566 children in the U.S. lost a parent to drug overdose, report researchers in a 2024 study in JAMA Psychiatry.
The crisis began nearly three decades ago, when pharmaceutical companies started pushing prescription opioids as safe and non-addictive. Pharmaceutical company emails revealed that executives mocked people in Appalachia as “pillbillies.” From there, people easily transitioned to fentanyl and heroin use. Some 70,000 people in the U.S. died of drug overdoses in 2025, down 14% from 2024.
As grandparents raising their grandchildren navigate the grief of losing their own children, they’re often dealing with the practicalities of having a grandchild (or grandchildren) in school and trying to address everyone’s mental and physical health.
“This is a community that has a lot of shame, a lot of guilt,” says Laura Brazan, who is raising her granddaughter and grandson in Louisiana. She also hosts the Grandparents Raising Grandchildren podcast.
Grandparents are the silent first responders of the opioid epidemic, she adds. In some cases, grandparents are ousted from their senior living facilities when they take on their grandchildren. Many start working again or dip into their retirement funds to afford increased grocery bills, school costs, and recreational activities.
“We have one car because we can't afford two cars. We don't go out to eat, and our kids cook with us. We can't afford babysitters very often,” Brazan says. “Our family [has] become a real core family, and we're there for those kids. They bring us a lot of joy.”
Yet, many families wonder, as they see states receiving opioid settlement funds into the billions, about the discrepancy between governments’ compensations and their own.
Money to address the opioid epidemic
A handful of states are looking to opioid settlement funds to help address grandparents’ financial challenges and worries. The biggest financial challenges are the basics, according to Najah Bhatty, a social worker who facilitates the Grandparents Raising Grandchildren program at the North Shore Senior Center in Northfield, Ill. Families often need help paying for housing, utilities, food, and clothing.
Cristina Diaz, caregiver program coordinator with suburban Cook County’s area agency on aging, AgeOptions, added, “They're very concerned with the high price of everything. Inflation, the SNAP cuts, especially the SNAP requirements and the SNAP age changes for the kids under their care, are really going to impact folks, unfortunately.”
Money to address the ongoing opioid epidemic comes from the companies that profited most during the opioid crisis. Cardinal, McKesson and AmerisourceBergen — the nation’s three major pharmaceutical distributors — and opioid manufacturer and marketer Johnson & Johnson settled their lawsuits in 2022 for $26 billion. In May 2026, Purdue Pharma and its owners, the Sackler family, reached an additional settlement for $7.4 billion for their role in the epidemic.
States each provide memorandums of understanding concerning how these funds are distributed. In Illinois and in Georgia, advisory boards meet quarterly and make decisions about funding proposals from organizations that work on prevention, treatment, recovery, and harm reduction services.
“While the settlement funds are often directed toward treatment and law enforcement, the hidden cost is being absorbed by the grandparents who have stepped in overnight to raise children left in the wake of this crisis — often with zero financial or systemic support,” Brazan says.
Her granddaughter, for example, required anesthesia to have seven rotten teeth pulled. “Out of pocket, it would have cost us over $27,000 to get her teeth fixed,” Brazan says. Exner’s grandson, meanwhile, needs to have his tonsils and adenoids removed — a surgery that will cost the family about $6,000, even with Exner’s insurance from her job at Sam’s Club.
Generations United is home to the National Center on Grandfamilies, which advocates alongside grandparents and other relatives for improved policies, programs, and support for families, says Deputy Executive Director Jaia Lent.
“We were concerned that as these opioid settlement discussions were happening, children and those kin caregivers were really being left out of many of the discussions about how to use the resources,” Lent says. “So, we put together a resource and have been convening a group of caregiver advocates that have been seeking to raise awareness about the impact of opioids on their families.”
The resource guide offers specific steps to advocate locally for the inclusion of grandfamilies/kinship families in opioid settlement fund allocation. Steps include researching how the funds are being managed in a specific state, attending public meetings, making a pitch for funding, writing a letter to local politicians or newspapers, and connecting with allies.
In February 2025, Elizabeth Mateer, a grandmother in Pittsburgh, Pennsylvania, who is raising her grandson due to her daughter’s substance use, followed those steps. She testified before the U.S. Senate during a hearing on older adults and the opioid epidemic. She called grandparents raising grandchildren “one of the least recognized populations impacted by the opioid crisis.”
Mateer revealed in her testimony that she and her husband had spent years staging interventions and entering their daughter into treatment facilities. Her husband delayed his retirement, as they spent $30,000 on admission deposits, and $10,000 a month in treatment costs. Opioid addiction, Mateer says, “takes a person’s soul and turns them into someone you don’t even recognize. We were desperate to save both mom and baby.”
Now, she says, “Our retirement is nothing like we thought it would be, driving the middle school carpool and hosting the baseball team picnic. We hope to stay healthy so that we can be there for our grandson.”
Like so many grandparents in this situation, their hope runs alongside their worries.
‘The umbrella of my family’
Each state receives a different amount of the opioid settlement funds, depending on the number of people impacted in that state. Georgia’s share of the opioid settlement is $636 million, distributed over 18 years through the state’s opioid abatement fund. Regional advisory councils make initial decisions on grant applications, but there is no formal process for allocating funds to affected grandfamilies.
- PREVIOUS REPORTING: This yearlong program for grandparents raising children strengthens communities for decades
Patricia Lawrence serves as the director of Project Healthy Grandparents, which has been based in the metro Atlanta area since 1995. The community-based research study provides a one-year intervention to grandparents who are raising their grandchildren when the parents are absent. Each year, PHG provides more than 500 registered nurse visits, 370 case management sessions and more than 540 referrals for critical needs, legal counsel and child care.
As state and federal funding dwindles, Lawrence says one of the state contracts funding PHG was cut by 40% in the past year, but she says she plans to apply for a grant through the opioid abatement trust “because a percentage of our grandchildren do end up with their grandparents because of opioids.”
When she first learned about the application process, she says, “It was just too short notice for me to pull something together, but my hope is to try and apply for some funding when that cycle opens up again in 2026.”
Illinois’ share of the settlement funds is $1.4 billion by 2038. About half – 55% – of the money goes to the Illinois Opioid Remediation Trust Fund, which issues payments for approved strategies. The Attorney General’s Office manages the other 45%.
In Illinois so far, no groups have proposed grants to fund grandparents raising their grandchildren due to the opioid epidemic. Many families say they could use the help, including Skokie, Ill., resident Cora Galbreath, who has raised a dozen of her grandchildren and is still working at age 75 to support herself and the three currently living with her.
“I’m the umbrella of my family,” she says.
Galbreath remembers the day 20 years ago now that her caller ID says Chicago Police Department. “When I saw that number come up, I was scared because I knew something had happened,” she says.
The officer on the line asked if she was the grandmother of an 8-year-old boy and his 4-year-old sister. “We’re going to bring you the kids because their mother is in no shape to take them,” Galbreath recalls the officer saying.
“The moment when [the children] arrived, they were all happy because I’ve always been in their lives. But you never know what these kids go through,” Galbreath says.
She has 36 grandchildren and 12 great-grandchildren, many of whom she’s raised — and also worried about. She worries about the trauma they’ve been through, the genetic conditions they may have inherited. “Some of the challenge is just being there. The great-grandkids and grandkids, if they ever need me, I got to be there,” she says.
She’s grateful to God, she says, but the responsibility is tough on her. “It's very hard, just to see them suffer,” she says.
Many states prohibit direct payments of opioid settlement funds to victims. But a few states have approved plans that open up funds to grandparents raising their grandchildren. In others, individual groups are submitting proposals or politicians are trying to pass laws to support kinship caregivers.
Here’s a mid-2026 snapshot of how they’re handling it:
- Alabama — Launched a pilot program through three Area Agencies on Aging, covering 15 counties. As of October 2024, grandfamilies can apply for a one-time grant of up to $2,000 ($500 per grandchild).
- Massachusetts — Boston is distributing up to $5,000 to families that have lost a relative to opioid overdose to cover expenses such as funeral services, childcare, clinical therapy, or legal services.
- New Mexico — New universal childcare regulation in the state exempt grandparents with legal custody of their grandchildren from work and school requirements. This makes them eligible for free childcare. Though the money doesn’t come directly from the opioid settlement funds, advocacy groups are also pushing for monthly stipends from the opioid settlement funds, specifically for grandparents raising grandchildren.
- Ohio — In 2025, nine nonprofits, along with Ohio residents who opioids have harmed, formed the Ohio Partnership of Families Impacted by Opioids. They wrote a proposal to the foundation, OneOhio, that oversees the state’s opioid settlement fund. The proposal outlined a plan for harm-reduction projects with 20% of money awarded going into a family emergency fund to cover child care, rent, and other necessities. The foundation denied the application.
- Pennsylvania — PA House Bill 1528, introduced in the State House of Representatives would establish the Grand-family Assistance Program Fund to direct opioid settlement funds through Area Agencies on Aging to assist grandfamilies with emergency needs and necessities.
‘We thought it would be temporary’
For Brazan, that grief also includes herself. She and her husband relocated 3,333 miles, from a home they’d built on the edge of a national forest in Montana to Louisiana, where they’re closer to her husband’s family.
“My husband is grieving the loss of his son and what his son has done to abandon his children. He's grieving the loss of his son while we're grieving over the situation that we're in and the loss of our retirement,” Brazan says.
When they first took in their grandchildren, ages 3 and 7, the children had never worn seatbelts, had no boundaries, didn’t go to sleep at normal hours, and were covered in bugs and dried feces. “When we took them, we thought it’d be temporary,” Brazan says.
She and her husband were living in Montana at the time, 45 minutes away from a small town. They enrolled the children in a three-room schoolhouse but soon realized they needed special services. The family as a whole needed more support. “So we had to change our whole retirement picture, which a lot of people do,” Brazan says.
She says she had been excited to take in the children at first, thinking she would bring them home, provide warm food and beds, and keep them clean. They would be so thankful, she thought, and happy. “Well, that’s not what happens,” Brazan says, four years later. “I’d never experienced raising children who have been through trauma. There's a lot more involved.”
Though she grieves, she doesn’t complain. “There’s something about sacrificing for others that really does make you stronger. You lose your life, you never stop grieving, but that doesn't mean you would change anything.”
For their first three years together, Brazan says that doing the right thing kept her motivated through navigating school support plans, the children’s mental health and behavioral challenges, and isolation from her peers. “Most people our age want to continue having cocktail parties and going on vacations and traveling. And so we're isolated from our age group,” she says.
Now, though, her perspective has shifted.
“Being able to have an opportunity to change a child’s life, to change the trajectory of a person's life, I can't think of anything I’d rather do,” Brazan says. “As grandparents, as an older generation biologically, there’s something that happens where you become more concerned about legacy than you do about laying on a beach.”
Part of her legacy will likely be the podcast Brazan has created to connect grandparents raising their grandchildren across the country. “I need to share all of this pain I’m going through with others, and I need to share the research and the experts and the stories so that people don’t feel alone,” she says.
Otherwise, worry, fear, and the unknowns could easily overwhelm her. For Brazan, those worries come up as questions: Am I going to be able to do this? What happens when I’m gone? How do we build trust after their sense of safety, right and wrong, and love have been so corrupted?
“Which is why we moved to an area where they had lots of cousins and lots of aunts and uncles and people that come over all the time — so they feel connected,” Brazan says.
She worries about if a major illness hits her or her husband, and about them moving slower. “We can’t crawl around on the floor, and we can’t always run and play baseball,” she says. “But I'll tell you, it makes you age quicker, and it keeps you younger at the same time.”
In Skokie, Galbreath knows that worry. She grew up in Louisiana — Brazan’s new home — raised jointly by her mother and grandmother. She remembers a simpler time of church on Sundays and picking cotton and corn for $3 a day. “My grandmother did not play,” Galbreath says. “We had our own farm. We worked — very hard. We did it all.”
Galbreath is still working hard and doesn’t plan to stop any time soon. She rattles off a list of grandchildren. “They graduated right out of my house. I try my best; I really do,” she says. “It's by the grace of God, I could have been one of those kids.”
And in Florida, Exner’s grandson is preparing to start kindergarten in August. She worries about his ability to sit still in class, but his preschool teacher has assured her that’s normal for his age, that he’s doing just fine.
This story was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and The Silver Century Foundation.
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