This is Part 2 of a three-part series examining the impacts of the opioid crisis on children and families in Mississippi and the state’s decisions on how to spend opioid settlement funds. Drew Hawkins reported this story while participating in the USC Annenberg Center for Health Journalism’s 2025 Data Fellowship.
- Part 1: As Mississippi waits to spend opioid settlement funds, children and families suffer
Mississippi will receive more than $400M to fight the opioid epidemic. So far, officials haven't directed it toward programs that support addiction recovery.
On a cool, overcast Tuesday in February, a group of patients at the Fairland Center in Dublin, Mississippi, gathered in the facility’s cafeteria to have donuts and coffee — and share their stories.
Destiny Bean took a survey form and filled it out.
“I am a victim of the opioid crisis,” she wrote. “It has been easier to be prescribed opioids than it has been to receive treatment for the withdrawal the opioids cause, leading to the use of street opioids. Substance treatment costs more than living as an addict for those without insurance."
At tables across the room, the patients filled out forms, wrote down their thoughts on sticky notes — and one of the young children drew a picture of a “health family,” with mom and dad smiling together.
These people — who have seen the impacts of the opioid crisis firsthand — are the voices that did not hold any decision-making power for how Mississippi will spend the hundreds of millions of dollars it’s received from settlements with lawsuits against opioid manufacturers, marketers and distributors.
They were not able to vote and rank funding applications submitted to the Mississippi Opioid Settlement Fund Advisory Council, a group formed by the state’s legislature tasked with receiving, reviewing, and scoring applications requesting a piece of those settlement funds. No one on the council who could grade the applications had real, lived experience of addiction.
Mississippi’s legislature is currently reviewing the recommendations submitted by the advisory council and, this session, is expected to allocate a portion of the funding from the more than $400 million the state is set to receive.
Through listening sessions, community events and callouts in Jackson, Hattiesburg, Dublin and Biloxi, the Gulf States Newsroom traveled nearly 5,500 miles across Mississippi and collected 219 written responses from people with lived experience of addiction. Respondents were free to write whatever they wanted and include as many ideas as they saw fit.
When asked what they believe the state should invest opioid settlement funds in, 55% of respondents said addiction treatment, 40% said support or education for the children and families of people with opioid use disorder, 31% said housing support, 15% said more mental health resources and 3% said transportation.
Additionally, 37% of respondents wrote that they supported Mississippi using the funds for harm reduction, a health-centered approach that reduces drug-related harms and fatal overdoses. It includes practices such as distributing naloxone (Narcan) and fentanyl test strips, as well as syringe exchanges and safe consumption rooms — places where people can use drugs under medical supervision.
Not a single respondent said opioid settlement funds should go to law enforcement, despite that being a common use in Mississippi. As of last summer, less than 1% of settlement funds spent by cities and counties had gone toward addiction-related programs. At least $400,000 has instead been used to pay police salaries, support department operating budgets, and purchase equipment such as body cameras and guns.
In addition to the data, the stories and responses received at these events contain a staggering amount of loss that illustrate the wide-ranging impacts of the opioid crisis.
Heather Marshall drove from North Mississippi to Biloxi for the Black Balloon Day remembrance event on March 6. Her daughter, Emily Johnson, was 21 when she died. She thought she was taking a Xanax. It wasn't — it was fentanyl, and it killed Johnson, her boyfriend, her grandmother, and a friend. Four people, in one night, from a single pill.
"Losing a child is the worst thing that's imaginable," Marshall said. "Something I'll never get over."
Marshall is one of thousands of Mississippi families who know the opioid crisis not as a policy question but as a date on a calendar. For her, it’s August 21, 2024.
For others, the dates are frozen in time:
May 11, 2025, for Jonathan and Shelby Aultman — the day they lost their daughter Chelsea;
April 6, 2015, for James Moore — the day his son Jeffrey died;
Christmas Day 2022, for Kristina at the Fairland Center — when she lost her mother to an overdose;
Mother’s Day 2020 for Alyson Koenig — when her husband overdosed and died while their children watched.
‘Treated me like an animal’
They also described, repeatedly and in their own words, the thing they said made it harder to survive: stigma, or judgment because of a perceived moral failing due to substance use.
James Moore, Jeffrey's father, spent years approaching his son's addiction as a character flaw. He said it took him a long time to understand what his son was actually up against.
"By the time you wake up on time, clean yourself up, dress yourself and feed yourself and get here and clock in at 9 o'clock with the rest of us," Moore told the room at the Hattiesburg listening session, recounting a conversation he once had with his son, "you have probably put more struggle in your day at that point than the rest of us will all day."
He said it was shame associated with stigma from substance abuse that kept his son from asking for help sooner, or from walking into a treatment center. That killed Jeffrey as much as the drugs did.
It’s the same stigma that Brenda Foster witnesses on a daily basis. As lead nurse navigator for the Mississippi State Department of Health's Opioid and Substance Use Disorder Program, she’s spent years sitting across from women at picnic tables outside her office, meeting people where they are — homeless, pregnant, fresh out of the emergency room, out of options.
As someone who’s never struggled with addiction, Foster said she didn't fully understand the weight of stigma until women started telling her directly.
"They would just look at me really funny and start crying," Foster said. "What's wrong? Well, you're the first person that hasn't treated me like an animal."
That response, she said, changed everything for her.
“That's when I started realizing, wait, we have a problem here,” Foster said.
The problem, as Foster describes it, comes from every direction. People with substance use disorder face judgment from the general public, from health care providers who dismiss them as drug-seekers, from the child welfare system and sometimes from within the recovery community itself.
“They get it from all sides — from people who don't understand substance use disorder, from the recovery community who feel like their journey should be just like yours, and it's not,” Foster said.
Casey Akin knows this firsthand. On March 9, 2022, she was found unresponsive in an extended stay motel room. Her three-year-old son found her. She had taken a pill laced with fentanyl. She woke up in a hospital, her son in CPS custody and four weeks pregnant. She called Foster, who told her what her options were.
"I had no idea that it was available," she said of the treatment programs that eventually saved her life. "I had absolutely no idea that it was available, but yet I'm out there in that lifestyle all day."
Akin described being treated with contempt in emergency rooms during her addiction — contempt that, she said, nearly cost her her life.
Foster has made changing that dynamic a central part of her work, partnering with hospitals to train emergency room staff to treat people in withdrawal or seeking help with buprenorphine as patients deserving of care, not suspicion.
"There is a life you can save right there," Foster said, "by simply treating them with respect and dignity and empathy."
Going to Jackson
On March 12, the Gulf States Newsroom brought it all to Jackson — the sticky notes, the written responses, the voices — and set up a table in the Mississippi State Capitol, inviting lawmakers to flip through a binder of handwritten responses and listen to a short audio story drawn from the sessions.
Some stopped. Some listened.
Rep. Bubba Carpenter, a Republican who represents Alcorn and Tishomingo Counties, paused at the table, flipped through the binder and listened to the audio. He said the story of a father losing his daughter around Christmas — Jonathan Aultman’s story — had stayed with him.
"I'm just thinking these folks need to be part of the legislative process to figure out what would be the best for them," Carpenter said of people with lived experience. "Because they're dealing with something that we might not ever know about. Every family probably has somebody they can name.”
Rep. Jeffrey Hullum III, a Democrat who represents Gulfport and Harrison County, listened intently with his eyes closed. He echoed Carpenter in saying people with lived experience should have a say in how the settlement funds get spent.
“Nobody knows better about the opioid crisis addiction than the ones who are afflicted by it and their family members,” Tullum said. “Their family members have to live with this, so we need to make sure this money's getting used in the right way.”
The community's voices still weren't being heard where it counted, Tullum said, and how the money has already been spent made that clear.
The lawmakers the Gulf States Newsroom spoke with at the Capitol expressed support for directing the funds toward treatment, housing and community-based programs. But whether that sentiment will translate into appropriations or inclusion in future decision-making processes is a question that will be answered this session.
For the people whose words filled the table — the sticky notes, the survey forms, the handwritten accounts of loss and survival shared from across Mississippi — the stakes of those decisions are not abstract, and their ideas about how to spend the money meant to help heal some of the damage caused by the opioid crisis are clear.
The Mississippi legislative session ends April 5 — another date on the calendar they’re watching.
This story was produced by the Gulf States Newsroom, a collaboration between Mississippi Public Broadcasting, WBHM in Alabama, WWNO and WRKF in Louisiana and NPR. Support for public health coverage comes from The Commonwealth Fund.
