The State of Michigan formally signed on to the proposed multibillion-dollar national settlements in August 2021, which is with Johnson & Johnson and the three largest pharmaceutical distributors in the country: Cardinal Health, McKesson, and AmerisourceBergen. Based on the settlement terms, there are 277 local units of government eligible to participate in Michigan. Payouts were determined using a formula that takes into account population and the impact of the opioid crisis including the number of overdose deaths, the number of residents with substance use disorder, and the number of opioids prescribed.