Baltimore has reached a $45 million settlement with pharmaceutical company Allergan related to the city’s lawsuit tied to the opioid epidemic. It’s a big sum compared to what the city would have received had it joined Maryland in a similar agreement.

City leaders took a gamble in 2023 when they became the only jurisdiction in the state to opt out of Maryland’s settlement with drug companies in hopes of securing a larger payout. Maryland settled with Allergan Finance LLC for $38 million. That global settlement would have awarded Baltimore just $7 million spread over seven years, according to news release from city officials on Monday.

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Under the city’s own deal, Allergan has agreed to pay the full $45 million sum within 30 days.

City leaders touted the deal as “an unprecedented recovery” that bolsters their continuing litigation against other opioid manufacturers. Allergan’s two drugs, Kadian and Norco, made up less than half a percent of the opioids sent to Baltimore pharmacies. Other defendants in the city’s suit were responsible for more than 80% of the opioids targeted at Baltimore pharmacies, officials said in the release.

“We are fully aware of the devastating toll that the actions of these defendants have taken on our City, and we have shown our commitment to ensuring that they pay their fair share to tackle the harms they have left in the wake of their greed,” said Baltimore City Mayor Brandon Scott in the release. “We are committed to ensuring that every penny of this and any other amount recovered is put to its most effective and best use to combat the opioid epidemic in Baltimore City at all levels.”

Scott announced plans to create a board that will oversee how the settlement money is spent and promised more details would be released soon. As part of the settlement, city leaders have committed to using at least $5 million for a peer navigator program, which supports people at various stages of recovery, and $5 million of the recovery for Charm City Care Connection, a nonprofit advocacy group serving individuals and communities affected by drug use and other issues.

Baltimore has long been the center of the deadly opioid epidemic in Maryland, with about 42% of the 2,456 fatal overdoses in the city in the year ending in January, the latest state data shows. The majority are linked to the powerful synthetic opioid fentanyl.

The deaths dropped slightly overall in Maryland in the data, but ticked up about 8% in the city, which is also showing a rise in cocaine-related deaths.

The Baltimore Banner and The New York Times recently published a yearlong joint investigation detailing overdose deaths in Baltimore. Nearly 6,000 people have died from overdoses in the last six years, the worst drug crisis ever seen in a major American city.

Many of the established programs in the city are aimed at harm reduction, which means passing out the opioid overdose remedy naloxone, providing clean needles to reduce spread of infection and testing for fentanyl. This is in addition to linking people to appropriate services, including addiction treatment with medications such as suboxone to ease withdrawal and curb cravings.

The overdose deaths nationally have exceeded 100,000 each year since 2021 largely because of fentanyl, which has supplanted heroin in street drugs along with other cheaply made and often dangerous additives. Many people do not know what they are using, and small amounts used once can kill.

Officials have said the coronavirus pandemic interrupted services for many people, setting back efforts to combat the epidemic.

The Baltimore City Council has scheduled a hearing later in June to examine the city’s response to the epidemic and The Banner’s findings.

This story will be updated.