In April 2020, the FXB Center for Health and Human Rights at Harvard University, Doris Duke Charitable Foundation, First Focus on Children, and Open Society Foundations convened a group of experts in public health, harm reduction, drug policy, and child welfare. The experts shared ideas on how to direct the opioid litigation settlement funds toward structural and policy reform that advances public health and health equity. The recommendations found in this position paper reflect the views of those participants.