Opioid Settlement Case Studies: Real Programs, Budgets & Outcomes
This library documents how communities across the country are using opioid settlement and abatement funds to expand prevention, treatment, recovery, and overdose prevention services. Each case study profiles a single program in a single jurisdiction and details its funding, partners, design, and outcomes, from same-day buprenorphine care in Burlington, Vermont, to a rural walk-in recovery center in Walker County, Alabama.
Use the filters to sort by settlement category, service type, population served, community type, state, and annual funding, then open any profile to review the budget, results, and lessons learned. Each model is presented as a reference point rather than a prescription, so you can adapt the elements that fit your community's needs and capacity.
One Shared Settlement Dashboard for Colorado's 19 Regions
19 regional councils across Colorado will share one public dashboard linking opioid settlement spending to local outcomes, built by a university data team.
Residential Treatment Where Mothers and Infants Stay Together
16 women and 16 infants can live together at a renovated Roanoke, VA house, where settlement funds keep care going after Medicaid authorization ends.
Recovery Village Pairing Certified Housing With Daily Rides
48 certified recovery beds opened near Martinsburg, WV in April 2025, with vans leaving at 4:30 a.m. to take residents to jobs, appointments and family visits.
Dedicated Prison Social Workers From Screening to Reentry
1,928 people in 12 Virginia prisons were served in 2025-2026 by settlement-funded social workers who carry substance use care from screening through release.
Public Health and Grants Offices Co-Managing Settlement Dollars
$124 million in Baltimore, MD moves through two paired city offices, one for public health strategy and one for grants, with every award on a public dashboard.
Naloxone Distribution Mapped to Local Overdose Data
Alamance County, NC tracks every naloxone dose by zip code, sending staff with a wagon to motel corridors and placing vending machines where overdoses cluster.
Turning a $25K Planning Grant Into a Federal Prevention Award
$25,000 in settlement funds paid for a year of training and grant-writing help in England, AR, and the coalition then won a five-year federal prevention grant.
Building a Behavioral Health Clinic and a Regional Workforce
100 free Mental Health First Aid seats and student internships are underway in Beckley, WV, as a recovery nonprofit readies its new behavioral health clinic.
Coordinator-Led Medication Treatment Across Two County Jails
250+ people take opioid use disorder medication in Santa Barbara County, CA's two jails, a third of all in custody, and leave with a follow-up appointment.
College-Led Training for Addiction Counselors and Court Volunteers
More than 100 child welfare staff and volunteers trained for two days in Buckhannon, WV, and 10 scholarships backed addiction counseling certificate students.
Volunteer-Run Recovery Fellowship Built on a Meal and a Ride
225 people gather each Friday at a south Louisville, KY church, where settlement funds cover the meal and the rides that bring newcomers back each week.
Bmore POWER: Peer Street Outreach at 12 Weekly Neighborhood Sites
In Baltimore, MD, a street outreach team staffed entirely by people with lived and living experience holds weekly sites and moves in when overdoses cluster.
Fort Lyon: Recovery Housing for Coloradans on a Former Army Post and VA Campus
464 residents lived at The Fort in 2025, a peer-led campus in Bent County, CO where people can stay up to two years to rebuild IDs, income and housing.
Therapeutic Mentoring for Rural Middle and Early High School Boys
In Gunnison County, CO, eight to 12 boys per cycle meet weekly with a therapist and are matched with paid mentors who have their own recovery experience.
EMBARK: In-Home Care Coordination for Pregnant Mothers
One coordinator now reaches 17 Kentucky counties, up from four, linking pregnant mothers to prenatal care, treatment and the rent that keeps a baby home.
Membership Recovery Café Where Every Employee Is a Peer
10,166 Kentuckians came through a peer-led recovery café in Lexington since 2024, where every staff member is in recovery and members join a weekly circle.
Monarch Sober Living Homes: Women's Recovery Housing
A $1.2 million capital purchase put an 11-bed women's recovery home in Wheat Ridge, CO under a 15-year contract that recaptures funds if the operator exits.
COMPASS: Rapid MAT Access for the Jail Population
97 people were on medication in the Chesterfield County, VA jail, delivered by a six-person team held separate from the therapeutic community already running.
Tying Settlement Dollars to Documented Gaps
Yolo County, CA maps its substance use gaps with providers before it spends, then ties every dollar of a $397,500 settlement budget to a documented need.
Prenatal Care and Addiction Medicine on One Team
10 to 12 pregnant clients at a time get prenatal care, addiction medicine and peer support from one team in Reno, Nevada, on $445K a year in settlement funds.