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 budget range, 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.
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.
HEART: Treatment That Follows People Into Custody
37 people in a northwest Virginia regional jail keep their opioid medication from the day they are booked, with counseling, peer support and groups inside.
Paid Therapy for a Rural County's Uninsured Workers
144 residents of Colorado's Gunnison County got 10 paid therapy sessions in 2025, each choosing their own therapist from a network of 57 local clinicians.
EMPOWERED: Care From Pregnancy to Two Years Postpartum
117 women in Las Vegas got counseling, peer support, and care coordination through pregnancy and two years postpartum, not six weeks, on $594K in settlement funds.
Converting a State Building into Rural Treatment Beds
A vacant state office building near Booneville, AR reopened as a licensed 24-bed residential treatment center on a one-time $738,903 settlement award.
Low-Barrier Therapy Scholarships for Rural Recovery
231 people in four rural Colorado counties applied for therapy scholarships that pay $125 a session and ask for no diagnosis and no proof of a problem.
Rural Treatment Court Built on Existing County Capacity
Danville and Pittsylvania County, VA run a five-phase treatment court on $209,000 a year, using the court, probation and clinic capacity they already had.
Same-Day Buprenorphine Care for Justice-Involved Adults
A walk-in clinic in Burlington, VT reached 170 new patients in year two, more than triple its target, on $150,000 a year to each of the two partner agencies.
Free Trauma Care Aimed at Veteran Substance Use
Sojourn Counseling uses Alabama settlement funds to treat combat and childhood trauma in veterans with EMDR and neurofeedback, at no cost to them.
Continuum of Care Recovery for Justice-Involved Adults
The Shoulder runs an Alabama continuum that carries justice-involved adults from residential treatment through recovery, housing, and employment.
Jail-Based Recovery and Reentry Program
Recidivism sits near 18% for Sevier County, AR's sheriff-led RSAT program, against a roughly 42% state average, on about $372K a year in settlement funds.
Emergency Departments as Bridges to Recovery
82% of ER patients linked to follow-up care in the first year, and 7 Virginia health systems are adopting the model through a free toolkit built on a $150K award.
Comprehensive Addiction in Pregnancy Clinic
UAB's weekly Birmingham clinic gives pregnant women with substance use disorder prenatal care, medication, treatment, and peer support in one visit, on $342K a year.
Eastern Ohio Correction Center: MAT & Aftercare
Eastern Ohio Correction Center launched MAT and aftercare for ~340 incarcerated people a year across nine Appalachian counties for $199,721.