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.
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.
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.
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.
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.
Walk-In Recovery Centers Across Seven Rural Counties
More than 6,000 people walked into a Lee County, KY recovery center since 2022, and the model now runs across seven rural counties on $865K in settlement awards.
Recovery-Friendly Workplace Certification for Employers
124 employers across 25 Colorado counties signed on to a recovery-friendly certification, built on a $500,000 opioid settlement infrastructure award.
Training Community Members for Frontline Behavioral Health Roles
Five cohorts drew trainees from 13 Kansas counties, preparing community members to work as community health workers with the mental health and addiction skills other courses leave out.
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.
Peer Support Inside the Public Defender's Office
Six settlement-funded peer staff, four direct-service peers plus a partially funded lead and supervisor, work inside Maryland's public defender offices, moving clients from jail into vetted treatment under attorney-client privilege.
Free Take-Home Naloxone at Emergency Departments
54 Virginia emergency departments now hand patients a free naloxone kit at discharge, with settlement funds covering the one cost no payer reimburses.
Peer Support Across Jails, Probation, and Recovery Courts
227 justice-involved people in New Hampshire got peer support in 2025 from staff who had lived recovery and incarceration, on $287K a year in settlement funds.
Peer-Led Jail Recovery with Free Outpatient Handoff
80% of participants in a rural northwest Kansas jail class were still in recovery a year later, on $500,000 in opioid settlement awards across two cycles.
Free App for Naloxone Response and Overdose Reporting
A free Arkansas app walks bystanders through naloxone in English, Spanish, and Marshallese and logs the save, built for $296,000 and $8,750 a year to run.
Shared Overdose Response Team for Small Police Agencies
Pulaski County, AR shares one overdose team with five small police agencies, pairing a source investigator with a peer, on a $369,824 settlement award.
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.
Police and Peer Post-Overdose Response Team
In Hot Springs, AR, a peer specialist and a police investigator visit overdose survivors together, reaching people in the hours when they are most open to help.