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 program type, population served, community type, and state, 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.
Same-Day Buprenorphine Care for Justice-Involved Adults
A walk-in clinic in Burlington, VT reached 170 new patients in year two by pairing justice outreach with same-day buprenorphine care. Annual cost: $300K.
Police + 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.
The Recovery Den: Rural Walk-In Center
Peer mentors in Walker County, AL logged 2,498 service visits in 2025 at a walk-in recovery center that runs on a $150K settlement award, no appointment needed.
Project Upstream: Prevention and Community Navigation
Project Upstream reaches 500+ residents a year across 8 Greater Manchester, NH communities, pairing prevention with navigation before problems deepen.
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.
Rise Recovery: Youth Addiction Services
Rise Recovery has served 1,538 participants this grant period across a Bexar County, TX youth continuum of school-based recovery, treatment, and peer support.
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.
Barrier Reduction for Homelessness
836 people leaving treatment moved into sober living homes across 20 Kansas counties through Mirror, Inc.'s weekly move-in assistance, all on a $280K award.
LIGHT Program for Justice-Involved Adults
In Selma, AL, Rise and Recover's LIGHT program cut the wait for a substance use assessment from six weeks to 72 hours, for $150K.
AIM Team: After-Hours Peer Response
Hamilton County, OH's AIM Team answered 328 overnight crisis calls in 2025 and drove 215 people directly to treatment after hours, on a $500K settlement budget.
Coalition Building for Prevention Funding
7 of 13 rural Arkansas coalitions won federal Drug Free Communities grants worth $13.1 million, all built on a $325,000 opioid settlement investment.
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.
Center for Employment Opportunities: Transitional Work and Peer Support
One dedicated peer specialist doubled job success for people in recovery in Louisville, KY, from 15% to over 30%, on a $255K settlement award.
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.
Multidisciplinary Homeless Response Team
Lawrence, KS cut unsheltered homelessness from 200+ to under 20 with a six-person peer-led street outreach team, catalyzed by a $200K opioid settlement award.