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.
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.
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.
19 Local Governments Pooling Settlement Funds
Three Colorado counties pool settlement dollars from 19 local governments under one council, backed by the first fiscal-agency relationship policy among Colorado's regional councils.
How Six Rural Counties Decide What to Fund
64 community interviews told six rural Colorado counties what to fund, and the resulting plan won a $1.2 million award on two part-time facilitator salaries.
Preparing Physicians to Treat Addiction
A two-year, $199,929 grant surveyed about 1,480 Sedgwick County physicians, residents, and students on what blocks addiction care, built the training they named, and opened Wichita's first addiction fellowship.
Funded Fellowships to Grow a Rural Behavioral Health Workforce
Western Colorado University pays tuition for 6 to 8 graduate fellows a year to run prevention projects in Gunnison County, CO, on a $216,600 settlement award over two years.
Centralized Tracking for Multi-Department Settlement Spending
Santa Clara County, CA puts every internal request for its $89M in opioid settlement funds through a grant-style review, tracked in one shared system.
Gap Analysis and Competitive Bids for Settlement Funds
Sacramento County, CA asked residents where to spend, ran its own gap analysis, and funded ten programs through a competitive bid. Its third-year settlement payment was $1.86M.
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.
Community-Guided Opioid Settlement Administration
Montgomery County, MD built settlement spending to last: a dedicated division, three competitive grant cycles, and funding substantiated for at least 18 years.
Safe and Healthy Macomb: Countywide Opioid Response
Macomb County, MI spent a year mapping gaps before funding a countywide opioid settlement portfolio, and initial data show a 12% drop in six-month recidivism for jail MAT participants.