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.
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 the Workforce to Staff It
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.
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.
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.
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.
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.
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.
Paid Therapy for a Rural County's Uninsured Workers
144 Gunnison County, Colorado residents received scholarships for up to 10 paid therapy sessions in 2025, each choosing a therapist from a network of 57 local clinicians.
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.
Converting a State Building into Rural Treatment Beds
A former state office building near Booneville, AR reopened as a licensed 24-bed residential treatment center on a one-time $738,903 settlement award.
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.
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.
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.
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.
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.
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.