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.
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.
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.
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.
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.
Rapid Responders & Community Programs Continuum
In Wake County, NC, Healing Transitions sends peer and EMS responders to overdose survivors within 24 to 72 hours, when re-engagement is most likely.
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.
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.
Safe and Healthy Macomb: Countywide Opioid Response
Macomb County, MI cut six-month recidivism 12% for jail MAT participants by steering $19.3M in opioid settlement funds to gaps across a countywide portfolio.