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.
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.
Dedicated Prison Social Workers From Screening to Reentry
1,928 people in 12 Virginia prisons were served in 2025-2026 by settlement-funded social workers who carry substance use care from screening through release.
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.
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.
COMPASS: Rapid MAT Access for the Jail Population
97 people were on medication in the Chesterfield County, VA jail, delivered by a six-person team held separate from the therapeutic community already running.
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.
HEART: Treatment That Follows People Into Custody
37 people in a northwest Virginia regional jail keep their opioid medication from the day they are booked, with counseling, peer support and groups inside.
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.
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.
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.
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.
Continuum of Care Recovery for Justice-Involved Adults
The Shoulder runs an Alabama continuum that carries justice-involved adults from residential treatment into recovery and job placement, with workforce training and agency-run housing in development.
Rise Recovery: Youth Addiction Services
Rise Recovery uses a ~$247K state opioid CORE contract to expand a Bexar County, TX youth continuum of school-based recovery, treatment, and peer support. Its programs overall have served 1,538 participants this grant period.
Emergency Departments as Bridges to Recovery
82% of ER patients linked to follow-up care in the first year. Seven Virginia health systems are adopting the model, and a $150K settlement award funds the free toolkit and statewide webinars.
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.
Eastern Ohio Correction Center: MAT & Aftercare
Eastern Ohio Correction Center used a $199,721 opioid settlement award to fund injectable MAT and a dedicated aftercare specialist for residents from nine Appalachian Ohio counties.