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.
Building a Behavioral Health Clinic and a Regional Workforce
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.
Therapeutic Mentoring for Rural Middle and Early High School Boys
In Gunnison County, CO, eight to 12 boys per cycle meet weekly with a therapist and are matched with paid mentors who have their own recovery experience.
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.
Paid Therapy for a Rural County’s Uninsured and Underinsured Residents
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.
EMPOWERED: Care From Pregnancy to Two Years Postpartum
117 women in Las Vegas received counseling, peer support, and care coordination through pregnancy and two years postpartum in 2025, supported by upward of $1 million in settlement funds since July 2023.
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.
Bluestem: Family Recovery Housing Preventing Foster Care Placement
Six townhomes in Lakewood, CO are designed to house whole families for a year of treatment and family therapy, with the aim of keeping children out of foster care while a parent recovers. The first family is expected in summer 2026.
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.
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.
Free Trauma Care Aimed at Veteran Substance Use
Sojourn Counseling uses Alabama settlement funds to treat combat and childhood trauma in veterans with EMDR and neurofeedback, at no cost to them.