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.
Recovery Village Pairing Certified Housing With Daily Rides
48 certified recovery beds opened near Martinsburg, WV in April 2025, with vans leaving at 4:30 a.m. to take residents to jobs, appointments and family visits.
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.
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.
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.
Monarch Sober Living Homes: Women's Recovery Housing
A $1.2 million capital purchase put an 11-bed women's recovery home in Wheat Ridge, CO under a 15-year contract that recaptures funds if the operator exits.
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.
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.
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.
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.
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.
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.
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.
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.
Youth Success Center for Prevention and Family Stabilization
Carter's Crew reached 5,000+ Arkansas youth in 2024 and is converting a 27,000-square-foot former school into a one-stop prevention and recovery hub for families.
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.