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.
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.
Volunteer-Run Recovery Fellowship Built on a Meal and a Ride
225 people gather each Friday at a south Louisville, KY church, where settlement funds cover the meal and the rides that bring newcomers back each week.
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.
Fort Lyon: Recovery Housing for Coloradans on a Former Army Post and VA Campus
464 residents lived at The Fort in 2025, a peer-led campus in Bent County, CO where people can stay up to two years to rebuild IDs, income and housing.
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.
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.
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.
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.
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.
Practical Needs First at a Peer-Run Recovery Hub
622 people were referred to detox, treatment and sober living in one year by peers at a Jonesboro, AR drop-in center built on a two-year, $250,000 settlement award.
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.
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.
Peer Support Inside the Public Defender's Office
Six settlement-funded peer staff, four direct-service peers plus a partially funded lead and supervisor, work inside Maryland's public defender offices, moving clients from jail into vetted treatment under attorney-client privilege.
Peer Support Across Jails, Probation, and Recovery Courts
227 justice-involved people in New Hampshire got peer support in 2025 from staff who had lived recovery and incarceration, on $287K a year in settlement funds.
Peer-Led Jail Recovery with Free Outpatient Handoff
80% of participants in a rural northwest Kansas jail class were still in recovery a year later, on $500,000 in opioid settlement awards across two cycles.
Shared Overdose Response Team for Small Police Agencies
Pulaski County, AR shares one overdose team with five small police agencies, pairing a source investigator with a peer, on a $369,824 settlement award.