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.
One Shared Settlement Dashboard for Colorado's 19 Regions
19 regional councils across Colorado will share one public dashboard linking opioid settlement spending to local outcomes, built by a university data team.
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.
Turning a $25K Planning Grant Into a Federal Prevention Award
$25,000 in settlement funds paid for a year of training and grant-writing help in England, AR, and the coalition then won a five-year federal prevention grant.
Tying Settlement Dollars to Documented Gaps
Yolo County, CA maps its substance use gaps with providers before it spends, then ties every dollar of a $397,500 settlement budget to a documented need.
19 Local Governments Pooling Settlement Funds
Three Colorado counties pool settlement dollars from 19 local governments under one council, backed by the first fiscal-agency relationship policy among Colorado's regional councils.
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.
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.
Campus Naloxone Training and Peer Recovery Model
In two years, the University of Central Arkansas trained 874 people in overdose response through the ARORP naloxone hero program and served 294 through peer recovery on a $202K settlement award.
Coalition Building for Prevention Funding
7 of 13 rural Arkansas coalitions won federal Drug-Free Communities grants totaling about $4.3 million, built on a $325,000 opioid settlement investment.
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.