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.
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.
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.
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.
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.
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.
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.
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.
The Recovery Den: Rural Walk-In Center
Peer mentors in Walker County, AL logged 2,498 service visits in 2025 at a walk-in recovery center that runs on a $150K settlement award, no appointment needed.
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.
Jail-Based Recovery and Reentry Program
Recidivism sits near 18% for Sevier County, AR's sheriff-led RSAT program, against a roughly 42% state average, on about $372K a year in settlement funds.
LIGHT Program for Justice-Involved Adults
In Selma, AL, Rise and Recover's LIGHT program set a 72-hour target for substance use assessments, down from waits of six weeks or more, for $150K.
Center for Employment Opportunities: Transitional Work and Peer Support
One dedicated peer specialist doubled job success for people in recovery in Louisville, KY, from 15% to over 30%, on a $255K settlement award.
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.