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 program type, population served, community type, and state, 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.
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.
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.
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.
Free Trauma Therapy Model for Veterans
Sojourn Counseling uses Alabama settlement funds to treat combat and childhood trauma in veterans with EMDR and neurofeedback, at no cost to them.
Campus Naloxone Training and Peer Recovery Model
In two years, the University of Central Arkansas trained 874 people in overdose response and served 294 through peer recovery, on a $202K settlement award.
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.
Emergency Departments as Bridges to Recovery
82% of ER patients linked to follow-up care in the first year, and 7 Virginia health systems are adopting the model through a free toolkit built on a $150K award.
Barrier Reduction for Homelessness
836 people leaving treatment moved into sober living homes across 20 Kansas counties through Mirror, Inc.'s weekly move-in assistance, all on a $280K award.
LIGHT Program for Justice-Involved Adults
In Selma, AL, Rise and Recover's LIGHT program cut the wait for a substance use assessment from six weeks to 72 hours, for $150K.
Coalition Building for Prevention Funding
7 of 13 rural Arkansas coalitions won federal Drug Free Communities grants worth $13.1 million, all built on a $325,000 opioid settlement investment.
Eastern Ohio Correction Center: MAT & Aftercare
Eastern Ohio Correction Center launched MAT and aftercare for ~340 incarcerated people a year across nine Appalachian counties for $199,721.