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 budget range, 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.
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.
Fort Lyon: Statewide Recovery Housing 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 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.
EMBARK: In-Home Care Coordination for Pregnant Mothers
One coordinator now reaches 17 Kentucky counties, up from four, linking pregnant mothers to prenatal care, treatment and the rent that keeps a baby home.
Immediate Medication Access for the General 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.
Tying Every Settlement Dollar to a Documented Gap
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.
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.
Student-Led Prevention on a Year-Round Rural Calendar
About 35 students in rural Graves County, KY plan and run a 12-month prevention calendar reaching four school systems, on a $90,200 state settlement award.
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.
Paid Therapy for a Rural County's Uninsured Workers
144 residents of Colorado's Gunnison County got 10 paid therapy sessions in 2025, each choosing their own therapist from a network of 57 local clinicians.
19 Local Governments Pooling Settlement Funds
Three Colorado counties pool settlement dollars from 19 local governments under one council, backed by the state's first fiscal-agency relationship policy.
EMPOWERED: Care From Pregnancy to Two Years Postpartum
117 women in Las Vegas got counseling, peer support, and care coordination through pregnancy and two years postpartum, not six weeks, on $594K in settlement funds.
Practical Needs First at a Peer-Run Recovery Hub
622 people reached detox, treatment and sober living in one year, sent by peers at a Jonesboro, AR drop-in center built on a $250,000 settlement award.
Converting a State Building into Rural Treatment Beds
A vacant state office building near Booneville, AR reopened as a licensed 24-bed residential treatment center on a one-time $738,903 settlement award.
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.
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.
Low-Barrier Therapy Scholarships for Rural Recovery
231 people in four rural Colorado counties applied for therapy scholarships that pay $125 a session and ask for no diagnosis and no proof of a problem.
Training Community Members for Frontline Behavioral Health Roles
Five cohorts drew trainees from 13 Kansas counties, teaching community health workers the mental health and addiction skills other courses leave out.
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.