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.
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.
Building a Behavioral Health Clinic and a Regional Workforce
100 free Mental Health First Aid seats and student internships are underway in Beckley, WV, as a recovery nonprofit readies its new behavioral health clinic.
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.
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.
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.
Paid Therapy for a Rural County’s Uninsured and Underinsured Residents
144 Gunnison County, Colorado residents received scholarships for up to 10 paid therapy sessions in 2025, each choosing a therapist from a network of 57 local clinicians.
Converting a State Building into Rural Treatment Beds
A former 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.
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.
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.
Funded Fellowships to Grow a Rural Behavioral Health Workforce
Western Colorado University pays tuition for 6 to 8 graduate fellows a year to run prevention projects in Gunnison County, CO, on a $216,600 settlement award over two years.
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.
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.
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.
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.