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.
Residential Treatment Where Mothers and Infants Stay Together
16 women and 16 infants can live together at a renovated Roanoke, VA house, where settlement funds keep care going after Medicaid authorization ends.
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.
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.
Bmore POWER: Peer Street Outreach at 12 Weekly Neighborhood Sites
In Baltimore, MD, a street outreach team staffed entirely by people with lived and living experience holds weekly sites and moves in when overdoses cluster.
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.
Police and Peer Post-Overdose Response Team
In Hot Springs, AR, a peer specialist and a police investigator visit overdose survivors together, reaching people in the hours when they are most open to help.
Youth Success Center for Prevention and Family Stabilization
Carter's Crew reached 5,000+ Arkansas youth in 2024 and is converting a 27,000-square-foot former school into a one-stop prevention and recovery hub for families.
Rise Recovery: Youth Addiction Services
Rise Recovery uses a ~$247K state opioid CORE contract to expand a Bexar County, TX youth continuum of school-based recovery, treatment, and peer support. Its programs overall have served 1,538 participants this grant period.
Friendly PEERsuasion at Girls Inc.
Girls Inc. of Central Alabama trains eighth-grade girls as peer leaders to carry substance misuse prevention to younger students, on a $75K annual award.
Comprehensive Addiction in Pregnancy Clinic
UAB's weekly Birmingham clinic gives pregnant women with substance use disorder prenatal care, medication, treatment, and peer support in one visit, on $342K a year.
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.
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.
Pathways to Progress: Residential Recovery Expansion
In Champaign-Urbana, IL, a single renovation expanded entry-level recovery capacity 40% and reserved 10 of 26 beds for opioid-impacted adults, on a $580,000 settlement grant.
Multidisciplinary Homeless Response Team
Lawrence, KS reduced unsheltered homelessness from more than 200 people in 2023 to under 20 by early 2026, with a six-person peer-led street outreach team supported in 2025 by a $200K opioid settlement award.