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.
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.
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.
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.
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.
Free Take-Home Naloxone at Emergency Departments
54 Virginia emergency departments now hand patients a free naloxone kit at discharge, with settlement funds covering the one cost no payer reimburses.
Police-Led Youth Drug Prevention Curriculum
27 of 28 Virginia Beach school resource officers now teach the LEAD drug prevention curriculum in local classrooms, funded entirely by a $140K settlement award.
Emergency Departments as Bridges to Recovery
82% of ER patients linked to follow-up care in the first year. Seven Virginia health systems are adopting the model, and a $150K settlement award funds the free toolkit and statewide webinars.