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.
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.
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.
Peer Support Inside the Public Defender's Office
Six settlement-funded peers work inside Maryland's public defender offices, moving clients from jail into vetted treatment under attorney-client privilege.
Peer Support Across Jails, Probation, and Recovery Courts
227 justice-involved people in New Hampshire got peer support in 2025 from staff who had lived recovery and incarceration, on $287K a year in settlement funds.
Shared Overdose Response Team for Small Police Agencies
Pulaski County, AR shares one overdose team with five small police agencies, pairing a source investigator with a peer, on a $369,824 settlement award.
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 + 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.
Rapid Responders & Community Programs Continuum
In Wake County, NC, Healing Transitions sends peer and EMS responders to overdose survivors within 24 to 72 hours, when re-engagement is most likely.
Rise Recovery: Youth Addiction Services
Rise Recovery has served 1,538 participants this grant period across a Bexar County, TX youth continuum of school-based recovery, treatment, and peer support.
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.
First Responder Confidential Support Program
Rhode Island police officers and their families made 10 to 12 confidential helpline calls a week within two months of launch, on $200K over two years.
AIM Team: After-Hours Peer Response
Hamilton County, OH's AIM Team answered 328 overnight crisis calls in 2025 and drove 215 people directly to treatment after hours, on a $500K settlement budget.
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.
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.