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.
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.
Coordinator-Led Medication Treatment Across Two County Jails
250+ people take opioid use disorder medication in Santa Barbara County, CA's two jails, a third of all in custody, and leave with a follow-up appointment.
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.
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.
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 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.
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.
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.
Free Trauma Care Aimed at Veteran Substance Use
Sojourn Counseling uses Alabama settlement funds to treat combat and childhood trauma in veterans with EMDR and neurofeedback, at no cost to them.
Continuum of Care Recovery for Justice-Involved Adults
The Shoulder runs an Alabama continuum that carries justice-involved adults from residential treatment into recovery and job placement, with workforce training and agency-run housing in development.
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.
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.
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.
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.