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.
Bluestem: Family Recovery Housing Preventing Foster Care Placement
Six townhomes in Lakewood, CO are designed to house whole families for a year of treatment and family therapy, with the aim of keeping children out of foster care while a parent recovers. The first family is expected in summer 2026.
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.
Recovery-Friendly Workplace Certification for Employers
124 employers across 25 Colorado counties signed on to a recovery-friendly certification, built on a $500,000 opioid settlement infrastructure 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.
Training Community Members for Frontline Behavioral Health Roles
Five cohorts drew trainees from 13 Kansas counties, preparing community members to work as community health workers with the mental health and addiction skills other courses leave out.
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.
Peer Support Inside the Public Defender's Office
Six settlement-funded peer staff, four direct-service peers plus a partially funded lead and supervisor, work inside Maryland's public defender offices, moving clients from jail into vetted treatment under attorney-client privilege.
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.
Preparing Physicians to Treat Addiction
A $199,929 grant surveyed about 1,480 Sedgwick County physicians, residents, and students on what blocks addiction care, built the training they named, and opened Wichita's first addiction fellowship.
Youth Mentoring as Substance Use Prevention
99% of referred children have an adverse experience. Big Brothers Big Sisters of South Texas is using a $95,000 state settlement award to expand a proven mentoring model into College Station, TX.
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.
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.
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.
Centralized Tracking for Multi-Department Settlement Spending
Santa Clara County, CA puts every internal request for its $89M in opioid settlement funds through a grant-style review, tracked in one shared system.
Gap Analysis and Competitive Bids for Settlement Funds
Sacramento County, CA asked residents where to spend, ran its own gap analysis, and funded ten programs through a competitive bid. Its third-year settlement payment was $1.86M.
Free App for Naloxone Response and Overdose Reporting
A free Arkansas app walks bystanders through naloxone in English, Spanish, and Marshallese and logs the save, built for $296,000 and $8,750 a year to run.
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 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.
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.