Good evening,

Across Appalachia, communities are showing what’s possible when we come together to tackle the evolving overdose crisis. This month brought both reasons for hope and reminders of the challenges ahead.

At the national level, leaders, advocates, and frontline workers gathered in Nashville for the 2025 Rx and Illicit Drug Summit. The event highlighted innovative programs, including youth-driven prevention campaigns and progress in reducing overdose deaths in several states. Community Education Group was on-site, connecting with partners and sharing updates from the Appalachia Opioid Remediation (AOR) project.

Recent CDC data shows a shifting landscape. While fentanyl-related deaths have declined in some states, overdoses involving stimulants like meth and cocaine are increasing. States are responding with a wide range of strategies, including expanded naloxone access, syringe services, drug checking tools, and emergency department-based treatment. Many of these efforts are funded through opioid settlement dollars.

At the same time, hundreds of federal grants were abruptly canceled by the Department of Justice. These cuts have disrupted support for victims, recovery programs, and violence prevention efforts across the country, creating uncertainty for many organizations already doing critical work on the ground.

Despite these challenges, Appalachian states continue to lead with creativity and commitment. In this issue, we highlight local initiatives, grant opportunities, and upcoming meetings from across the region. Each story reflects the power of community-driven solutions and shared resolve to build a better response.

Thanks for being part of this work.

— The CEG Team

Community Education Group had the honor of presenting two posters at this year’s Rx and Illicit Drug Summit in Nashville, highlighting our Appalachia Opioid Remediation (AOR) work. We also hosted a table and had the chance to reconnect with our partners on North Carolina’s Opioid Settlement Technical Assistance Team (OSTAT) and others from across the Appalachian region.

The summit brought together thousands of prevention, treatment, and policy leaders from all 50 states. Kentucky Attorney General Russell Coleman delivered a keynote address, sharing the state’s new youth-focused campaign, “Better Without It,” which uses student athletes and influencers to promote healthy, drug-free lifestyles.

It was a powerful reminder of how collaboration across states and sectors can move this work forward.

Alabama

Chairman Rex Reynolds outlined a robust use of the state’s $300M+ in opioid settlement funds, including $41M in this year’s appropriations for treatment, prevention, recovery, and law enforcement initiatives. The state is investing in higher education partnerships, with $3M split between UAB, Auburn, and USA Health. It also launched the “Opioids Take” campaign to improve public awareness and access to services, and allocated $1.5M to expand veteran-specific mental health and substance use programs.

Georgia

Macon-Bibb County is deploying nearly $500,000 in opioid settlement funds to:

• Install vending machines offering Narcan, test strips, and hygiene supplies in high-risk areas
• Launch a jail-based Overdose Education & Naloxone Distribution (OEND) pilot
• Expand public education around fentanyl, xylazine, and methamphetamine use

Kentucky

• Louisville’s proposed $1.2 billion budget includes opioid funds to open two new 24/7 shelters, and expand emergency response programs with co-responder teams and medical staff on behavioral health calls.
• Carter County is forming a community advisory board to guide opioid fund use, with a strong emphasis on youth prevention and innovative pilot programs. Public town halls were held April 24 and May 13.
• The Council for Postsecondary Education received $500,000 to open five Collegiate Recovery Resource Centers supporting students with substance use challenges.

Maryland

Maryland is preparing to release its second round of opioid settlement grants this July, prioritizing small, community-based organizations. In March, the state awarded $12.4 million to 28 groups including:

• Baltimore Safe Haven for LGBTQ+ harm reduction services
• Youth Empowerment Source for school-based prevention and naloxone distribution

The state has also expanded MOUD access in correctional facilities and is investing in continuity of care for people reentering the community.

Mississippi

Mississippi Today has hired reporter Allen Siegler to lead accountability journalism around the state’s opioid settlement spending and mental health services. The state, emerging from federal oversight, is receiving hundreds of millions in opioid settlement funds. Coverage will track investments at both local and state levels to ensure transparency and effectiveness.

North Carolina

• Wilson County has installed five naloxone kiosks in strategic locations using federal and settlement dollars. These repurposed newspaper racks provide free 24/7 access to Narcan, test strips, and harm reduction education. The model is expanding to Edgecombe, Nash, Warren, and Wayne counties.
• Cumberland County is offering up to $800,000 across five projects. Proposals must include cross-sector partnerships and be delivered via the county’s Recovery Resource Center. A priority scoring system gives extra weight to small nonprofits and organizations new to county funding.

Ohio

Ohio’s rural counties are finding creative ways to maximize modest settlement allocations:

• Noble County, with $100,000 in funds, is investing in school prevention, court system improvements, and setting aside a portion for future initiatives. “We plan on using every penny,” said Commissioner Allen Fraley.
• Knox County created cross-sector focus groups to guide funding decisions, while Lima partnered with Allen County to pool resources and avoid duplicating infrastructure.
• Trumbull County proposed a $3 million, three-year plan to:

• Launch jail-based behavioral health treatment and job training
• Hire a reentry case manager to coordinate services
• Upgrade body scanners to prevent drug smuggling
• Continue a workforce development program through Flying High Inc.

Separately, Trumbull County received a $750,000 grant from the Ohio Attorney General to:

• Hire two full-time social workers and a part-time nurse
• Provide medications for opioid withdrawal in the jail

Seneca County has allocated $350,000 of its settlement funds, with two-thirds supporting the PIVOT Drug Court and one-third going to rural EMS. Commissioner Paradiso emphasized the focus on sustainability and alignment with community infrastructure.

Pennsylvania

Restorative Roots, Luzerne County’s only licensed male recovery house network, is expanding to serve more residents. The operators have applied for opioid settlement funds to support stays for eight clients. However, uncertainty looms as federal grant cuts threaten $150K in recovery services funding for the county.

South Carolina

Laurens County has authorized a $1.9 million anti-opioid education program for 8,500 students, in partnership with Play Safe. Two local staff will deliver school- and parent-based prevention messages. Plans also include a treatment component and a Memorandum of Understanding (MOU) to facilitate implementation. Additionally, Laurens County emphasizes transparency by adopting public comment changes tied to opioid fund deliberations and broader governance practices.

Tennessee

Sumner County continues to be recognized for forward-thinking implementation. Since forming its opioid committee, overdose deaths have decreased by nearly 27%—far exceeding the statewide decline of 5–6%. Investments include funding for Recovery Court expansion, capital improvement planning, and innovative vending machines offering naloxone and harm reduction supplies. The county has also partnered with the University of Tennessee and will be highlighted at a statewide opioid abatement summit for exemplary fund stewardship. Watch the full opioid abatement committee meeting here.

Virginia

Virginia has emerged as a national leader in reducing fentanyl overdose deaths, achieving a 44% drop in 2024, the largest decline in the country according to the CDC. This success has been attributed to a comprehensive approach combining local, state, and federal collaboration, a robust public awareness campaign led by First Lady Suzanne Youngkin, and targeted opioid abatement investments. Richmond, VA, alone has invested over $380,000 in peer recovery programs, distributing funds across five organizations including CARITAS, the McShin Foundation, and Saint Luke Legacy Center to expand peer training and service delivery. The New River Valley Regional Commission has also launched a multi-county recovery ecosystem emphasizing anti-stigma campaigns, mobile harm reduction, and youth-led education—demonstrating the power of regional planning and cross-sector leadership.

West Virginia

West Virginia continues to prioritize infrastructure and emergency shelter access through its opioid settlement funds. In Huntington, Mayor Patrick Farrell announced that $1.3 million of the city’s allocation will fund a new low-barrier shelter offering housing, food, and on-site addiction services. Despite some community concerns about location, officials emphasized that public safety and community integration remain central to the project’s design.

Lawrence County, TN Round 2: Opioid Abatement Settlement Grant— application info. (DUE 5/4)

Cumberland County, NC (RFP) to Address Opioid Crisis— application info. (DUE 5/30)

Want your event or upcoming meeting published in the AOR newsletter? Email us at AOR@communityeducationgroup.org