Good Afternoon!

As communities across Appalachia continue working to combat the opioid crisis, opioid settlement funds are playing an increasingly critical role in funding prevention, treatment, and recovery efforts. However, a growing concern is emerging nationwide: states are increasingly relying on these settlement dollars to fill gaps left by shrinking federal funding.

A recent CBS News report highlights how some states, facing budget shortfalls and declining federal support, are diverting opioid settlement funds to cover existing programs, raising concerns about whether these dollars are truly being used for their intended purpose—expanding addiction treatment and harm reduction services. As opioid response advocates, we must remain vigilant in ensuring these funds are spent transparently and effectively to create lasting change in our communities.

Visit the AOR Database

To help track how these funds are being allocated, we’re excited to highlight the Appalachia Opioid Remediation (AOR) Database—a comprehensive resource designed to monitor opioid settlement spending across the region. This database provides state-by-state breakdowns, funding trends, and policy insights, ensuring that local leaders, advocates, and community members have access to the information they need to hold decision-makers accountable.

Explore the AOR Database here: AOR Database

With that in mind, here’s this week’s roundup of opioid settlement updates across the region.

The National Harm Reduction Coalition (NHRC), in partnership with the Opioid Response Network (ORN), is offering free virtual training sessions exploring harm reduction, trauma-informed care, and their intersections with homelessness and domestic violence.

February 26 | 2:00 – 4:00 PM ET – Working at the Intersection of Harm Reduction, Homelessness, and Domestic Violence

Learn how intimate partner violence, homelessness, and substance use intersect and how harm reduction can empower survivors.

March 12 | 3:00 – 5:00 PM ET – Trauma-Informed Care for Service Providers

Designed for non-clinical providers, this session covers trauma’s impact on mental health and substance use, with a harm reduction approach to supporting individuals with co-occurring disorders.

Register Here | More sessions coming soon!

Georgia

Douglas County has officially appointed members to its Opioid Advisory Council, a newly formed body tasked with overseeing the county’s opioid settlement funds and ensuring they are used for prevention, treatment, and recovery initiatives.

The advisory council includes representatives from law enforcement, public health, behavioral health services, and community organizations, bringing diverse expertise to the decision-making process. Their primary goal is to strategically allocate opioid settlement dollars to support evidence-based programs that address substance use disorder and overdose prevention in Douglas County.

Kentucky

A heated debate is unfolding in Carter County, KY, as local officials face pushback over a proposal to use opioid settlement funds to build an ice-skating rink. The county has earmarked $15,000 of its opioid abatement funds for the project in November 2024, arguing that it will provide a safe, substance-free space for youth and families to prevent future opioid use.

Critics, including local health advocates and residents, argue that opioid settlement funds should be spent directly on addiction treatment, harm reduction, and recovery services, rather than recreational infrastructure. Community members have taken to social media and local meetings to voice their opposition, while county leaders insist that investing in prevention is a legitimate use of the funds.

Watch community reactions: Facebook Video

in Christian County, KY, local officials are finalizing how to distribute their share of opioid settlement funds, with a strong focus on treatment and prevention. The Christian County Health Department and local recovery organizations are among the entities expected to receive funding to expand addiction treatment, mental health services, and overdose prevention programs.

Louisville Mayor Proposes Using Opioid Settlement Funds for Treatment Services

Louisville Mayor Craig Greenberg has unveiled a plan to use opioid settlement funds to expand substance use treatment and harm reduction services across the city. The proposal, which must be approved by Metro Council, would dedicate $24 million to fund new and existing recovery programs aimed at reducing overdose deaths and improving long-term treatment access.

Key Investments in Greenberg’s Proposal:

• Expanding treatment options for individuals with substance use disorders.
• Increasing access to naloxone and harm reduction services to prevent overdoses.
• Enhancing recovery housing to provide stable environments for those transitioning out of treatment.
• Funding mental health support services to address co-occurring disorders.

Maryland

A new Maryland House bill aims to increase transparency and accountability in how opioid settlement funds are spent across the state. The legislation requires more detailed tracking and reporting of how counties and agencies use their share of the state’s opioid settlement dollars, ensuring funds are allocated to evidence-based prevention, treatment, and recovery programs.

Supporters argue that clearer oversight will prevent misallocation of funds, similar to concerns raised in other states where settlement dollars have been directed toward projects with little direct connection to opioid abatement. Opponents worry that additional reporting requirements could slow down fund distribution for urgent services.

Advocates Push for Full Funding of MAT in Maryland’s Correctional Facilities

A new push is underway to ensure Maryland complies with its legislative mandate to provide Medication-Assisted Treatment (MAT) for incarcerated individuals struggling with opioid use disorder. While Maryland law requires funding for MAT in correctional facilities, advocates argue that the state has yet to fully meet this obligation, limiting access to life-saving treatment for incarcerated individuals. SB-942 outlines viable funding sources, including opioid abatement funds, to successfully implement MAT programs in local detention centers.

MAT, which includes buprenorphine and methadone, is a gold-standard treatment for opioid addiction and has been proven to reduce withdrawal symptoms, lower overdose risk upon release, and improve long-term recovery outcomes. Advocates are calling for full compliance with the funding mandate, emphasizing that denying MAT to incarcerated individuals worsens recidivism rates and perpetuates the cycle of addiction and incarceration.

Baltimore Swears in First-Ever Opioid Restitution Advisory Board

On February 20, 2025, Baltimore Mayor Brandon M. Scott swore in the city’s first-ever Opioid Restitution Advisory Board, a diverse group of experts and individuals with lived experience who will advise the city on the distribution of opioid settlement funds.

“This board is diverse in background, experience, and perspective but united in its commitment to making Baltimore a leader in responding to the opioid epidemic,” said Mayor Scott. “Their voices will be instrumental in ensuring these funds are used effectively and center the needs of all Baltimoreans.”

Board Members Include:

• Public health experts, addiction medicine specialists, and peer recovery coaches
• Individuals with lived experience of opioid use disorder and recovery
• Representatives from city government, law enforcement, and advocacy organizations

Baltimore has also extended the public comment period through March 15, 2025 for residents to provide feedback on:

• The Community Engagement Plan, which outlines public involvement in opioid fund decisions.
• The Accountability and Transparency Plan, which details how funds will be tracked and publicly reported.
• Residents can submit comments here.

Baltimore City Council to Hold Hearings on Opioid Crisis Response and Settlement Funds

The Baltimore City Council has announced plans for four public hearings to assess the city’s response to the opioid crisis, including how opioid settlement funds are being allocated.

Councilwoman Phylicia Porter emphasized the importance of transparency, collaboration, and accountability in addressing the epidemic, which claims an average of two lives per day in Baltimore.

Key Focus Areas of the Hearings:

• City’s Response to Opioid Crisis – Evaluating the efforts of city agencies, healthcare providers, and community organizations in combating opioid addiction and overdoses.
• Opioid Restitution Funds – Ensuring settlement funds are effectively used for prevention, treatment, and recovery initiatives.
• Psychiatric Rehabilitation Programs (PRP) – Reviewing the accessibility, effectiveness, and oversight of behavioral health services.
• Recovery Homes and Substance Abuse Clinics – Addressing the quality and regulation of recovery housing and treatment facilities.

The Mayor’s Office has confirmed its participation, and final hearing dates will be announced soon. The hearings aim to provide critical oversight to ensure Baltimore maximizes its resources and interventions in combating the opioid epidemic.

North Carolina

Nearly a year after receiving $5.3 million in opioid settlement funds, Wilmington and New Hanover County are seeing measurable progress in treatment and overdose prevention efforts. The city-county opioid settlement committee recently reviewed key outcomes, highlighting significant gains in access to medication-assisted treatment (MAT), a decline in overdose rates, and expanded community support programs.

Key Impacts:

• Coastal Horizons’ MAT program at the county detention center has served over 120 individuals in six months, more than doubling the previous year’s numbers.
• Opioid-related deaths and non-fatal overdoses have dropped for the first time in years, with non-fatal overdoses declining by 150 cases and deaths decreasing by nearly 20.
• Economic and social benefits—local leaders emphasized that these funds directly support individuals in recovery while reducing long-term costs on healthcare and law enforcement.

Looking ahead, $4 million has been allocated for 15 programs in the 2025-26 fiscal year, as part of the county and city’s long-term opioid response strategy. New Hanover County and Wilmington will receive a total of $36 million in settlement funds through 2039 to continue supporting prevention, treatment, and recovery initiatives.

Davidson County officials recently provided updates on how they plan to allocate $6.6 million in opioid settlement funds, answering public questions about transparency, spending priorities, and program effectiveness. The county emphasized a balanced approach that includes funding for:

• Harm reduction and prevention programs

• Expanded addiction treatment services

• Support for law enforcement and first responders

With funding decisions still ongoing, Davidson County leaders are working to ensure these dollars make a long-term impact in fighting the opioid epidemic. Further discussion will occur at the March opioid settlement fund committee.

Burke County Opioid Coordinator Position Still Open

Job Opportunity: Opioid Coordinator – Burke County

Salary Range: $88,000 – $108,000

Deadline: Open Until Filled

Burke County is seeking a project manager to oversee its opioid settlement strategies, including community partnerships, coalition-building, and program development. This position will play a key role in reducing opioid-related injuries and deaths in the county.

More details & application: Burke County Careers

Ohio

Mahoning County officials are in the process of determining how to allocate $7.4 million in opioid settlement funds to maximize their impact on prevention, treatment, and recovery efforts.

During recent discussions, local leaders emphasized the need to ensure transparency and strategic investment in programs that will have a long-term effect on reducing opioid-related harm in the community. Officials are considering funding for:

• Expanded substance use treatment programs, including Medication-Assisted Treatment (MAT) and behavioral health services.
• Harm reduction strategies, such as naloxone distribution and overdose prevention education.
• Support for law enforcement and first responders, equipping them with resources to respond to opioid-related emergencies.
• Recovery housing and workforce reentry programs, helping individuals transition from treatment to independent living.

Mahoning County Commissioner Anthony Traficanti stressed the importance of ensuring these funds are used effectively to address the ongoing opioid crisis, rather than being diverted for unrelated expenses. County officials plan to continue gathering input from community stakeholders before finalizing funding allocations.

Pennsylvania

Despite concerns over recent federal funding uncertainties, Pennsylvania officials have reassured the public that addiction treatment and recovery programs remain funded for now. According to Department of Drug and Alcohol Programs Secretary Latika Davis-Jones, there is no immediate risk of losing federal support for substance use services in the state.

However, Davis-Jones acknowledged that long-term stability remains uncertain, particularly as opioid settlement funds are increasingly being used to fill budget gaps in some states. She emphasized that Pennsylvania’s approach is focused on sustainability, ensuring that programs funded through state and federal resources, as well as opioid settlements, remain viable in the years ahead.

Lebanon County Pursues Additional $3.6 Million in Opioid Settlement Funds for Treatment Programs

Lebanon County officials are applying for nearly $3.6 million in second-wave opioid settlement funding to expand treatment and recovery initiatives. This follows the $4.2 million in first-wave funding the county is already receiving, bringing its total opioid settlement allocations to $7.8 million through 2039.

The newly requested funds would help launch two critical opioid response programs, addressing both incarcerated individuals and community outreach:

Opioid Use Disorder Outreach Program – $325,000 over 13 years

• Administered by the RASE Project, this program will provide peer recovery services one day per week across Lebanon County.

Medication-Assisted Treatment (MAT) Induction Program – $1.95 million over 13 years

• This initiative at the Lebanon County Correctional Facility (LCCF) would introduce MAT services for individuals entering the county jail who have not previously been in treatment.
• Commissioners approved the program 2-1, with Commissioner Jo Ellen Litz voting against due to concerns about not requesting competitive bids before selecting PrimeCare Medical to oversee the program.

If the funding is approved, the county will still have $1.35 million remaining from the second-wave settlement funds to allocate toward future opioid abatement efforts.

Tennessee

The Veterans Center of East Tennessee (VCET), a veteran-focused addiction recovery and support center in Rogersville, is seeking $120,000 in opioid settlement funds from the Hawkins County Commission to remain operational beyond April.

Last year, the county provided a one-time contribution of $97,000 in opioid settlement funds to help launch the VCET and its addiction recovery services. While the center hoped to secure grant funding to sustain operations independently, most grant sources require two years of documented expenditures above $50,000 before consideration. As a result, VCET founders Michael and Jessica Paul returned to the county’s Budget Committee this week to request additional funding.

The county’s Budget Committee postponed a decision on the request, citing the need to assess how much opioid settlement funding remains available for the upcoming fiscal year. Some committee members expressed support for funding the VCET but not covering its entire annual budget. Finance Director Eric Buchanan noted that other organizations may also request opioid settlement funds, requiring careful allocation.

West Virginia

Mason County Commission Approves $70K in Opioid Settlement Funds

The Mason County Commission has approved $70,000 in opioid settlement funds to support substance use prevention, treatment, and recovery efforts in the community. During the February meeting, commissioners also approved an AmeriCorps request, highlighting a broader push to address opioid-related challenges through public service initiatives.

Fairmont to Open Opioid Settlement Funding Applications by Spring

City officials in Fairmont, WV plan to open applications for opioid settlement funding this spring, allowing local organizations and service providers to apply for grants aimed at addressing substance use disorder, treatment expansion, and harm reduction.

The Fairmont City Council has been working on developing a structured application process to ensure funds are allocated transparently and effectively, prioritizing programs that have a lasting impact on the opioid crisis.

Preston County Advisory Board Focuses on Long-Term Opioid Settlement Strategy

The Preston County Opioid Settlement Advisory Board provided its first round of updates to county commissioners, emphasizing a data-driven approach to identifying specific needs and funding priorities.

Key updates from the board include:

• Four meetings held so far, with ongoing discussions on long-term strategies.
• A focus on sustainability, ensuring that programs continue beyond the life of the settlement funds.
• Collaboration with local experts to determine how best to allocate funding for prevention, treatment, and recovery services.

Maryland‘s Office of Opioid Response “MOOR” Grant—application info. (Due 2/28)

Dauphin County, Pennsylvania — application info. (DUE 2/28)(courtesy of OpioidSettlementTracker.com)

Miami County, Ohio— application info. (DUE 2/28)(courtesy of OpioidSettlementTracker.com)

Montco 2024 Implementation Grant, Pennsylvania— application info. (Due 3/3)

Richmond County, North Carolina — application info. (DUE 3/17), mandatory pre-application meeting 2/24 (courtesy of OpioidSettlementTracker.com)

Weirton, West Virginia — application info. (“[f]unding decisions are made by the Weirton City Council”) (courtesy of OpioidSettlementTracker.com)

Harrison County, Kentucky

The Harrison County Fiscal Court has issued a Request for Proposals (RFP) for projects aimed at preventing and addressing the impact of the opioid epidemic. Funding is available for organizations focusing on opioid prevention, harm reduction, treatment, and recovery, including support for substance use disorder, polysubstance use, and co-occurring mental health issues.

• Application Period: February 1, 2025 – March 31, 2025
• Funding Period: July 1, 2025 – June 30, 2026

The number of awards and funding amounts will vary annually based on available settlement funds. Interested entities can obtain the full RFP package from the Bluegrass Area Development District or online at Harrison County Fiscal Court News.

Virginia STOP! Grant— application info. (DUE 4/1)