Good afternoon,
As we approach the final edition of the AOR Newsletter next week, we want to thank everyone who has followed along, submitted updates, and helped us track the impact of opioid settlement funding across Appalachia. This week marks the last opportunity to take our 2-minute reader survey before the newsletter pauses. With just 11 responses from nearly 900 subscribers, early results point to a clear preference: readers value policy analysis and spending transparency. Sections on grant opportunities and meetings are viewed as less useful, and we’ll use that feedback to refocus future content.
This week’s national spotlight highlights growing concerns over the misuse of opioid settlement funds. Reports from Partnership to End Addiction and KFF Health News document widespread diversions of dollars meant for treatment and recovery—ranging from luxury concerts to law enforcement infrastructure—despite clear settlement guidelines. With only three states offering formal mechanisms to report misuse, a new crowdsourced database launched by the Opioid Policy Institute and Popular Democracy could help improve oversight and empower communities to take action.
Let’s ensure these funds are used as intended—to save lives and build long-term recovery infrastructure.
Warmly,
The AOR Team
State Updates
Alabama
Alabama continues to expand its use of opioid settlement funds through infrastructure upgrades and legal victories. In Tuscaloosa County, settlement dollars are supporting new medical monitoring equipment in the jail, aimed at improving inmate care and staff response to medical crises. Meanwhile, Attorney General Steve Marshall announced a new $11.7 million settlement with eight additional opioid manufacturers, adding to the nearly $730 million Alabama has secured to date. These companies—Mylan, Hikma, Amneal, Apotex, Indivior, Sun, Alvogen, and Zydus—will pay fines over the coming years, while several are barred from manufacturing or marketing opioid products. The funding will further Alabama’s aggressive abatement and public health response efforts.
🔗 Tuscaloosa County jail upgrades
Georgia
Georgia will receive an additional $20 million in opioid settlement funds as part of a national agreement with eight pharmaceutical companies, bringing the state’s total secured to over $1 billion. Attorney General Chris Carr announced the funds will support addiction treatment, prevention, and recovery services across Georgia, especially in overdose-impacted regions. The new settlements restrict marketing of high-dose opioids, with Indivior agreeing to cease opioid production entirely for the next 10 years. Carr also highlighted law enforcement efforts like “Operation Hold the Line” and the Gang Prosecution Unit’s fentanyl seizures as part of the state’s broader strategy to fight the crisis.
Kentucky
Kentucky continues its statewide push to improve transparency, public input, and infrastructure around opioid settlement funding. The Kentucky Opioid Abatement Advisory Commission is hosting a public comment session in Lexington on July 24 in partnership with Project Ricochet to gather feedback and answer grant-related questions. Meanwhile, a new Opioid Funds Spending Portal is live and all cities must report their use of funds by August 31 under regulation 040 KAR 9:020.
In Carter County, Renee Parsons from the Business Cultivation Foundation confirmed that the Olive Hill Arts & Heritage Center received $80,000 in opioid settlement funding to expand its music and theater programming. In Clark County, local officials are planning a Recovery Community Center and reviewing use of funds with support from KACo and ASAP.
In Murray, the City Council approved a partnership with Volunteers of America Mid-States to launch a new Recovery Community Center, with services such as peer support, recovery group meetings, referrals, and sober social events. The center will be staffed predominantly by individuals in recovery, with $100,000 annually provided by the city, contingent on state grant support.
🔗 KYOAAC Spending Discussion – July 24
🔗 Olive Hill Tourism: Opioid Funds Support Music and Theatre
Maryland
Maryland is facing a critical crossroads in its opioid settlement strategy following federal budget cuts to addiction and mental health services. The Maryland Opioid Restitution Fund Advisory Council is urging the state not to backfill lost federal funding with settlement dollars, emphasizing the need to prioritize long-term investments in harm reduction, recovery, and prevention. Maryland will receive $250 million over 15 years, with 70% allocated to localities.
On July 1, new legislation expanded how counties can access and use these funds. House Bills 728 and 729 modified the rules of the Opioid Restitution Fund to give local governments greater control. Another bill established a paramedic training program to expand access to buprenorphine, supporting faster intervention and overdose reversal in the field.
The Maryland Office of Overdose Response released updated recommendations for localities, emphasizing family-centered support, street-based outreach, naloxone distribution, recovery access, and diversion programs.
🔗 Federal Budget Forces Opioid Funding Decisions
🔗 Maryland Updates Opioid Fund Rules & Launches Buprenorphine Program
Mississippi
Mississippi’s path toward distributing its opioid settlement funds is gaining momentum but remains fraught with delays and scrutiny. The newly formed Opioid Settlement Fund Advisory Council held its first meeting on July 9, with members expressing concern about the lack of clarity in proposed rules and the grant application process. Supreme Court Chief Justice Michael Randolph and others emphasized the need for transparency and accountability, warning against the misuse of public health dollars—a problem seen in the state’s past handling of tobacco and TANF funds.
Mississippi has received $85 million in opioid settlements so far, with the council overseeing $73.3 million. Originally aiming to open the grant application in mid-July, the state now anticipates a brief delay as eligibility and scoring criteria are refined. Meanwhile, public health initiatives like the naloxone vending machine installed in the Jackson Medical Mall—funded by private groups—demonstrate growing momentum for harm reduction. Mississippi could also receive another $6.3 million through a national settlement involving eight opioid manufacturers.
🔗 Opioid advisory council meets in Jackson
🔗 Mississippi struggles to finalize distribution process
🔗 State could receive $6.3M in new settlement
🔗 Naloxone vending machine launches in Jackson
New York
New York continues to lead nationally in securing opioid settlement funds and translating them into direct public health investments. On July 10, Attorney General Letitia James announced an additional $720 million settlement with eight pharmaceutical companies, bringing the state’s total secured for abatement, treatment, and prevention efforts to more than $3 billion. New York will receive up to $38.7 million from this latest agreement, alongside additional treatment medications and restrictions on future opioid sales.
At the city level, Mayor Eric Adams and Acting Health Commissioner Dr. Michelle Morse reported the lowest quarterly overdose death rate in five years, marking progress in reversing the epidemic. In response, New York City is allocating $4 million annually to nine providers to expand low-threshold access to methadone and buprenorphine. These services are part of a broader strategy under the HealthyNYC initiative to reduce overdose deaths by 25% by 2030.
North Carolina
North Carolina continues to advance its opioid settlement efforts with local innovation, state-level coordination, and significant new funding. Cumberland County and Fayetteville will receive another $575,000 from the latest $720 million national opioid settlement involving eight drug makers. These funds will support housing and treatment expansion priorities identified by community members. To date, the area has secured over $35.58 million in settlement funds and has seen a 32.7% drop in ER overdose visits.
Guilford County held its third annual stakeholder input session to evaluate ongoing efforts, including naloxone and test strip distribution, new residential treatment construction, and expanded harm reduction services. Haywood County announced it will use $2 million of its $9.6 million allocation to expand peer support and psychiatric care in a new treatment and prevention program. Orange County opened registration for its second annual community update, and a new portal launched for cities to report fund use.
The Attorney General’s office confirmed North Carolina will receive up to $23 million from the latest national settlement and reminded eligible counties and municipalities to sign on within three months to maximize funding.
🔗 Orange County Opioid Meeting
🔗 Guilford County stakeholder session
🔗 NC AG announces $720M settlement
Ohio
Counties across Ohio are leveraging opioid settlement funds to build recovery housing, expand crisis response infrastructure, and strengthen youth prevention programs. Washington County allocated $842,617 in its third round of funding, including $350,000 to establish the Shawn Patrick Recovery House, honoring a young man lost to addiction. Other grants went to nonprofits supporting reentry, domestic violence survivors, youth services, and county recovery specialists.
Cuyahoga County is shifting $7 million in settlement funds toward a new behavioral crisis center at the former St. Vincent Charity Hospital. The 24/7 facility—slated to open in 2026—will offer crisis stabilization, detox, and long-term treatment linkage, replacing the county’s existing diversion center. Though some officials raised concerns about sustainability and the transition, advocates applauded the expanded service model.
Jefferson County used settlement dollars to support the Sycamore Youth Center’s after-school programming ($25,000) and the Jefferson County Resource Network ($30,000), focusing on prevention and education. Meanwhile, Trumbull County committed $92,000 to upgrade its jail’s body scanner to improve safety by detecting hidden contraband.
🔗 Washington County Recovery House funding
🔗 Cuyahoga County crisis center plan
🔗 Jefferson County supports youth programs
🔗 Trumbull County jail scanner upgrade
🔗 Cuyahoga County commits $7M to crisis center
Pennsylvania
Pennsylvania’s opioid settlement landscape continues to evolve—bringing both programmatic progress and mounting public concern over transparency.
A major investigative report by Spotlight PA revealed that the Pennsylvania Opioid Misuse and Addiction Abatement Trust, which oversees the state’s $2 billion settlement allocation, is not subject to the state’s Right-to-Know Law. Despite its authority to distribute—and withhold—funding from counties, the Trust is shielded from public records access. Critics, including families affected by the opioid crisis, argue that this undermines accountability and community trust.
Meanwhile, Philadelphia’s pivot away from community-led grantmaking is drawing criticism. The Parker Administration ended its partnership with the Scattergood Foundation and launched a city-managed initiative, shifting away from participatory funding models that many grassroots groups valued. Delays and a lack of transparency left nonprofits scrambling to sustain summer programming.
On a more positive note, the PA General Assembly passed legislation to expand naloxone distribution and enhance pharmaceutical transparency (SB 95). And in July, Washington County allocated $842,617 in its third settlement disbursement, with $350,000 going toward the creation of the Shawn Patrick Recovery House.
🔗 Spotlight PA: Opioid Trust Transparency Concerns
🔗 Kensington Voice: Community Groups Navigate Funding Shift
South Carolina
South Carolina is set to receive up to $10 million as part of a new $720 million national opioid settlement with drug manufacturers including Mylan, Hikma, Amneal, Apotex, Indivior, Sun, Alvogen, and Zydus. According to Attorney General Alan Wilson, the funds will support opioid treatment and prevention programs statewide. Most companies in the agreement are barred from promoting opioids and selling products containing over 40mg of oxycodone. Indivior, while excluded from that marketing ban, is restricted from manufacturing or selling opioids for 10 years but may continue distributing medications for opioid use disorder. South Carolina joins nine other states in this latest settlement effort.
🔗 WIS-TV: South Carolina to Receive Up to $10M from Opioid Settlement
Tennessee
Tennessee counties continue to shape local opioid abatement strategies through active governance and community engagement. In Sumner County, the Opioid Abatement Committee met on July 16 to debate expanding commissioner involvement to improve oversight and advocacy. While the group favored retaining its ad hoc format for flexibility, members emphasized the importance of prioritizing prevention and including voices from local schools in future planning.
Meanwhile, Marshall County scheduled its own Opioid Abatement Committee meeting for July 15 at the Courthouse Annex to advance local planning efforts.
🔗 Rutherford County Commissioners Debate Committee Structure
🔗 Sumner County Opioid Abatement Committee Meeting Agenda (July 16, 2025)
Virginia
Virginia continues to scale up opioid response initiatives with support from the Virginia Opioid Abatement Authority. Richmond installed new vending machines stocked with naloxone and test strips, and Montgomery County approved over $4.95 million in abatement funds across three programs. Two new residential treatment programs—Strong Futures in Norton and Four Truths in Roanoke—will provide recovery housing for pregnant and parenting women. The state also secured $16.4M from a multistate opioid settlement with eight drugmakers. Madison County accepted a $1,011 settlement from the Henry Schein litigation. Meanwhile, Richmond County’s board resolved a months-long internal conflict involving opioid funds, and Montgomery County also approved participation in a related settlement.
🔗 Montgomery County Budget Actions
West Virginia
West Virginia First Foundation released its first local expenditure report covering July 2023–June 2024, detailing how cities and counties are using opioid settlement funds. The report includes outcome highlights, funding amounts, and awardee details. Notably, Buckhannon allocated $50,000 for addiction counseling scholarships at Wesleyan College, and the GameChanger program—despite concerns about its lack of research evidence—has already received $310,000 from Harrison, Marion, and Mason counties to implement school-based youth prevention education. A new curriculum, developed by Hartley Health Solutions, will launch in fall 2025.
Governor Patrick Morrisey announced West Virginia recorded the largest year-over-year reduction in overdose deaths in the country—nearly 41%—with opioid-related deaths down 69%, fentanyl deaths down 71%, and meth deaths down 64%. The state attributes progress to expanded treatment, prevention, and stricter enforcement policies under legislation like Lauren’s Law.
Yet, accountability concerns persist. A statewide investigation by WVU journalism students found inconsistent local oversight in distributing funds, with limited community engagement and a lack of expert input. Programs like Lauren’s Wish and the Neighborhood S.H.O.P. received WV First Foundation grants, but many harm reduction efforts—especially syringe service programs—were excluded from funding despite strong evidence of effectiveness. Counties like Boone used funds instead for jail costs or infrastructure, while Preston County created an advisory board of individuals with lived experience to guide spending.
In Charleston, city council approved a $1 million grant initiative managed by United Way, with a new nine-member opioid community council—including someone in long-term recovery—tasked with evaluating funding requests in prevention, treatment, and recovery.
🔗 Buckhannon/Wesleyan scholarships
Grant Opportunities
For more grant opportunities, check out: OpioidSettlementTracker.com. To share unlisted grant opportunities, email tips@OpioidSettlementTracker.com. For other tips, contact aor@communityeducationgroup.org.
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