Thank you for reading and sharing the Appalachia Opioid Remediation (AOR) Newsletter. Since its launch, this newsletter has provided regular, detailed updates on how opioid settlement funds are being spent across Appalachian states—connecting community advocates, public health leaders, and policy experts to emerging trends and transparency efforts.
As of this edition, we are pausing the AOR Newsletter. This work has been entirely unfunded, and we are actively seeking sustainable support to continue it in the future. We deeply appreciate your readership, engagement, and patience as we consider what’s next. If you haven’t already, please take our final reader survey to help us shape what comes next.
In the meantime, we encourage you to explore the full state-by-state summaries in this edition, as well as the key national updates below:
• NGA Task Force Priorities for FY26: The National Governors Association’s Public Health and Disaster Response Task Force urged Congress to fund essential programs that address disasters, public health infrastructure, behavioral health, cybersecurity, and maternal health. Read the full letter here.
• Commentary on Purdue and Narrative Shift: Dr. Lynn R. Webster challenges the dominant narrative that opioid settlements should serve solely as restitution for Purdue Pharma’s actions. Instead, he argues for sustained investment in upstream drivers like mental health care, housing, and employment. Read his piece, “Continued Blaming of Purdue Pharma Won’t Solve the Opioid Crisis,” here.
Lastly, if you’re looking to stay informed during our hiatus, don’t miss the curated list of national opioid fund trackers and transparency tools included in this edition.
With gratitude,
The AOR Team
State Updates
Alabama
Oversight:
🔗 Opioid Settlement Fund Oversight Commission
🔗 Alabama Opioid Overdose and Addiction Council
Spending Updates:
🔗 Walker County uses $200K in opioid funds to launch mental health mobile crisis team
Walker County Commissioners approved $200,000 in opioid settlement funds to support a new mental health mobile crisis team through Northwest Alabama Mental Health Center. The program will be co-funded by the state after two years. Officials emphasized long-term sustainability, early intervention, and county-wide support for addressing mental health and substance use crises.
Funding Threats:
🔗 Alabama officials worry about life-saving Narcan program’s future as CDC grants stall
State and county officials raised alarms over potential disruptions to naloxone distribution as CDC’s OD2A funding faces delays. Jefferson County, which has seen a 42% drop in overdose deaths, attributes progress to wide-scale naloxone distribution and worries that without continued federal support, overdose fatalities could climb again. Some are considering using opioid settlement funds as a fallback, despite concerns about sustainability.
Bid Opportunity:
🔗 Opioid Settlement Funds – Services RFP
Alabama issued a Request for Proposals from nonprofit and government agencies to implement programs aligned with Exhibit E of the opioid settlement agreements. Projects must address prevention, treatment, recovery, or other authorized interventions.
Georgia
Oversight:
🔗 Georgia Opioid Abatement Trust
Spending Transparency:
🔗 List of Grantees and Award Amounts
The Georgia Opioid Abatement Trust has published a comprehensive list of all grantees and their award amounts, offering full transparency into settlement fund distribution across the state. The list includes local governments, nonprofits, and treatment providers implementing a wide range of prevention, treatment, and recovery services.
Kentucky
Oversight:
🔗 Kentucky Opioid Abatement Advisory Commission (KYOAAC)
Transparency and Reporting:
🔗 Webinar Recap: Opioid Settlement Fund Reporting Portal
As of July 1, 2025, Kentucky local governments are required to use a new online portal to report their use of opioid settlement funds. A July 22 webinar provided a walkthrough of the system and the expectations for FY2025 reporting. All reports are due by August 31, 2025. This represents a step toward stronger accountability and transparency.
Maryland
Oversight:
🔗 Maryland Opioid Restitution Fund
County Activity:
🔗 Prince George’s Health Department Seeks $106.7M Budget Amid Funding Challenges
Prince George’s County proposes using $12.1 million from its new opioid local abatement special revenue fund to support remediation efforts as part of its FY2026 health department budget. The county anticipates continued state funding over the next 18 years. Staffing shortages and budget uncertainties remain key concerns.
🔗 Talbot County Approves $96K in Micro Grants for Community Support
Talbot County approved $96,800 in opioid microgrants to five local organizations through its restitution fund. These grants are intended to sustain prevention and crisis response programs often overlooked by larger state funding streams.
🔗 Kent County Commissioners Approve Local Abatement Plan
Kent County adopted a local abatement plan, enabling access to state settlement funds for prevention and treatment programs. Commissioners emphasized the need for transparency and are exploring new public reporting strategies.
Mississippi
Oversight:
🔗 Office of the Attorney General – Opioid Settlement
Current Status:
Mississippi has not released public reporting on how opioid settlement funds are being allocated or spent. While Attorney General Lynn Fitch’s office maintains a general overview webpage, there is no state-managed dashboard, list of grantees, or documentation on local or state-level use of funds. Stakeholders continue to call for increased transparency and accountability.
New York
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Oversight: 🔗 Opioid Settlement Fund Advisory Board (OSFAB) 🔗 FY2023 Opioid Settlement Fund Tracker Reporting and Transparency: Debate over Federal Backfill Intensifies Tensions are rising in New York’s Opioid Settlement Fund Advisory Board over whether to recommend using settlement funds to offset an anticipated $3 billion federal Medicaid shortfall: Some board members criticized the state for moving too slowly—reporting $200 million unspent—and warned against using settlement money as a budget stopgap. Others defended the state’s pace, citing multi-year contracts and complex disbursement procedures. The board’s chair withdrew a vote on the issue after members remained split. A decision may come in September, just before the October 1 federal budget deadline. Despite internal friction, OASAS highlighted a 32% reduction in overdose deaths statewide, attributing the success to ongoing OSF-funded initiatives like medication access, recovery support, and harm reduction. 📰 Finger Lakes 1: “New York opioid board divided on covering federal funding losses” 📰 Spectrum News: “Opioid funding board clashes on involvement in N.Y. fed funding fight” |
North Carolina
Oversight:
🔗 NC Opioid Settlement Official Website
Reporting and Transparency:
Haywood County’s Plan Faces Pushback Over 12-Step Clubhouse Exclusion
Haywood County approved a $2.9 million spending plan for opioid settlement funds—its share of the nearly $10 million to be received over 18 years—emphasizing treatment and diversion programs. But a coalition of people in recovery urged the commissioners to fund a permanent facility for 12-step meetings. Despite emotional public comments and general commissioner support, the final budget excluded any clubhouse funding.
The seven-part, $2.93 million strategy includes:
- $1M+ for housing, peer support, job training, transportation, and childcare
- $500K for jail-based addiction treatment
- $500K for diversion programs
- $350K for evidence-based treatment
- $250K for reentry programs
- $200K for naloxone distribution
- $100K for employment services
Haywood is following the Option A pathway under the state’s MOA, choosing from Exhibit A strategies rather than undergoing a broader strategic planning process. Expenditures will be tracked under a new multi-year settlement project fund, with annual reports required. Contracts with local partners will be finalized in future meetings.
Ohio
Oversight:
Reporting and Transparency:
Chillicothe Approves Opioid Fund Participation and Housing Initiative
The Chillicothe City Council voted to participate in a new national opioid settlement, bringing additional funds into the city. Discussions also included returning $34,486 in unspent COVID-19 relief funds and authorizing bond funds for new vehicles. The city continues to prioritize affordable housing development, while also addressing public concerns around environmental safety at a former industrial site.
Cuyahoga County Launches Peer Navigator Program at Jail with Opioid Funds
Using a state allocation from the Opioid Remediation Grant, Cuyahoga County is developing a Peer Navigator and Support program to assist residents at the Corrections Center who are impacted by mental health and substance use disorders. Three full-time navigators will begin support while individuals are in custody and continue care post-release. The program—run in partnership with MetroHealth—is part of a broader effort to reduce crises and promote long-term recovery within the jail population. Proposals for service providers are due August 8.
📰 Chillicothe Town Council Meetings
📰 Cuyahoga County Press Release
Pennsylvania
Oversight:
🔗 PA Opioid Misuse and Addiction Abatement Trust
There are no new press or public meeting updates this week, but the Trust continues to oversee the distribution of opioid settlement funds across Pennsylvania’s 67 counties and eligible municipalities. The Trust’s online platform offers transparency into awards and reporting requirements, with ongoing data collection on fund use for prevention, treatment, recovery, and public safety efforts.
South Carolina
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Oversight: 🔗 South Carolina Opioid Recovery Fund (SCORF) Board South Carolina could receive up to $10 million through a new national settlement involving eight drug manufacturers, including Mylan, Hikma, and Indivior. The state joined nine others in the agreement, which also includes restrictions on opioid marketing and distribution. According to Attorney General Alan Wilson, the funds will support treatment and prevention programs across the state. |
Tennessee
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Oversight: 🔗 Tennessee Opioid Abatement Council Reporting and Transparency: Sumner County held an Opioid Abatement Committee meeting on July 16 to discuss increasing commissioner involvement and potentially formalizing the committee structure. Members emphasized flexibility, prioritizing prevention, and including representatives from local schools to strengthen community-based strategies. Marshall County held its own Opioid Abatement Committee meeting on July 15, though no detailed summary was publicly posted. Rutherford County officials debated shifting from an ad hoc to a formal committee structure while reaffirming the importance of commissioner representation and community input. They agreed that long-term, prevention-focused strategies would be critical. |
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Virginia
Oversight:
🔗 Virginia Opioid Abatement Authority
🔗 YouTube Channel for Meeting Recordings
Reporting and Transparency:
Leadership: Governor Glenn Youngkin appointed Jenny Sachs, Ph.D., LCSW, CIP, to the Virginia Opioid Abatement Authority board. 🔗 Press Release
Local spending: Arlington County allocated $400,000 in settlement funds to create a three-year epidemiologist position supporting opioid prevention and education efforts through the Arlington Addiction Recovery Initiative. Board members emphasized this would not require taxpayer funding. 🔗 Full article
Technical assistance: A recording of the July 24 Abatement Academy is now available. The session provides updates on funding streams, reporting requirements, and technical support for grantees. 🔗 Watch here
West Virginia
Oversight:
🔗 West Virginia First Foundation
🔗 2025 Local Spending Report (FY2024)
Spending summary:
According to a July 2025 analysis by West Virginia Watch, local governments in West Virginia spent just $6.9 million (9.4%) of the $72.8 million they received in FY2024 opioid settlement funds. Out of 226 recipients, 144 reported no expenditures, and 16 failed to submit reports.
🔗 See the full article with interactive tables
Key spending categories:
- Law Enforcement: $3.64M
- Includes cruisers, radios, salaries, and restitution for past policing costs
- Largest line item: $352K from Princeton to its general fund
- Quick Response Teams (QRT): $685K
- Notably, Charleston spent $500K on QRT and mental health staff through CARE
- Emergency Medical Services (EMS): $643K
- Equipment, vehicles, and supplies—e.g., $95K from Wheeling for medical gear
- Jail Fees: $519K
- Clay, Grant, and Upshur counties used funds to offset incarceration costs
- Treatment & Recovery: $444K
- Mostly nonprofit grants and support to Day Report Centers (e.g., $200K from Cabell County to Lily’s Place)
- Youth Services: $413K
- GameChanger alone received over $270K from Marion County
- Some funds went to summer camps, magicians, and track repairs
- Government Transfers: $354K
- Includes general fund infusions and interlocal payments (e.g., Mingo to Kermit)
The spending raised concerns about the disproportionate use of funds on enforcement rather than treatment, prevention, or long-term public health infrastructure.
Settlement Trackers
Under each state summary, you’ll find a direct link to that state’s opioid settlement council, abatement authority, or oversight body (where available). For broader data collection, transparency efforts, and national context, explore the following resources:
Opioid Settlement Tracker
https://www.opioidsettlementtracker.com/globalsettlementtracker
Tracks how opioid settlement funds are distributed across states and municipalities.
National Academy for State Health Policy (NASHP)
https://nashp.org/state-tracker/state-opioid-settlement-spending-decisions
Maintains a state-by-state tracker of opioid settlement spending decisions.
MuckRock Settlement Spending Reports
Investigative journalism platform monitoring local government transparency and spending, including opioid fund usage.
KFF Health News – Opioid Settlement Reporting Project
https://kffhealthnews.org/opioid-settlements
Covers how states are spending (or failing to spend) opioid settlement funds.
Johns Hopkins Bloomberg School of Public Health – Opioid Industry Documents Archive (OIDA)
https://www.industrydocuments.ucsf.edu/opioids
Houses public records, litigation documents, and corporate materials related to the opioid industry and settlements.
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