Good afternoon,

Across the Appalachian region, we’re seeing real momentum as local leaders, community groups, and public health partners continue turning opioid settlement dollars into meaningful action. From expanding access to harm reduction and treatment to investing in recovery support and prevention, the work happening on the ground is both inspiring and urgently needed.

We also want to extend our deepest sympathies to those in Kentucky who were impacted by the recent tornadoes. Our thoughts are with the families who lost loved ones and with the communities working to recover and rebuild.

What stands out this week is the creative, community-driven energy behind these efforts. Whether it’s rural hospitals in Georgia ramping up their response, Kentucky counties exploring how best to support children and families, or North Carolina locals pushing for more direct services, people are stepping up with care and commitment.

We hope this week’s roundup offers a helpful snapshot of what’s happening across the region, along with new ideas, funding opportunities, and upcoming public meetings to support your work.

–The CEG Team

Georgia

Georgia is making data-driven investments to reduce opioid-related harm, with overdose deaths sharply declining since mid-2023. Georgia Southern University received nearly $800,000 from the Opioid Crisis Abatement Trust to support four key projects:

• Strengthening critical access hospitals’ ability to respond to the opioid crisis in rural areas.
• Training recovery community organization leaders in nonprofit management.
• Mapping harm reduction services and assessing policy barriers and workforce gaps.
• Enhancing Georgia Southern’s collegiate recovery program for students in recovery.

Additionally, in Bulloch County, local leaders have advocated for using opioid settlement funds to support treatment programs like Freedom Through Recovery.

Kentucky

Local governments continue to navigate the use of opioid settlement funds:

• Trigg County budgeted $228,748 for FY2026 for addiction prevention, treatment, and transportation services. Officials are awaiting strategic guidance from the local health board.
• Christian County included $100,100 in administration funds for settlement planning and is developing a proposal to expand jail-based treatment and counseling.
• The Kentucky Association of Counties (KACo) has created an opioid settlement resource library and hired a staff member to assist counties with planning and implementation.

Maryland

Maryland saw a 31% drop in overdose deaths in 2024—its largest decline in nearly a decade:

• Advocates credit the decline to expanded naloxone access, increased use of buprenorphine and methadone, and system-level improvements.
• State and local leaders warn, however, that proposed federal budget cuts could undermine these gains, especially the elimination of the $56 million naloxone grant program.
• Emphasis is being placed on contingency management, mobile nursing teams, and addressing racial disparities in treatment access.

New York

New York reported a 32% decrease in overdose deaths and continues to expand opioid settlement investments:

• $400 million in new funding has supported new treatment clinics, like the methadone clinic in Saranac Lake, funded with over $800,000 to serve rural Adirondack communities.
• The state is also supporting:
• Mobile outreach and harm reduction teams in Saratoga County.
• The RISE Above residential rehab and street outreach program.
• Expansion of naloxone and fentanyl test strip distribution.
• Officials are prioritizing access to medication-assisted treatment and tailoring outreach to disproportionately impacted populations, including young Hispanic men.

North Carolina

North Carolina’s opioid settlement strategies continue to evolve:

• Brunswick County included extensive investments in its FY26 recommended budget, including:
• A clinician in DSS to support opioid-related crisis response.
• Expanded residential recovery services through providers like CRCI and The Healing Place.
• A health educator focused on prevention.
• Sustained support for the Community Paramedicine and ARROW jail-based treatment programs.
• Naloxone distribution to at-risk individuals and their social networks.
• Statewide, Attorney General Josh Stein announced a tentative $86 million national settlement with Indivior, with North Carolina expected to receive $2.5 million.
• Dare County approved its FY26 opioid settlement budget, allocating:
• $115,000 for a Recovery Court Case Manager.
• $71,400 for a Peer Support Specialist.
• $65,300 for naloxone and test strips.
• $60,000 each for jail-based programming and treatment.
• $12,000 for social determinants of health-related supports.
• Harnett County partnered with local hotels to provide naloxone training for frontline staff.

Pennsylvania

Allegheny County has announced a $20 million allocation from opioid settlement funds to support multiple strategies:

• $8.8 million for substance use disorder treatment in the county jail, including a newly licensed medication-assisted treatment (MAT) unit
• $2 million for peer support programs to maintain recovery post-release
• $3.5 million to expand recovery housing, creating at least 130 new beds
• Investment in mobile harm reduction units offering supplies and wound care
• Launch of an open solicitation platform for future funding proposals, with July 2025 application deadlines

Additional context:

• Preliminary 2024 data shows a 39% drop in overdose deaths in Allegheny County
• Advocates warn that federal budget cuts may jeopardize continued harm reduction efforts

South Carolina

In Greer, City Council approved nearly $400,000 in opioid funds for:

• Treatment and recovery services at the Indigo Hope Neighborhood Impact Center, delivered by the Forrester Center for Behavioral Health

Tennessee

Nashville’s first free naloxone vending machine has seen rapid uptake:

• Up to 1,500 naloxone doses distributed weekly through a partnership with Fund Recovery and Twice Daily
• Metro Nashville plans to use part of its $23 million settlement allocation to launch a broader recovery initiative

Additional efforts:

• New “Leave Behind” programs equip first responders to distribute naloxone and harm reduction tools directly to those most at risk
• Nashville saw a 25 percent drop in overdose deaths from 2023 to 2024

West Virginia

The West Virginia First Foundation awarded $17 million in initial settlement funding to 94 grantees. Funded initiatives include:

• 32.4% for drug diversion and interdiction programs
• 23.5% for youth prevention and workforce development
• 21.8% for services supporting pregnant and parenting women and child advocacy centers
• 22.3% for recovery and transitional housing

Additional updates:

• Moundsville received $216,000 and created a local grant opportunity for nonprofits offering prevention, treatment, and recovery
• Mercer County is forming an opioid task force to guide the use of its $2.5 million in settlement funds
• Huntington and Cabell County are still awaiting resolution in a pending opioid litigation case

Yancey County, NC has opened its FY 2025–2026 Opioid Settlement Grant RFP, now accepting applications from local partners — application info. (DUE 6/13)

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

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

2025 Georgia Opioid Crisis Abatement Trust Grant— application info. (DUE 6/18)

Cobb County, GA (RFP) to Address Opioid Crisis— application info. (DUE 7/11)

New York – OASAS continues to fund workforce development efforts, including scholarship programs for CASAC training.

• Additional RFPs and funding streams may be available through county-specific portals or state MOA advisory boards.

City of Moundsville, WV invites organizations to apply for opioid settlement funds— application info.

City of Fairmont, WV invites organizations to apply for opioid settlement funds. A 20% match will be required for all projects.— application info.

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