Resources for Advocates

A Roadmap for Opioid Settlement Funds: Supporting Communities & Ending the Overdose Crisis

More than 130 organizations from across the country signed on to this Roadmap that calls for opioid settlement dollars to be used for public health programs and efforts to invest in communities. The Roadmap can also be used as a template for local organizations to write their own list of recommendations for state and local decision makers charged with allocating settlement funds.

Read It Here

Call to Action on Opioid Settlement Funds from Scientists and Researchers

A coalition of drug policy and public health researchers, scientists, and clinicians call on decision makers to urgently prioritize opioid settlement funding for 1) community-based programs for people who use drugs; 2) medications for addiction treatment; and 3) housing-first programs.

Read It Here

Local Opioid Settlement $$ Advocacy Toolkit (example!)

This toolkit from Texas Harm Reduction Alliance is a great example that organizations in other states could replicate for local advocacy efforts.

Learn More

Leveraging Opioid Settlement Funds for Public Health and Harm Reduction

CEG and the National Association of County and City Health Officials (NACCHO) partnered on a 3-part webinar series about how local health departments and their community partners can leverage opioid settlement funds to support evidence-based syndemic strategies to reduce harms associated with opioid use. Check out the recordings and resulting ‘Quick How-To Guide.’

Learn More

Understanding Opioid Settlements and Their Connection to Recovery-to-Work

CEG and Development District Association of Appalachia (DDAA) partnered on this webinar to discuss how Local Development Districts can leverage opioid settlement funds to support recovery-to-work efforts in Appalachia.

Learn More

State Community Advocate Guides

Vital Strategies and Christine Minhee of released comprehensive guides on opioid settlement funds for all 50 states and the District of Columbia! Each guide contains essential information on total funding, legal mechanism(s) governing the process, and funding allocations in each state. The guides also offer critical information on other key areas such as:

  • How decisions are made on the use of settlement funding at state and local levels
  • The role of advisory bodies, including the involvement of people with lived experience
  • Additional parameters states may have on approved uses for the funds
  • What measures states have put in place to promote transparency and accountability
  • Relevant state-specific resources
  • How to engage in the process as a community advocate

Learn More

KFF Health News

Reporter Aneri Pattani of KFF Health News is investigating the use of opioid settlement funds across the country in a yearlong series of stories. Their webpage also includes resources to help people investigate opioid settlement spending in their state/county. You can find all the articles Aneri has written on this topic here, and you can send her tips for future ones via this form.

Lastly: KFF Health News allows other news outlets to republish their stories (online or in print) for free. So, if there’s a local newspaper, radio station, etc. that you think should republish this – to help get the attention of local stakeholders – please let them know. Details on republishing are here.

Learn More

Principles For the Use of Funds from The Opioid Litigation

Vital Strategies along with the folks over at Johns Hopkins Bloomberg School of Public Health who developed the “Opioid Litigation Principles” developed this great doc outlining how advocates can expand on existing efforts to make sure their state’s opioid settlement funds are used in accordance with the Principles.

Learn More

Reporting on Addiction

ROA has created a guide to assist journalists who are interested in writing stories on opioid settlements, and they help to connect journalists with subject matter experts so that their reporting is evidence-based. Check out their website to add yourself as a local expert. And if you speak with a journalist about opioid settlements for any reason, you may want to share this resource with them.

Learn More

Resources for State and Local Decision Makers

National Association of Counties Opioid Solutions Center

NACo’s Opioid Solutions Center provides several resources to help counties maximize the impact of opioid settlement dollars, including:

Additionally, NACo, in partnership with Vital Strategies, developed the Opioid Solutions Leadership Network, a national cohort of county leaders pursuing innovative and evidence-based solutions with opioid settlement funds.

Learn More

Community Guide for Sustainable Opioid Settlement Fund Investments

The Duke Margolis Institute for Health Policy’s Community Guide provides state and local leaders with a structured approach to allocate opioid settlement funds effectively. The three key strategies to do this are: 1) assess community needs and resources; 2) collaborate with partners for maximum impact, and 3) plan a sustainable approach by integrating settlement funds with existing resources.

Learn More

Equity Considerations for Local Health Departments on Opioid Settlement Funds

The Legal Action Center, with the support of the National Association of County and City Health Officials (NACCHO) produced the Equity Considerations for Local Health Departments on Opioid Settlement Funds Checklist. This resource aims to guide health officials through decision-making for the allocation and distribution of opioid settlement funds, highlighting health equity principles such as community engagement, oversight and accountability, and cultural humility. The document first encourages local health departments to conduct a needs assessment which meaningfully centers input from people who use drugs and communities disproportionally impacted by the overdose crisis. The document also emphasizes that helping people access resources to meet their health-related social needs (i.e. housing, childcare assistance, food assistance, health care access, and transportation) helps facilitate people’s entry to and retention in various wellness services including substance use treatment. For any questions about this checklist or other resources related to integrating health equity into overdose prevention, please contact

Read it Here

Implementing Best Practices Across the Continuum of Care to Prevent Overdose: A Roadmap for Governors

This 2023 publication from the National Governor’s Association and O’Neill Institute provides evidence-based and promising actions states and territories can consider as they work to strengthen the Continuum of Care for people at risk for overdose, including those with Substance Use Disorder. Recommendations are oriented from a public health perspective and exclusively focused on overdose prevention, and they reflect the current landscape of overdose and risk which is now primarily driven by illicitly manufactured fentanyl rather than prescription opioids.

Read it Here

Maximizing the Impact of Opioid Litigation Settlements

The O’Neill Institute at Georgetown Law has released several publications identifying strategies to optimize the design and impact of settlements and judgments related to the opioid crisis. The Model Opioid Litigation Proceeds Act from 2021 guides states through the establishment of a dedicated fund, separate from the state’s general treasury fund, that is designated for remediation purposes. And their 2023 publication, Conflicts of Interest and Opioid Litigation Proceeds: Ensuring Fairness and Transparency, identifies best practices from states with extensive protocols for conflicts of interest and provides recommendations based on these findings.

Learn More

State Principles for Financing Substance Use Care, Treatment, and Support Services

A report from Center for Health Care Strategies urges states to strengthen their SUD treatment systems through sustainable financing strategies that increase access to evidence-based strategies, including by strategically allocating opioid settlement funds. They encourage states to convene a diverse group of people with lived and living experience of drug use along with other subject matter experts in the decision-making process for allocating settlement dollars and to prioritize funds for investments in services and infrastructure needs not covered by Medicaid and other existing state/federal funding streams.

Read it Here

Strategies for Effectively Allocating Opioid Settlement Funds

This publication from RAND Corporation provides recommendations for addressing the root causes of overdose deaths.

Learn More

Quick Guide to Conducting a Needs Assessment

This publication from NACo and Johns Hopkins School of Public Health outlines the steps to conducting a community health needs assessment in preparation for spending settlement funds.

Learn More

Evidence Based Strategies for Abatement of Harms from the Opioid Epidemic

This publication from Legal Action Center was jointly produced by several national addiction experts and contains recommendations and evidence-based strategies for investment of opioid settlement funds.

Learn More

From the War on Drugs to Harm Reduction: Imagining a Just Overdose Crisis Response

In April 2020, the FXB Center for Health and Human Rights at Harvard University, Doris Duke Charitable Foundation, First Focus on Children, and Open Society Foundations convened a group of experts in public health, harm reduction, drug policy, and child welfare. The experts shared ideas on how to direct opioid settlement funds toward structural and policy reform that advances public health and health equity.

Learn More

Primer on Spending Funds from the Opioid Litigation

This guide for state and local decision makers was developed by Johns Hopkins School of Public Health to give specific examples related to each of the 9 core abatement strategies named in most settlement agreements.

  • If you are working with or have heard of a state, county, or city whose settlement planning or spending aligns with the Principles and you think their work should be recognized as a national example, consider nominating them. Along with their award, they will be featured on the Principles website highlighting their achievement.

Learn More

6 toolkits to help #EndOverdose

These toolkits from Vital Strategies are packed with strategies to advance public health responses to the overdose crisis.

Learn More

Evidence Based Strategies for Abatement of Harms from the Opioid Epidemic

This publication from Partnership to End Addiction includes cost estimates for scaling programs and discusses how some programs may be more practical than others given each state’s political, financial, and infrastructure circumstances.

Learn More

How to Optimize the Opioid Settlements

This seminar from Penn LDI discusses best practices for managing opioid settlement funds and emphasizes that the management of settlement money is a political process that requires the government to hear thoughts and desires from the public in order to have the most impact with their funds.

Learn More

Overdose Fatality Review Model Law

Jurisdictions that don’t already have an Overdose Fatality Review (OFR) team established may consider using opioid settlement funds to set one up in order to properly examine and understand the circumstances leading up to a fatal overdose. This webinar from the Legislative Analysis and Public Policy Association (LAPPA) discusses the legislative framework for establishing county-level, multidisciplinary OFR teams in individual states. 

Watch Here

Protecting Our Communities: All Neighborhoods Need Health-Centered Approaches to be Safe and Just

This toolkit from Drug Policy Alliance was designed to help advocates understand recent trends in health, houselessness, crime and enforcement, and needed responses to support communities. The resource includes several program spotlights and mentions opioid settlements as one consideration for funding health-centered approaches that result in healthy and safe communities.

Read It Here

Resources for Service Providers

National Harm Reduction Technical Assistance Center

The NHRTAC provides access to several technical assistance providers across the country and offers free help to anyone in the country providing (or planning to provide) harm reduction services to their community.

Learn More

Harm Reduction Hacks

This comprehensive resource from NASTAD is designed to guide organizations in developing syringe services programs from organizational design to program implementation and data reporting.

Learn More

Supporting and Building the Peer Recovery Workforce: Lessons from the Foundation for Opioid Response Efforts 2023 Survey of Peer Recovery Coaches

Many jurisdictions across the country are investing opioid settlement dollars into the peer workforce, and it’s so important that peers are fully appreciated and supported in their work. This survey report shares about peers’ experiences with training, certification, supervision, and compensation, what motivates them to do their work, and what supports they would need to remain in the profession.

Learn More

Community-Based Participatory Research in Harm Reduction Settings

This NASTAD-developed resource provides an overview of best practices for forming mutually beneficial community-academic research partnerships within harm reduction settings.  

One of the core strategies listed in the opioid settlement litigation Exhibit E is ‘evidence-based data collection and research analyzing the effectiveness of the abatement strategies within the state.’ This toolkit is intended to assist harm reduction workers who are considering participating in research activities to ensure participants and programs are the primary beneficiaries of research efforts. The CBPR resource can be used by community-based organizations, researchers, health departments, and other harm reduction service providers who work with people who use drugs or support Syringe Services Programs (SSPs).

Learn More

Best Practice Guidance for Post-Overdose Outreach

A qualitative study from 2023 details the paradox of involving police in post-overdose outreach, which could trigger fear and mistrust among overdose survivors and their social networks and undermine the engagement and prevention goals of these measures. Many jurisdictions throughout Appalachia have discussed using settlement funds for post-overdose response programs and should think critically about which stakeholders will be charged with leading these collaborations.

This guidance from the PRONTO research team provides recommendations for the structure and operations of such programs and is designed for consideration by local community stakeholders to make program design and implementation decisions that will best serve each unique community. Program sponsors might find this guidance useful in determining programmatic and evaluation criteria for funding. 

Read It Here

How Civil Legal Aid Can Use Opioid Settlement Funds

This episode of the Legal Services Corporation “Talk Justice” podcast features legal leaders from Arkansas, Kentucky and Texas discussing how their organizations acquired opioid settlement funds and the impactful legal services they are providing to those affected by opioid use disorder

Listen Here

A Primer for Implementation of Overdose Education and Naloxone Distribution (OEND) in Jails and Prisons

Overdose is the leading cause of death among people recently released from prison, and the 3rd leading cause of death among those in custody in U.S. jails, but less than a third of jails provide naloxone education and training to individuals prior to their release or naloxone kits at discharge. Even fewer allow people to carry naloxone while in custody, despite the position of the National Commission on Correctional Healthcare that naloxone kits should be readily available to all people in the facility, including people who are incarcerated.

That said, using opioid settlement dollars can be used to invest in OEND in jails! Check out this primer developed by RTI International in 2019 for things to consider when doing jail or prison based naloxone education and distribution.

Read It Here

Medication for Opioid Use Disorder in Jails and Prisons

Methadone and Buprenorphine are the gold-standard treatments for opioid use disorder, however, they remain widely unavailable to people involved with the criminal legal system. If your community is investing opioid settlement funds into MOUD/MAT in jails check out these resources:

The Jail and Prison Opioid Project is a trove of information for developing programs.

The Bureau of Justice Assistance’s Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) produced a podcast series about medication-assisted treatment (MAT) in rural jails:

MAT in Rural Jails Episode 1: A Jail Medical Staff Administrator’s Perspective

MAT in Rural Jails Episode 2: A Peer Specialist’s Perspective

MAT in Rural Jails Episode 3: A Community-based Medical Provider’s Perspective

MAT in Rural Jails Episode 4: A MAT Program Coordinator’s Perspective

MAT in Rural Jails Episode 5: A Jail Administrator’s Perspective

And don’t forget about the NACo opioid solutions strategy brief: Providing Effective Treatment for OUD for Incarcerated Populations which discusses best practices and implementation guidelines.

Center on Rural Addiction

If your organization has a rural address (check here), the Center on Rural Addiction can provide NaloxBoxes and other harm reduction supplies at no charge. Email

Learn More

Rethinking Substance Use Prevention

A growing body of research on the effects of adverse and positive childhood experiences and on the importance of social and structural determinants of health have made it increasingly clear that an earlier and broader approach to prevention is necessary. This report from Partnership to End Addiction argues that we must rethink our approach to “prevention” in order to prevent the next inevitable iteration of the opioid crisis. 

Read it here

Registries of Effective Prevention Programs

Are you looking for evidence-based behavioral health programs to pursue with opioid settlement funds? Check out these registries where you can search by topic as well as age and other population demographics.

Blueprints for Healthy Youth Development

What Works Clearinghouse

Additionally, the Bureau for Behavioral Health Clearinghouse was designed for use by organizations in West Virginia (although most programs are not WV-specific, so this resource could be helpful for any state.)

FAQ – Intramuscular Injectable Naloxone

This FAQ from Remedy Alliance is a great resource for learning about low-cost generic naloxone! And if you’d like to register to receive free or low-cost naloxone, check out their full website.

Readiness Assessment for Harm Reduction Vending Machines

If your jurisdiction is interested in using settlement funds to set up a harm reduction vending machine, check out this guide to help you determine the best path forward.

Learn More

Distribution of Safer Drug Smoking Supplies as a Public Health Strategy

This issue brief from the University of Washington discusses the benefits of distributing safer smoking supplies, a harm reduction strategy that many organizations lack dedicated funding for and may consider using settlement funds to support.

Learn More

Wound Care and Medical Triage

This guide from NASTAD discusses many ways to prevent and care for wounds associated with drug use and includes a list of helpful supplies to distribute or have on hand.

Learn More

Sign Up for the AOR Listserve

For more context and the most up-to-date information, sign up for the AOR Listserve!