NACo's Opioid Solutions Center empowers local leaders to invest resources in effective treatment, recovery, prevention and harm reduction practices that save lives and address the underlying causes of substance use disorder.

Counties are on the frontline of the opioid epidemic, providing public services that save lives and support recovery. Our 911 call centers and county-run crisis lines are the first to receive calls for help when an overdose happens. Our first responders, and increasingly mental health clinicians, are the first to arrive on the scene to stabilize the crisis and offer support. Our local crisis triage centers serve as safe places before, during and after a behavioral health crisis to access services, treatment and immediate and ongoing care.

New funding from opioid settlements presents an opportunity for counties to sustain and strengthen our response to the ongoing opioid epidemic. To help counties maximize the impact of this unique funding stream, NACo is developing custom planning, implementation and peer learning resources through the Opioid Solutions Center.

Approved Strategies

The two largest opioid settlements include requirements on how funds can be spent. Learn more about approved uses of the funds that are high-impact and under county authority.

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Syringe Services Programs

Syringe Services Programs (SSPs) provide low-barrier access to sterile supplies for safer substance use, naloxone and overdose prevention tools like fentanyl test strips and drug checking services.

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Effective Treatment for Opioid Use Disorder for Incarcerated Populations

Medication-assisted treatment is considered the “gold standard” of care for opioid use disorder (OUD). The FDA has approved three medications for treating OUD: methadone, buprenorphine and naltrexone.

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Treatment and Recovery for Pregnant and Parenting People

During pregnancy, the evidence-based standard of care for opioid use disorder (OUD) is treatment with methadone or buprenorphine. 

Quick Guides

Tools, templates and strategic guidance for maximizing the impact of opioid settlement funds on your community’s opioid abatement priorities. 

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The Principles Quick Guide to Conducting a Needs Assessment

The Principles for the Use of Funds From the Opioid Litigation are nationally recognized guidance for states, counties and cities receiving money from the lawsuits against entities that contributed to the opioid epidemic.

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The Principles Quick Guide to Creating a Settlement Council

The Principles for the Use of Funds From the Opioid Litigation are nationally recognized guidance for states, counties and cities receiving money from the lawsuits against entities that contributed to the opioid epidemic.

Cityscape

Opioids: How Settlement Dollars Advance City and County Opioid Abatement

Building on a strong history of collaboration, including the National City-County Task Force on Opioids, NACo and the National League of Cities examined preliminary data on the distribution of opioid settlement dollars across cities, counties and states. This brief highlights how cities and counties are working together to abate the overdose crisis, including pooling opioid settlement funds to create a more comprehensive system of care for people with substance use disorder. 

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Technical Assistance from the Opioid Response Network

NACo is collaborating with the Substance Abuse and Mental Health Services Administration-funded Opioid Response Network (ORN). ORN offers no-cost, evidence-based training and education to meet local needs in addressing the opioid crisis. 

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Counties in Action

While each county is navigating a unique combination of legal and administrative processes, all counties are working commendably to ensure these funds make the greatest possible difference in our communities. These examples provide a snapshot of how counties are quickly and strategically employing settlement funds to save lives and address the underlying causes of substance use disorder.

Featured News

Tony McDowell (right), executive director, Virginia Opioid Abatement Authority, speaks to Stephen Acquario, executive director, New York State Association of Counties and Gina Nikkel, executive director, Association of Oregon Counties Jan. 10 in Washington, D.C.  Photo by Charlie Ban
County News

Opioid fight gets resources, faces pitfalls after settlement

Counties are receiving a sizable amount of money from the national opioids settlement, but the needs generated by the crisis continue to grow.

Travis Landry, regional vice president of WestCare Wisconsin,Inc. speaks about treatment services in Milwaukee County, Wis. Photo by Jennifer Anderson
County News

Family response is key to treating opioid disorders

Milwaukee County, Wis. is taking steps to make sure those resources are as close to the people who need them as possible, including strategic placing of harm-reduction vending machines in historically underinvested neighborhoods.

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Press Release

Counties Form National Network of Opioid Settlement Decision Makers

30 counties selected to represent county excellence in opioid settlement implementation

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Program Contact

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Samantha Karon

Senior Program Manager – Substance Use Disorder

NACo's Opioid Solutions Center is supported in part by Arnold Ventures and The Pew Charitable Trusts. The Opioid Solutions Leadership Network is made possible through our partnership with Vital Strategies and with additional support from The Pew Charitable Trusts.