Out of the hundreds of lawsuits between governments and opioid manufacturers, distributors and retailers, two have reached settlements with a nationwide impact: the $26 billion settlement with Johnson & Johnson, McKesson, AmeriSource Bergen and Cardinal Health and the $6 billion settlement with Purdue Pharma (on appeal in federal court as of October 2022). Both of these settlements require that the majority of settlement funds go towards future opioid abatement and provide an extensive – though not exhaustive – list of approved uses in a document referred to as Exhibit E.

ACCESS EXHIBIT E

To help counties assess and prioritize the many approved uses of opioid settlement funds, NACo worked with a team of advisors to identify 25 high-impact strategies that are under county authority. For each of these 25 strategies, NACo is developing concise briefing documents customized to county government. Each brief focuses on a specific opioid abatement strategy and summarizes the available evidence, best practices for implementation, county examples and links to additional resources, including opportunities for specialized technical assistance. Briefs will be continuously released on this page.

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Medication-Assisted Treatment (“MAT”) for Opioid Use Disorder: A NACo Opioid Solutions Strategy Brief

The Food and Drug Administration (FDA) has approved three medications that safely and effectively treat opioid use disorder (OUD) to improve the health and wellbeing of people living with OUD. MAT is defined by on-going, long-term treatment with one of these three medications. 

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Effective Treatment for Opioid Use Disorder for Incarcerated Populations: A NACo Opioid Solutions Strategy Brief

Medication-assisted treatment (MAT) is considered the “gold standard” of care for opioid use disorder (OUD). Because incarceration is a known driver of opioid overdose, failure to provide this gold standard of care to incarcerated individuals may exacerbate health risks in your community.

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Naloxone to Reverse Opioid Overdose

Naloxone is a “rescue” drug that quickly and safely reverses opioid overdose. It is available as an injectable solution and as a nasal spray. Naloxone works by blocking the effects of opioids in the body. Virtually all opioid overdose deaths are preventable if naloxone is administered in time. 

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Treatment for Neonatal Abstinence Syndrome: A NACo Opioid Solutions Strategy Brief

Neonatal Abstinence Syndrome or NAS (also called Neonatal Opioid Withdrawal Syndrome or NOWS) is a condition that sometimes affects newborns of parents who have taken opioids during pregnancy. Because NAS does not cause long-term health consequences, treatment with MOUD – as opposed to withdrawal and abstinence – is safer for both parents and their infants.

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Syringe Services Programs: A NACo Opioid Solutions Strategy Brief

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. SSPs also provide a range of other services, such as options for safe syringe disposal, overdose recognition and response training and help accessing services for HIV, substance use disorders and more. 

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Treatment and Recovery for Pregnant and Parenting People: A NACo Opioid Solutions Strategy Brief

Effective treatment for pregnant and parenting people means expanding access to MOUD and adopting a family-centered approach that prioritizes keeping families together.

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Post-Overdose Response Teams

Post-overdose response teams (also called quick response teams or post-overdose outreach programs) conduct outreach and offer services to people who have experienced an overdose within about 72 hours of the overdose event.

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Increasing Access to Evidence-Based Treatment: A NACo Opioid Solutions Strategy Brief

Our health care system’s capacity to provide medications for opioid use disorder (MOUD) falls far below the current demand for care. Only 1 in 4 people who need MOUD are able to access them. A multi-pronged approach is needed to build up the treatment workforce, create effective pathways to care and save lives.