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

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.

Funding from the national 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 provides custom planning, implementation and peer learning resources through the Opioid Solutions Center.

The Opioid Solutions Leadership Network is growing!

Learn more about a new opportunity for staff of state associations of counties to join NACo's Opioid Solutions Leadership Network.

Strategy Briefs

The national opioid settlement agreements include parameters for how funds can be spent. To help counties assess and prioritize the various types of eligible expenditures, NACo identified a subset of approved strategies that are high impact and under county authority. For each strategy, NACo provides a summary of the evidence, considerations for implementation and county examples. 

Planning Principles

The Principles for the Use of Funds From the Opioid Litigation are nationally recognized guidance for states, counties and cities receiving opioid settlement funds. The Principles encourage governments to 1) spend the money to save lives, 2) use evidence to guide spending, 3) invest in youth prevention, 4) focus on racial equity and 5) develop a fair and transparent process for deciding how to spend the funding. The resources below serve as a quick reference to help counties operationalize the Principles in our administration of opioid settlement funds.  

person holding pen marking up document

The Principles Quick Guide to Removing Policy Barriers

After decades of research into effective interventions for opioid use disorder, there are now many evidence-based solutions to the prevention, treatment, recovery, and reduction of harms associated with opioid use. For an evidence-based program to produce the intended results, it may first be necessary to remove laws and regulations that interfere with proper implementation of the program. By conducting a policy review, county leaders can proactively identify and amend policies that may otherwise limit the impact of opioid settlement investments.

Woman presenting to group of people

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.

talking circle

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.

Case Studies

People working together

Promising Practices for Collaboration on State and Local Opioid Settlement Spending

Between 2022 and 2040, states, counties and cities expect to receive over $50 billion in payments from the national opioid settlements. As settlement payments are disbursed in the coming years, continued state-local coordination is key to ensuring that these resources are effectively invested.

three volunteers holding box of clothes

Five Questions for Counties Considering Harm Reduction as an Opioid Abatement Strategy

For America’s counties, harm reduction complements prevention, treatment and recovery services to create a more holistic and effective system of care.

two women talk in a conference room

Advancing Health Equity Through County Opioid Abatement Strategies

To support counties with utilizing opioid settlement funds to advance health equity, NACo developed case studies on five counties that are integrating opioid settlement funds into ongoing health equity initiatives. This resource details steps taken by these counties during the first year of opioid settlement payments and considerations for counties in other jurisdictions.

Featured News

Mountain Lakes Memorial Hospital Life Care Specialist Mandy Kuntz, left, converses with Amy Upchurch, R.N. Photo courtesy the Georgia Rural Health Innovation Center
County News

Urban opioid education moves to rural counties

A hospital program in Fulton County, Ga. that educates patients on opioids, and is working to prevent misuse and dependency at the source, is expanding to four rural counties in Georgia.

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.

Dr. Branch speaking to an audience
News

County Officials Discuss Harm Reduction as a Path Forward through the Overdose Epidemic

At NACo’s 2023 Legislative Conference, county officials discussed harm reduction as a path forward through the opioid epidemic. Three participants in NACo’s Opioid Solutions Leadership Network served as panelists at the workshop. 

bike
Press Release

Counties Form National Network of Opioid Settlement Decision Makers

30 counties selected to represent county excellence in opioid settlement implementation

Stay up-to-date on the Opioid Solutions Center

Complete the form to sign up for emails with the latest news and resources from the NACo Opioid Solutions Center.