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.

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 is developing custom planning, implementation and peer learning resources through the Opioid Solutions Center.

Quick Guides

The Principles for the Use of Funds From the Opioid Litigation are nationally recognized guidance for states, counties and cities receiving opioid settlement funds. These resources serve as a quick reference to help counties operationalize the Principles in our administration of opioid settlement funds.  

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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.

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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.

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

Through the national opioid settlements, counties have access to flexible resources that can enhance our existing opioid response strategies, including incorporating or expanding the role of harm reduction in our systems of service. How counties can integrate harm reduction depends on the policy environment, including on whether counties have broad authority, limited authority or face state-imposed barriers. To help counties assess the utility and feasibility of harm reduction in our jurisdictions, this resource explores five questions from counties in different policy contexts.

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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.

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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. 

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.

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. 

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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