Supporting local decision makers managing opioid settlement funds: A public health approach

August 2024

Graphic showing two public health workers talking with a man sitting on a city street.
Photo of Bridge and Engagement Services (BEST) Neighborhoods team courtesy of San Francisco Department of Public Health
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Opioid settlement funds have created an opportunity to strategically invest in evidence-based public health strategies that apply a multi-level, multi-sector prevention approach to strengthening communities and addressing the opioid epidemic. The resources listed here support local efforts to spend these funds wisely.

Over the course of several years, an expected $50 billion will be awarded to state and local jurisdictions and more than $1.5 billion to tribal communities across the United States to address the consequences of the opioid epidemic, including rising overdose deaths and the spread of infectious diseases associated with substance use.

In 2023, Prevention Institute received funding from the Centers for Disease Control and Prevention to lead the project “Supporting Local Governments Using Opioid Settlement Funds on Evidence-Based Programs.” Through this project, Prevention Institute and its partners – including Big Cities Health Coalition, ChangeLab Solutions, RTI International, and SheRay’s & Associates, LLC – sought to provide technical assistance and capacity building to state and local government officials to identify, select, and fund evidence-based strategies through opioid settlement dollars to prevent substance misuse, overdose, and death, and reduce the consequences of substance use more generally.

This set of online resources is intended to offer guidance to policymakers, health departments, community advocates, service providers, and other changemakers as they consider policies and programming to establish using opioid settlement dollars.”

Prevention Institute encourages jurisdictions to complement harm reduction, treatment, and recovery services with primary prevention strategies and solutions that address changes at the community level that are intended to reduce substance exposure and use in the first place.

This set of online resources is intended to offer guidance to policymakers, health departments, community advocates, service providers, and other changemakers as they consider policies and programming to establish using opioid settlement dollars. This site presents planning, implementation, and evaluation strategies that are supported by evidence and actively implemented by practitioners in the field, as well as background information on the opioid settlements. These resources, which were compiled in July of 2024, are not meant to be comprehensive, but rather, a starting point for continued research, conversation, and planning.

This project is supported by Cooperative Agreement Number NU38OT000305 from the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS). Please note that the views and opinions expressed in the resources included on this site are those of the authors and publishing institutions and do not necessarily represent the official views of, nor serve as an endorsement by, the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Prevention Institute, and the aforementioned project partners.

Featured Resources

Source: KFF Health News
Description: A hub for national news on opioid settlements and interactive tools to find information on state/local settlement payouts and state decision-making bodies

Source: Christine Minhee
Description: A set of 51 state-specific guides analyzing total settlement funds and allocation, decision-making processes, and additional resources for community advocates

Source: Johns Hopkins Bloomberg School of Public Health
Description: List of five principles to guide jurisdictions in the use of opioid settlement funds

Source: FXB Center for Health and Human Rights at Harvard University
Description: Offers 11 recommendations for policy makers and advocates on how to use settlement funds. Guided by principles around supporting the health and wellbeing of people who use substances and people with opioid dependence, and addressing the structural drivers of opioid use and dependence

Source: U.S. Centers for Disease Control and Prevention
Description: A list of 10 evidence-based public health strategies that states and jurisdictions can implement to prevent overdose

Source: Christine Minhee and Legal Action Center
Description: 51-state collection of opioid settlement community grant portals and request-for-proposal announcements, with a focus on accessibility of funds to community-based organizations

Source: ChangeLab Solutions and Prevention Institute
Description: Addresses challenges, opportunities, and promising strategies for local jurisdictions making decisions on the use of settlement funds

Measuring Impact: How to Consider Monitoring, Evaluating, Tracking Progress and Outcomes of the Opioid Settlement Funding

Source: RTI International and Prevention Institute
Description: Coming Fall 2024 – Guidance for states and community organizations on adopting an effective Monitoring and Evaluation framework to measure the impact of opioid settlement fund allocations

Insights to Navigating Community Mobilization through the Opioid Epidemic

Source: SheRay’s and Prevention Institute
Description: Coming Fall 2024 – Insights on community engagement and including people with lived and living experience in opioid settlement fund planning

Source: Prevention Institute
Description: A glossary of key terms related to understanding, planning for, and implementing activities using opioid settlement funding

Primary Prevention Strategies and Solutions Across the Substance Use Continuum

Source: Prevention Institute
Description: Coming Fall 2024 – A set of core principles and table of strategies outlining Prevention Institute’s approach to uplifting primary prevention approaches for responding to the opioid epidemic

Resources: Learning to Action

Identified resources are organized across a continuum of managing opioid settlement dollars. Please click one of the four blue tabs below to explore each resource category:

Planning Guidance: Suggested principles, frameworks, and core abatement strategies to consider throughout settlement fund decision-making                 

Implementation Models: Example policies and programming implemented using settlement funding and information on harm reduction, treatment, and recovery services

Evaluation + Sustainability: Information on monitoring and evaluating the uses and impact of opioid settlement funding, including example spending dashboards

Background Information: Legal and historical context for the national opioid settlements, including state-by-state breakdowns of funding allocation, expenditures, and decision-making structures

TitleTypeTagsSourceSuggested AudienceDescription
A Roadmap for Opioid Settlement Funds: Supporting Communities & Ending the Overdose CrisisGuidance DocumentPrimary Prevention

Harm Reduction + Treatment

Policy + Legislation
VOCAL-NYPolicymakers

Advocates
Settlement fund priorities outlined by a national coalition of 133 advocacy and direct service organizations, including examples of “good” and “problematic” spending
Opioid Use Disorder: City Actions and Opportunities to Address the EpidemicGuidance DocumentPrimary Prevention

Harm Reduction + Treatment

Policy + Legislation
National League of Cities PolicymakersHighlights effective collaborative city efforts to address the opioid epidemic and highlights opportunities to expand those efforts
Multiplying the Impact of Opioid Settlement Funds by Investing in Primary Prevention  Journal ArticlePrimary Prevention

Research

Fund Allocation
Journal of Hospital Medicine Policymakers

Direct Service Providers
Describes primary prevention strategies medical institutions can implement with settlement funds, including economic opportunities, affordable housing, and capacity building
Primer on Spending Funds from the Opioid LitigationGuidance DocumentPrimary Prevention

Harm Reduction + Treatment

Fund Allocation
Johns Hopkins Bloomberg School of Public HealthPolicymakersHelps identify evidence-based programs for each of the nine core abatement strategies described in the Johnson & Johnson settlement agreements
Equity Considerations for Local Health Departments on Opioid Settlement Funds Guidance DocumentResearch

Lived + Living Experience

Policy + Legislation
Legal Action CenterHealth DepartmentsA checklist to guide county and city health officials through decision-making and priority-setting on accessing and dispersing settlement funds, with a focus on health equity
Evidence-Based Strategies for Abatement of Harms from the Opioid EpidemicGuidance DocumentResearch

Harm Reduction + Treatment

Policy + Legislation
Legal Action CenterPolicymakersEvidence-based recommendations for investments that will improve medical treatment, strengthen prevention and harm reduction programming, and address the legal and policy systems
ONDCP Announces Model Law for States to Help Ensure Opioid Litigation Settlements Funds Address Addiction and OverdoseNews ReportPolicy + LegislationThe White HousePolicymakersAnnounces the release of a model law for state legislatures that would help ensure settlements funds are appropriately and transparently directed
Navigating Settlement Fund Decision-Making with Integrity, Transparency, and AccountabilityGuidance DocumentFund AllocationJohns Hopkins Bloomberg School of Public HealthPolicymakersDiscusses the need for ethical standards and transparency in opioid litigation boards and commissions
National Opioid Settlement Dashboard: Your City, Your FundsGuidance DocumentFund Allocation

Harm Reduction + Treatment

Primary Prevention
National League of CitiesPolicymakersInteractive tool that helps cities and counties estimate their expected amount of allocated settlement funds and data-backed investment recommendations
The Principles Quick Guide to Removing Policy BarriersGuidance DocumentPolicy + LegislationNational Association of CountiesPolicymakers

Advocates
Describes how to conduct a formal review and amendment of policies that may otherwise limit the impact of opioid settlement investments
The Principles Quick Guide to Creating a Settlement CouncilGuidance DocumentFund Allocation

Lived + Living Experience
National Association of CountiesPolicymakersDescribes how to create and manage a settlement council that works with local decision makers to decide how to best use opioid settlement dollars
The Principles Quick Guide to Conducting a Needs AssessmentGuidance DocumentFund Allocation

Lived + Living Experience

Research
National Association of CountiesHealth DepartmentsDescribes how to conduct a local needs assessment to guide opioid settlement dollar disbursement
Applying a Social Determinants of Health Approach to the Opioid EpidemicJournal ArticlePrimary Prevention

Lived + Living Experience

Research
Health Promotion PracticeGeneralDescribes the efforts of three Ohio counties to address the community conditions that increase the risk of unhealthy substance use and addiction
Tribal PrinciplesGuidance DocumentLived + Living Experience

Harm Reduction+ Treatment

Fund Allocation
John Hopkins Center for Indigenous HealthGeneralList of five principles to guide tribes and their partners in the use of opioid settlement funds
TitleTypeTagsSourceSuggested AudienceDescription
Opioids Solutions Center: Counties in ActionGuidance DocumentFund Allocation

Harm Reduction + Treatment
National Association of CountiesPolicymakers

Health Departments
Describes how six counties nationwide are quickly and strategically employing settlement funds to save lives
How Are Opioid Settlement Funds Being Spent So Far?News ReportPrimary Prevention

Harm Reduction + Treatment
Health AffairsPolicymakers

Advocates
Outlines settlement fund priorities based in a public health approach and assesses spending one year after funds disbursement began
2023 State of the States: Legislative Roadmap for Reducing Overdose Deaths and Increasing Access to TreatmentGuidance DocumentHarm Reduction + Treatment

Policy + Legislation
Legislative Analysis and Public Policy AssociationPolicymakers

Advocates
Outlines ten policy strategies that states can implement to reduce overdose deaths and increase access to substance use treatment
Boston Opioid Settlements Community Engagement ReportGuidance DocumentFund Allocation

Lived + Living Experience
Boston Public Health CommissionPolicymakers

Health Departments
Describes the City of Boston’s process for gathering community and organizational input on how to use local opioid settlement funds
Advancing Health Equity Through County Opioid Abatement StrategiesGuidance DocumentHarm Reduction + Treatment

Lived + Living Experience

Fund Allocation
National Association of CountiesPolicymakers

Health Departments
Case studies on five counties that are integrating opioid settlement funds into ongoing health equity initiatives
Engaging with People with Lived Experience in Opioid Settlement Decision-MakingGuidance DocumentLived + Living ExperienceNational Academy for State Health PolicyPolicymakers

Direct Service Providers
Summarizes strategies that states have adopted for engaging with people with lived and living experience in opioid settlement decision-making
Understanding Stigma Through the Lived Experiences of People With Opioid Use DisorderJournal ArticleLived + Living Experience

Research
Drug and Alcohol DependenceGeneralExplores the lived experiences of people who were in recovery from opioid use disorder or a family member, with a focus on stigma
Whole Person Recovery From Substance Use Disorder: A Call for Research Examining a Dynamic Behavioral Ecological Model of Contexts Supportive of RecoveryJournal ArticleLived + Living Experience

Research

Primary Prevention
Addiction Research and TheoryGeneralSummarizes research that has considered broader environmental and policy influences on substance use and introduces a new theoretical model of recovery
Preventing Overdose and Reducing Drug-Related Harm: Policy and implementation guides for state and local changeGuidance DocumentHarm Reduction + Treatment

Policy + Legislation

Primary Prevention
ChangeLab SolutionsPolicymakers

Health Departments
Eleven policy strategies and a roadmap to policy implementation that can advance equity and prioritize care over punishment
Harm Reduction Legal Project ResourcesGuidance DocumentPolicy + Legislation

Harm Reduction + Treatment
Network for Public Health LawGeneralResources to support organizations in understanding and navigating laws and regulations that hamper harm reduction initiatives
Aligning City, County and State Resources to Address the Opioid EpidemicGuidance DocumentFund Allocation

Policy + Legislation
National League of CitiesPolicymakersSummarizes key findings from the six-city 2018 Mayors’ Institute on Opioids, including common priorities and lessons learned
Five Questions for Counties Considering Harm Reduction as an Opioid Abatement StrategyGuidance DocumentFund Allocation

Harm Reduction + Treatment
National Association of CountiesPolicymakersOverview of various harm reduction initiatives implemented by counties in different policy contexts nationwide
Public Health Considerations for Strategies and PartnershipsGuidance DocumentHarm Reduction + TreatmentU.S. Centers for Disease Control and PreventionHealth Departments

Direct Service Providers
Provides examples of evidence-based and promising strategies that can help local communities prevent overdoses
About Overdose Data to Action (CDC)Guidance DocumentHarm Reduction + TreatmentU.S. Centers for Disease Control and PreventionHealth DepartmentsPresents a framework for integrating data on nonfatal and fatal overdoses and prevention strategies
Syringe Services Programs: A Technical Package of Effective Strategies and Approaches for Planning, Design, and ImplementationGuidance DocumentHarm Reduction + TreatmentU.S. Centers for Disease Control and PreventionHealth Departments

Direct Service Providers
Provides evidence of the effectiveness of strategies and approaches for supporting successful planning, design, implementation, and sustainability of syringe services programs
What You Should Know About XylazineGuidance DocumentHarm Reduction + TreatmentU.S. Centers for Disease Control and PreventionGeneralDescribes the dangers of xylazine, a non-opioid sedative often found in combination with opioids, and related harm reduction strategies
Linking People with Opioid Use Disorder to Medication TreatmentGuidance DocumentHarm Reduction + TreatmentU.S. Centers for Disease Control and PreventionDirect Service ProvidersStrategies to support linkage to opioid use disorder care for clinicians and service providers
A Stimulant Guide: Answers to Emerging Questions about Stimulants in the Context of the Overdose Epidemic in the United StatesGuidance DocumentHarm Reduction + Treatment

Research
U.S. Centers for Disease Control and PreventionHealth Departments

Direct Service Providers
Answers common questions about stimulants, stimulant use, stimulant overdose, and stimulant overdose prevention strategies
Engaging People with Lived Experience to Improve Federal Research, Policy, and PracticeGuidance DocumentLived + Living ExperienceU.S. Department of Health and Human ServicesPolicymakersResources with lessons learned and key considerations from a range of methods for engaging people with lived and living experience in research, policy, and practice
Harm Reduction FrameworkGuidance DocumentHarm Reduction + TreatmentSubstance Abuse and Mental Health Services AdministrationHealth Departments

Direct Service Providers
A comprehensive framework that informs SAMHSA’s harm reduction activities and partnerships with other government and community partners
Opioid-Overdose Reduction Continuum of Care Approach (ORCCA) Practice Guide 2023Guidance DocumentHarm Reduction + Treatment

Lived + Living Experience
Substance Abuse and Mental Health Services AdministrationDirect Service Providers

Advocates
Includes guidance, resources, and insights on implementing strategies from the Opioid-Overdose Reduction Continuum of Care Approach to reduce opioid overdose deaths
TitleTypeTagsSourceSuggested AudienceDescription
Strategic Prevention FrameworkGuidance DocumentResearchSubstance Abuse and Mental Health Services AdministrationHealth Departments

Direct Service Providers
Toolkit outlining a five-step planning process and two principles for preventing substance misuse and promoting mental health
Appalachia Opioid Remediation Database DatabaseFund AllocationAppalachia Opioid RemediationGeneralDatabase outlining how counties in the 13 states of Appalachia are managing and spending settlement funds
Indicators for Monitoring Opioid Litigation SpendingGuidance DocumentFund AllocationJohns Hopkins Bloomberg School of Public Health and Vital StrategiesPolicymakersInteractive tool to guide counties and states in investing in effective overdose prevention strategies and monitoring how investments are reducing overdose risk
North Carolina Opioid Settlements: Local Spending Plans DashboardDatabaseFund AllocationNorth Carolina Opioid SettlementsGeneralDashboard of local spending to address the opioid overdose epidemic, providing a strong example of data transparency and reporting
State Opioid Response Grant: Writing Goals and SMART ObjectivesGuidance DocumentFund AllocationWest Virginia Department of Health and Human ResourcesPolicymakersOffers guidance on writing program goals and objectives to keep opioid response activities strategic, focused, and organized
Opioid Measurement Toolkit: Leveraging Aligned Data and Measures to Sustain Opioid Settlement Fund InvestmentsGuidance DocumentFund AllocationDuke University Margolis Institute for Health PolicyPolicymakers

Direct Service Providers
Outlines a practical approach for integrating settlement-funded interventions into accountable payment and whole-person care model structures
Specifying Monitoring and Evaluation Measures for Local Overdose Prevention and Response Strategies: A ToolkitGuidance DocumentFund AllocationNational Association of County and City Health OfficialsHealth Departments

Direct Service Providers
Provides concrete examples to guide organizations in monitoring and evaluating overdose prevention and response program progress and short-term outcomes
TitleTypeTagsSourceSuggested AudienceDescription
Opioid Settlement Fund Landscape Report – Summary of FindingsGuidance DocumentPolicy + Legislation

Lived + Living Experience

Fund Allocation
Big Cities Health Coalition and Prevention InstituteGeneralSnapshot of findings from a Winter 2023 survey and analysis of planning, processes, opportunities, and challenges related to the use of opioid settlement funds in states and local jurisdictions
State Opioid Settlement Spending DecisionsGuidance DocumentFund AllocationNational Academy for State Health PolicyPolicymakersProvides an overview of how different states were deciding to allocate settlement funds as of May 2024
A Quick “How-To” Guide for Understanding Opioid Settlements State-to-StateGuidance DocumentPolicy + LegislationNational Association of County and City Health OfficialsGeneralA guide to opioid settlements, including how to find out about state-specific use of settlement funds and resources for community members, local decision-makers, and service providers to learn more
Opioid Settlement Dollars: A Breakdown of the Process and What it Means for Your Work in Overdose PreventionGuidance DocumentPolicy + LegislationChristine Minhee, National Overdose Prevention Network, & Dialogue4HealthPolicymakersA set of presentation slides providing a summary of opioid settlements and states’ spending plans, the settlement agreement’s contractual protections and opportunities for advocacy, and an analysis of the Exhibit E list of approved opioid remediation uses
Official Tribal Opioids Settlement WebsiteGuidance DocumentPolicy + LegislationBrownGreer PLCGeneralThe official site for information on Tribal Opioid Settlements, including the history and current status of the lawsuits, announcements, and information on how tribes can receive and use funds
FAQ & Explanatory Charts – National Opioids SettlementGuidance DocumentPolicy + LegislationPlaintiffs’ Executive CommitteeGeneralThe official site for the national opioids settlements, with the latest updates on ongoing litigation and links to relevant legal documents
Opioid Settlement Fund Landscape ReportGuidance DocumentPolicy + Legislation

Lived + Living Experience

Fund Allocation
Drexel University Dornsife School of Public Health, Big Cities Health Coalition and Prevention InstituteGeneralAnalysis of planning, processes, opportunities, and challenges related to the use of opioid settlement funds in states and local jurisdictions conducted in Winter 2023

Planning Guidance

Type: Guidance Document
Tags: Primary Prevention, Harm Reduction + Treatment, Policy + Legislation
Source: VOCAL-NY
Suggested Audience: Policymakers, Advocates
Description: Settlement fund priorities outlined by a national coalition of 133 advocacy and direct service organizations, including examples of “good” and “problematic” spending

Type: Guidance Document
Tags: Primary Prevention, Harm Reduction + Treatment, Policy + Legislation
Source: National League of Cities
Suggested Audience: Policymakers
Description: Highlights effective collaborative city efforts to address the opioid epidemic and highlights opportunities to expand those efforts

Type: Journal Article
Tags: Primary Prevention, Research, Fund Allocation
Source: Journal of Hospital Medicine
Suggested Audience: Policymakers, Direct Service Providers
Description: Describes primary prevention strategies medical institutions can implement with settlement funds, including economic opportunities, affordable housing, and capacity building

Type: Guidance Document
Tags: Primary Prevention, Harm Reduction + Treatment, Fund Allocation
Source: Johns Hopkins Bloomberg School of Public Health
Suggested Audience: Policymakers
Description: Helps identify evidence-based programs for each of the nine core abatement strategies described in the Johnson & Johnson settlement agreements

Type: Guidance Document
Tags: Research, Lived + Living Experience, Policy + Legislation
Source: Legal Action Center
Suggested Audience: Health Departments
Description: A checklist to guide county and city health officials through decision-making and priority-setting on accessing and dispersing settlement funds, with a focus on health equity

Type: Guidance Document
Tags: Research, Harm Reduction + Treatment, Policy + Legislation
Source: Legal Action Center
Suggested Audience: Policymakers
Description: Evidence-based recommendations for investments that will improve medical treatment, strengthen prevention and harm reduction programming, and address the legal and policy systems

Type: News Report
Tags: Policy + Legislation
Source: The White House
Suggested Audience: Policymakers
Description: Announces the release of a model law for state legislatures that would help ensure settlements funds are appropriately and transparently directed

Type: Guidance Document
Tags: Fund Allocation
Source: Johns Hopkins Bloomberg School of Public Health
Suggested Audience: Policymakers
Description: Discusses the need for ethical standards and transparency in opioid litigation boards and commissions

Type: Guidance Document
Tags: Fund Allocation, Harm Reduction + Treatment, Primary Prevention
Source: National League of Cities
Suggested Audience: Policymakers
Description: Interactive tool that helps cities and counties estimate their expected amount of allocated settlement funds and data-backed investment recommendations

Type: Guidance Document
Tags: Policy + Legislation
Source: National Association of Counties
Suggested Audience: Policymakers, Advocates
Description: Describes how to conduct a formal review and amendment of policies that may otherwise limit the impact of opioid settlement investments

Type: Guidance Document
Tags: Fund Allocation, Lived + Living Experience
Source: National Association of Counties
Suggested Audience: Policymakers
Description: Describes how to create and manage a settlement council that works with local decision makers to decide how to best use opioid settlement dollars

Type: Guidance Document
Tags: Fund Allocation, Lived + Living Experience, Research
Source: National Association of Counties
Suggested Audience: Health Departments
Description: Describes how to conduct a local needs assessment to guide opioid settlement dollar disbursement

Type: Journal Article
Tags: Primary Prevention, Lived + Living Experience, Research
Source: Health Promotion Practice
Suggested Audience: General
Description: Describes the efforts of three Ohio counties to address the community conditions that increase the risk of unhealthy substance use and addiction

Implementation Strategies

Type: Guidance Document
Tags: Fund Allocation, Harm Reduction + Treatment
Source: National Association of Counties
Suggested Audience: Policymakers, Health Departments
Description: Describes how six counties nationwide are quickly and strategically employing settlement funds to save lives

Type: News Report
Tags: Primary Prevention, Harm Reduction + Treatment
Source: Health Affairs
Suggested Audience: Policymakers, Advocates
Description: Outlines settlement fund priorities based in a public health approach and assesses spending one year after funds disbursement began

Type: Guidance Document
Tags: Harm Reduction + Treatment, Policy + Legislation
Source: Legislative Analysis and Public Policy Association
Suggested Audience: Policymakers, Advocates
Description: Outlines ten policy strategies that states can implement to reduce overdose deaths and increase access to substance use treatment

Type: Guidance Document
Tags: Fund Allocation, Lived + Living Experience
Source: Boston Public Health Commission
Suggested Audience: Policymakers, Health Departments
Description: Describes the City of Boston’s process for gathering community and organizational input on how to use local opioid settlement funds

Type: Guidance Document
Tags: Harm Reduction + Treatment, Lived + Living Experience, Fund Allocation
Source: National Association of Counties
Suggested Audience: Policymakers, Health Departments
Description: Case studies on five counties that are integrating opioid settlement funds into ongoing health equity initiatives

Type: Guidance Document
Tags: Lived + Living Experience
Source: National Academy for State Health Policy
Suggested Audience: Policymakers, Direct Service Providers
Description: Summarizes strategies that states have adopted for engaging with people with lived and living experience in opioid settlement decision-making

Type: Journal Article
Tags: Lived + Living Experience, Research
Source: Drug and Alcohol Dependence
Suggested Audience: General
Description: Explores the lived experiences of people who were in recovery from opioid use disorder or a family member, with a focus on stigma

Type: Journal Article
Tags: Lived + Living Experience, Research, Primary Prevention
Source: Addiction Research and Theory
Suggested Audience: General
Description: Summarizes research that has considered broader environmental and policy influences on substance use and introduces a new theoretical model of recovery

Type: Guidance Document
Tags: Harm Reduction + Treatment, Policy + Legislation, Primary Prevention
Source: ChangeLab Solutions
Suggested Audience: Policymakers, Health Departments
Description: Eleven policy strategies and a roadmap to policy implementation that can advance equity and prioritize care over punishment

Type: Guidance Document
Tags: Policy + Legislation, Harm Reduction + Treatment
Source: Network for Public Health Law
Suggested Audience: General
Description: Resources to support organizations in understanding and navigating laws and regulations that hamper harm reduction initiatives

Type: Guidance Document
Tags: Fund Allocation, Policy + Legislation
Source: National League of Cities
Suggested Audience: Policymakers
Description: Summarizes key findings from the six-city 2018 Mayors’ Institute on Opioids, including common priorities and lessons learned

Type: Guidance Document
Tags: Fund Allocation, Harm Reduction + Treatment
Source: National Association of Counties
Suggested Audience: Policymakers
Description: Overview of various harm reduction initiatives implemented by counties in different policy contexts nationwide

Type: Guidance Document
Tags: Harm Reduction + Treatment
Source: U.S. Centers for Disease Control and Prevention
Suggested Audience: Health Departments, Direct Service Providers
Description: Provides examples of evidence-based and promising strategies that can help local communities prevent overdoses

Type: Guidance Document
Tags: Harm Reduction + Treatment
Source: U.S. Centers for Disease Control and Prevention
Suggested Audience: Health Departments
Description: Presents a framework for integrating data on nonfatal and fatal overdoses and prevention strategies

Type: Guidance Document
Tags: Harm Reduction + Treatment
Source: U.S. Centers for Disease Control and Prevention
Suggested Audience: Health Departments, Direct Service Providers
Description: Provides evidence of the effectiveness of strategies and approaches for supporting successful planning, design, implementation, and sustainability of syringe services programs

Type: Guidance Document
Tags: Harm Reduction + Treatment
Source: U.S. Centers for Disease Control and Prevention
Suggested Audience: General
Description: Describes the dangers of xylazine, a non-opioid sedative often found in combination with opioids, and related harm reduction strategies

Type: Guidance Document
Tags: Harm Reduction + Treatment
Source: U.S. Centers for Disease Control and Prevention
Suggested Audience: Direct Service Providers
Description: Strategies to support linkage to opioid use disorder care for clinicians and service providers

Type: Guidance Document
Tags: Harm Reduction + Treatment, Research
Source: U.S. Centers for Disease Control and Prevention
Suggested Audience: Health Departments, Direct Service Providers
Description: Answers common questions about stimulants, stimulant use, stimulant overdose, and stimulant overdose prevention strategies

Type: Guidance Document
Tags: Lived + Living Experience
Source: U.S. Department of Health and Human Services
Suggested Audience: Policymakers
Description: Resources with lessons learned and key considerations from a range of methods for engaging people with lived and living experience in research, policy, and practice

Type: Guidance Document
Tags: Harm Reduction + Treatment
Source: Substance Abuse and Mental Health Services Administration
Suggested Audience: Health Departments, Direct Service Providers
Description: A comprehensive framework that informs SAMHSA’s harm reduction activities and partnerships with other government and community partners

Type: Guidance Document
Tags: Harm Reduction + Treatment, Lived + Living Experience
Source: Substance Abuse and Mental Health Services Administration
Suggested Audience: Direct Service Providers, Advocates
Description: Includes guidance, resources, and insights on implementing strategies from the Opioid-Overdose Reduction Continuum of Care Approach to reduce opioid overdose deaths

Evaluation + Sustainability

Type: Guidance Document
Tags: Research
Source: Substance Abuse and Mental Health Services Administration
Suggested Audience: Health Departments, Direct Service Providers
Description: Toolkit outlining a five-step planning process and two principles for preventing substance misuse and promoting mental health

Type: Database
Tags: Fund Allocation
Source: Appalachia Opioid Remediation
Suggested Audience: General
Description: Database outlining how counties in the 13 states of Appalachia are managing and spending settlement funds

Type: Guidance Document
Tags: Fund Allocation
Source: Johns Hopkins Bloomberg School of Public Health and Vital Strategies
Suggested Audience: Policymakers
Description: Interactive tool to guide counties and states in investing in effective overdose prevention strategies and monitoring how investments are reducing overdose risk

Type: Database
Tags: Fund Allocation
Source: North Carolina Opioid Settlements
Suggested Audience: General
Description: Dashboard of local spending to address the opioid overdose epidemic, providing a strong example of data transparency and reporting

Type: Guidance Document
Tags: Fund Allocation
Source: West Virginia Department of Health and Human Resources
Suggested Audience: Policymakers
Description: Offers guidance on writing program goals and objectives to keep opioid response activities strategic, focused, and organized

Type: Guidance Document
Tags: Fund Allocation
Source: Duke University Margolis Institute for Health Policy
Suggested Audience: Policymakers, Direct Service Providers
Description: Outlines a practical approach for integrating settlement-funded interventions into accountable payment and whole-person care model structures

Type: Guidance Document
Tags: Fund Allocation
Source: National Association of County and City Health Officials (NACCHO)
Suggested Audience: Health Departments, Direct Service Providers
Description: Provides concrete examples to guide organizations in monitoring and evaluating overdose prevention and response program progress and short-term outcomes

Background Info

Type: Guidance Document
Tags: Policy + Legislation, Lived + Living Experience, Fund Allocation
Source: Big Cities Health Coalition and Prevention Institute
Suggested Audience: General
Description: Coming Fall 2024 – Snapshot of findings from a Winter 2023 survey and analysis of planning, processes, opportunities, and challenges related to the use of opioid settlement funds in states and local jurisdictions

Type: Guidance Document
Tags: Fund Allocation
Source: National Academy for State Health Policy
Suggested Audience: Policymakers
Description: Provides an overview of how different states were deciding to allocate settlement funds as of May 2024

Type: Guidance Document
Tags: Lived + Living Experience, Harm Reduction + Treatment, Fund Allocation
Source: John Hopkins Center for Indigenous Health
Suggested Audience: General
Description: List of five principles to guide tribes and their partners in the use of opioid settlement funds

Type: Guidance Document
Tags: Policy + Legislation
Source: National Association of County and City Health Officials
Suggested Audience: General
Description: A guide to opioid settlements, including how to find out about state-specific use of settlement funds and resources for community members, local decision-makers, and service providers to learn more

Type: Guidance Document
Tags: Policy + Legislation
Source: Christine Minhee, National Overdose Prevention Network, & Dialogue4Health
Suggested Audience: Policymakers
Description: A set of presentation slides providing a summary of opioid settlements and states’ spending plans, the settlement agreement’s contractual protections and opportunities for advocacy, and an analysis of the Exhibit E list of approved opioid remediation uses

Type: Guidance Document
Tags: Policy + Legislation
Source: BrownGreer PLC
Suggested Audience: General
Description: The official site for information on Tribal Opioid Settlements, including the history and current status of the lawsuits, announcements, and information on how tribes can receive and use funds

Type: Guidance Document
Tags: Policy + Legislation
Source: Plaintiffs’ Executive Committee
Suggested Audience: General
Description: The official site for the national opioids settlements, with the latest updates on ongoing litigation and links to relevant legal documents

Opioid Settlement Fund Landscape Report

Type: Guidance Document
Tags: Policy + Legislation, Lived + Living Experience, Fund Allocation
Source: Drexel University Dornsife School of Public Health, Big Cities Health Coalition and Prevention Institute
Suggested Audience: General
Description: Coming Fall 2024 – Analysis of planning, processes, opportunities, and challenges related to the use of opioid settlement funds in states and local jurisdictions conducted in Winter 2023

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