Overview

Opioid Settlement in Buncombe County

Buncombe County will receive more than $30 million between 2022 and 2039 as part of the statewide Opioid Settlement. The County follows North Carolina’s settlement agreement, which outlines how funds must be managed, what they can support, and what must be reported each year.

In 2022, Buncombe County created a community vision to guide this work:

“Buncombe County is a community where substance use recovery is characterized by timely and coordinated holistic care centered in empathy, cultural responsiveness, and evidence-based methods from prevention to long-term recovery.”

- Opioid Settlement Fund Steering Committee Vision Statement

Project Timeline

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FY2026 – Continuing Core Services & Planning for the Future

Budget: $3,218,194

All core services continued, including PORT, Reentry Services, harm-reduction outreach, and social-needs support. To sustain services into FY 2027,  the county evaluated funding requests and planned a new community engagement initiative to update the county’s opioid strategic plan through 2030.

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FY2025 – Sustaining Growth & Supporting Storm Recovery

Spending: $2,914,819

The expanded Post Overdose Response Team (PORT) model continued responding to high overdose volumes and helping individuals begin treatment. Reentry programs maintained strong outcomes, and social-needs supports scaled up to stabilize housing and access to care. Naloxone distribution and harm-reduction outreach adapted quickly after Tropical Storm Helene. Culturally relevant work advanced through Latinx/Black community events.

  • PORT responded to nearly 1,000 overdoses, and 77% of individuals started treatment.
  • 83% of Reentry Services participants avoided re-arrest.
  • $240K supported participant access to housing, communication tools, transportation, employment, and treatment.
  • 4,000+ naloxone kits distributed, with trainings and outreach for shelters and community care stations during storm recovery.
  • Secured major grants, including $3.5M for recovery housing and $510K for an inclusive healing space.

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FY2024 – Expanding Capacity & Strengthening Community Outreach

Spending: $2,350,848

Funding allowed Post Overdose Response Team (PORT) to grow into a 24/7, four-team model and strengthened connections for individuals leaving incarceration. The County launched a Social Determinants of Health fund to support basic needs like housing and transportation, significantly expanded naloxone distribution, and created a multilingual Hope & Healing campaign. A new Inclusive Connection & Healing Coordinator improved outreach in marginalized communities.

  • Distributed 6,456 naloxone kits, installed Naloxboxes, and expanded public training efforts.

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FY2023 – Stabilizing Essential Services

Spending: $352,612

Buncombe County used initial settlement funds to prevent major service gaps by funding Reentry Services for individuals returning from jail and the Post Overdose Response Team (PORT). Funds also expanded naloxone access, launched public overdose-response trainings, and supported a large countywide planning effort to guide long-term strategies, including a deep dive into recovery housing access gaps.

  • Brought together 40+ stakeholders for the Opioid Settlement Strategic Planning Steering Committee
  • Conducted 31 community feedback sessions and gathered 1,118 surveys to identify needs, gaps, and priorities.

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FY2022 – Building the Foundation

Buncombe County received a Dogwood Health Trust grant and established the infrastructure needed to manage opioid settlement investments. Funding supported the hiring of a Behavioral Health Manager to lead planning, coordination, and cross-department collaboration, along with a Behavioral Health & Justice Analyst to provide project management and data analysis. Buncombe County didn't spend any Opioid Settlements dollars in fiscal year 2022, but it laid the groundwork for strategic implementation in the years that followed.

Frequently Asked Questions

According to the Memorandum Of Agreement
Between The State of North Carolina and Local Governments on Proceeds Relating to the Settlement of Opioid Litigation
, Option A outlines the following as approved strategies for the use of Opioid funds.

1. Collaborative strategic planning. Support collaborative strategic planning to address opioid misuse, addiction, overdose, or related issues, including staff support, facilitation services, or any activity or combination of activities listed in Exhibit C to the MOA (collaborative strategic planning).
2. Evidence-based addiction treatment. Support evidence-based addiction treatment consistent with the American Society of Addiction Medicine’s national practice guidelines for the treatment of opioid use disorder – including Medication-Assisted Treatment (MAT) with any medication approved for this purpose by the U.S. Food and Drug Administration – through Opioid Treatment Programs, qualified providers of Office-Based Opioid Treatment, Federally Qualified Health Centers, treatment offered in conjunction with justice system programs, or other community-based programs offering evidence-based addiction treatment. This may include capital expenditures for facilities that offer evidence-based treatment for OUD. (If only a portion of a facility offers such treatment, then only that portion qualifies for funding, on a pro rata basis.)
3. Recovery support services. Fund evidence-based recovery support services, including peer support specialists or care navigators based in local health departments, social service offices, detention facilities, community-based organizations, or other settings that support people in treatment or recovery, or people who use drugs, in accessing addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need to improve their health or well-being.
4. Recovery housing support. Fund programs offering recovery housing support to people in treatment or recovery, or people who use drugs, such as assistance with rent, move-in deposits, or utilities; or fund recovery housing programs that provide housing to individuals receiving Medication-Assisted Treatment for opioid use disorder.
5. Employment-related services. Fund programs offering employment support services to people in treatment or recovery, or people who use drugs, such as job training, job skills, job placement, interview coaching, resume review, professional attire, relevant courses at community colleges or vocational schools, transportation services or transportation vouchers to facilitate any of these activities, or similar services or supports.
6. Early intervention. Fund programs, services, or training to encourage early identification and intervention for children or adolescents who may be struggling with problematic use of drugs or mental health conditions, including Youth Mental Health First Aid, peer-based programs, or similar approaches. Training programs may target parents, family members, caregivers, teachers, school staff, peers, neighbors, health or human services professionals, or others in contact with children or adolescents.
7. Naloxone distribution. Support programs or organizations that distribute naloxone to persons at risk of overdose or their social networks, such as Syringe Service Programs, post-overdose response teams, programs that provide naloxone to persons upon release from jail or prison, emergency medical service providers or hospital emergency departments that provide naloxone to persons at risk of overdose, or community-based organizations that provide services to people who use drugs. Programs or organizations involved in community distribution of naloxone may, in addition, provide naloxone to first responders.
8. Post-overdose response team. Support post-overdose response teams that connect persons who have experienced non-fatal drug overdoses to addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need to improve their health or well-being.
9. Syringe Service Program. Support Syringe Service Programs operated by any governmental or nongovernmental organization authorized by section 90-113.27 of the North Carolina General Statutes that provide syringes, naloxone, or other harm reduction supplies; that dispose of used syringes; that connect clients to prevention, treatment, recovery support, behavioral healthcare, primary healthcare, or other services or supports they need; or that provide any of these services or supports.
10. Criminal justice diversion programs. Support pre-arrest or post-arrest diversion programs, or pre-trial service programs, that connect individuals involved or at risk of becoming involved in the criminal justice system to addiction treatment, recovery support, harm reduction services, primary healthcare, prevention, or other services or supports they need, or that provide any of these services or supports.
11. Addiction treatment for incarcerated persons. Support evidence-based addiction treatment, including Medication-Assisted Treatment with at least one FDA-approved opioid agonist, to persons who are incarcerated in jail or prison.
12. Reentry Programs. Support programs that connect incarcerated persons to addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need upon release from jail or prison, or that provide any of these services or supports.

A fiscal year is a 12-month period used for accounting, budgeting, and financial reporting. Unlike the calendar year, Buncombe County's fiscal year runs from July 1 to June 30. 

Buncombe County does not currently have an open process for funding external organizations. Other opportunities for funding, when available, are added to the Procurement page or the Community Investment Grants page on our website.

Have comments, questions, or concerns for the Buncombe County Opioid Settlement Team? Leave them below.

Monthly, Free Community Overdose Reversal Training Empowers Individuals

Community Overdose Reversal Training Article(click on the image to read full article)

North Carolina Opioid Settlement Fund 

Click the image below to explore the North Carolina Opioid Settlement homepage.