Opioid Settlement Overview

​Buncombe County will receive $16,175,039 over a 17-year period as a part of the Opioid Settlement paid out to communities across the US to address harm caused by the Opioid epidemic. The Memorandum of Agreement Between the State of North Carolina and Local Governments on the Proceeds Relating to the Settlement of Opioid Litigation outlines how the money should be managed, what the money can be spent on, and what will need to be reported to the state.  

Steering Committee

Buncombe County is fortunate to have a wide network of passionate individuals and organizations that are dedicated to helping mitigate the negative impacts of the opioid epidemic and building a stronger and more resilient community. Leadership has established a steering committee that will craft recommendations for how best to invest the money to reduce substance use and overdose in Buncombe County. The steering committee, which is made up of county staff, agency partners, and community leaders will coordinate efforts to elicit community feedback, analyze root causes of Opioid and substance misuse, and identify key strategies for addressing that harm locally.  This committee is guided by a strategic vision established in the group’s first meetings: “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.”

Key Steering Committee Findings on Common Root Causes of Substance-Use and Related Harm:

  • Adverse Childhood Experiences/Trauma
  • Social isolation
  • Geographic isolation
  • Systemic marginalization
  • Disrupted, limited, or incomplete education opportunities
  • Poverty
  • Criminal justice involvement
  • Housing insecurity and homelessness


“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




Currently $ 458,500 in Buncombe County Opioid Settlement Funds have been alotted to various providers addressing key strategies to reduce harm and support recovery efforts.  Commissioners unanimously agreed to file paperwork in March of 2023 that could provide as much as $12,949,951 in additional funding from the Opioid Litigation Settlement. Recently, the NCDOJ announced additional settlements with CVS, Walgreens, Walmart, Allergan, and Teva to the tune of an additional $600 million for North Carolina state and local governments, which could be about another 12 million dollars to Buncombe County.  


Opioid Funding through June 2023


Community Survey Results

Nearly 700 community members responded to the Opioid Settlement Fund Survey. Nearly 400 Substance Use Experience surveys were completed by those who are most affected by substance use.  Peer Support Specialists completed a specialized survey about challenges facing the "boots on the ground" mission of helping people with substance use disorder navigate a myriad of issues in seeking treatment and receiving on-going support.  Across each of these surveys, key themes were realized. 

What we've heard from the community

•Insufficient access and options for affordable treatment in/around Buncombe County
•Housing & Homelessness
•Crime & Public Safety Concerns
•Impact on children & families
•Social Determinants of Health Barriers
•Need for Increased Education & Awareness
•Overdose, Deaths, Increasing Risk


To view the complete survey results click here.


In the Substance Use Experience survey, respondents indicated overwhelmingly that being uninsured was the biggest hurdle to accessing resources.


Where The Opioid Settlement Team is Headed

Next steps for the Opioid Settlement planning team include developing selection criteria for funding projects. This criteria will allow the team to evaluate projects equitably. The team will also work to finalize monitoring and evaluation plan. The Strategic Planning Report is slated to release in May of 2023 and be implemented in July of this year. 

Action Recommendations

  • Bold intervention to address the increasing lethality of drug supplies by prioritizing life-saving and harm-reducing measures today by funding naloxone distribution, evidence-based addiction treatment, and recovery support services.
  • Apply a sense of urgency to investment in prevention and longer-term planning to address systemic root causes of substance use by funding early intervention efforts, employment-related services, recovery housing, and collaborative strategic planning.


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

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North Carolina Opioid Settlement Fund 

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