Greene County, North Carolina Approves $60,448 in Opioid Settlement Funds for Addiction Treatment

Greene County commissioners have approved a comprehensive spending plan for $60,448 in opioid settlement funds, directing the resources toward evidence-based addiction treatment, recovery support services, and harm reduction initiatives for the 2026-27 fiscal year. The allocation represents a strategic approach to addressing substance use disorders in this rural eastern North Carolina community.

Lead: Local Decision-Making in Action

During their June meeting, Greene County commissioners adopted a resolution establishing how the county will deploy its share of national opioid settlement funds. County Manager Kyle DeHaven explained that while the expenses were incorporated into the budget ordinance, the separate resolution fulfills requirements established by the opioid settlement agreements.

"This is something above and beyond that the opioid settlement agreements that we are all part of ask us to do annually," DeHaven told commissioners. "It really is just a resolution that breaks out how some of the opioid funds will be spent in the current year."

The resolution authorizes spending across five strategic categories, with the majority dedicated to direct treatment services.

Greene County's allocation stems from the national opioid litigation settlements that have distributed more than $50 billion to states and local governments across the United States. North Carolina's share totals approximately $1.5 billion, with funds flowing to both state agencies and local counties over an 18-year period.

Under agreements negotiated by state officials, counties receive direct allocations to address the ongoing impacts of the opioid crisis in their communities. The settlement funds come from major pharmaceutical manufacturers, distributors, and pharmacy chains that played roles in fueling the epidemic.

The funding structure requires counties to authorize and report specific spending strategies before using the money, ensuring transparency and accountability in how these resources address addiction and overdose prevention.

Breaking Down the $60,448 Allocation

Evidence-Based Addiction Treatment: $36,427

The largest portion of Greene County's opioid settlement funds—nearly 60 percent—will support direct treatment services. According to the approved resolution, this allocation includes:

Funding for a clinical social worker to provide mental and behavioral health services
A contract with a medical doctor to provide medication-assisted treatment (MAT)
Travel and registration costs for professional development
Supplies for drug screenings and assessments

Medication-assisted treatment combines FDA-approved medications—such as buprenorphine, methadone, or naltrexone—with counseling and behavioral therapies. Research consistently demonstrates that MAT is the most effective approach for treating opioid use disorder, reducing overdose deaths by approximately 50 percent compared to non-medication approaches.

Collaborative Strategic Planning: $14,365

The second-largest allocation supports administrative infrastructure for managing opioid settlement funds. This includes contract costs, travel, and registration for the Community Recovery Division director, who oversees fund management, staff coordination, reporting requirements, and program development.

Effective stewardship of settlement funds requires dedicated personnel to ensure compliance with state and federal guidelines while maximizing community impact.

Recovery Support Services: $4,386

This flexible funding category may support equipment and supplies, contracts with partner agencies, medication for uninsured residents, food and gas cards, telephone costs, postage, vehicle expenses, and other direct support services for individuals in recovery.

Recovery support services address the practical barriers that often derail treatment progress—transportation challenges, food insecurity, communication needs, and medication costs for those without insurance coverage.

Naloxone Distribution: $3,570

The county designated funds specifically for naloxone training and supplies, including a kiosk for distributing naloxone, fentanyl test strips, and related educational materials. Naloxone—the opioid overdose reversal medication—has saved countless lives when administered promptly during overdose emergencies.

Recovery Housing Support: $1,700

The smallest allocation supports safe and sober transitional and permanent housing through contracts with partner agencies. Stable housing represents a critical foundation for sustained recovery, yet remains one of the most significant barriers for individuals completing formal treatment programs.

Impact: What This Means for Rural Communities

Greene County's approach illustrates how smaller, rural jurisdictions are leveraging opioid settlement funds to build comprehensive addiction response systems. With a population of approximately 20,000 residents spread across largely rural terrain, the county faces unique challenges in delivering behavioral health services.

Rural communities nationwide experience disproportionate overdose death rates while simultaneously confronting provider shortages, transportation barriers, and limited treatment infrastructure. Strategic deployment of settlement funds can help bridge these gaps.

The county's emphasis on medication-assisted treatment aligns with clinical guidelines from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the American Society of Addiction Medicine (ASAM), which identify MAT as the gold standard for opioid use disorder treatment.

What's Next: Implementation and Accountability

With the resolution approved, county staff will now execute contracts, establish partnerships with treatment providers, and begin delivering services. The opioid settlement framework requires ongoing reporting to demonstrate how funds reduce overdose deaths, expand treatment access, and support recovery.

Greene County joins other North Carolina counties—including Orange County, which recently approved opioid settlement funding for a new Behavioral Health Director position—in deploying these resources to address the ongoing addiction crisis.

For families in Greene County seeking addiction treatment or recovery support, these funds represent expanded access to evidence-based care closer to home. The combination of medication-assisted treatment, recovery housing assistance, and naloxone availability creates multiple intervention points for individuals at various stages of the recovery journey.

If you or someone you love is struggling with substance use, help is available. The SAMHSA National Helpline provides free, confidential treatment referral and information 24/7 at 1-800-662-HELP (4357).