Boston Puts Another $700,000 in Opioid Settlement Money Into Community Overdose Response

BOSTON — Six neighborhood organizations will share a new $700,000 round of Community Overdose Response Grants, Mayor Michelle Wu and the Boston Public Health Commission (BPHC) announced on September 29, funding community-designed overdose prevention and response programs through mid-2028.

The grant round is the second of its kind in Boston and is paid for out of the litigation that ended with pharmaceutical companies settling claims over their role in the opioid epidemic — an epidemic the city says killed nearly 3,000 people in Boston between 2015 and 2024.

The recipients, selected after reviews by a community committee, the city, and BPHC, are:

Boston HEAT
Bowdoin Street Health Center
Casa Esperanza
Community Caring Clinic
North Suffolk Community Services
Upham's Community Care

Alongside the grants, BPHC announced two service expansions: a new care-coordination arm of its PAATHS treatment access program, and longer hours for its street outreach team.

What the Money Buys

The city frames the grants as a way to build capacity outside the clinic walls. The six organizations will run "community-informed" overdose prevention and response programming — the kind of neighborhood-level work that reaches people who are not walking into a treatment intake office on their own.

Boston has prior data on what that looks like. In 2024, BPHC awarded grants to five community organizations that, according to the city, connected nearly 2,000 people to substance use treatment and other services, trained 760 people in overdose prevention, and distributed 5,100 doses of naloxone — the medication that reverses an opioid overdose.

The new round builds on those results and extends funding further out, to mid-2028, which matters for staffing: community organizations that lose grant funding mid-year rarely keep their outreach workers.

Care Coordination and Street Outreach Expand

The bigger operational change is inside BPHC itself.

PAATHS (Providing Access to Addictions Treatment, Hope and Support) has been Boston's walk-in front door for substance use care — assessments, treatment referrals, and navigation into withdrawal management (detox), Clinical Stabilization Services, Transitional Support Services, medication for opioid use disorder, and outpatient treatment. After a six-month pilot, BPHC is launching PAATHS Care Coordination (PCC), in which staff stay attached to a client as they move between providers and levels of care.

The barriers PCC is designed to absorb are the familiar ones: transportation, language access, and housing instability. Those are precisely the issues that cause people to drop out of treatment between one appointment and the next, even when a bed or a prescription has already been arranged.

BPHC is also expanding its Recovery Services Bureau street outreach team — known locally as the "Red Shirts" for their bright uniforms — which engages people on the street, connects and transports them to care, and handles syringe collection. The team sweeps parks and schools every morning and afternoon for syringe litter and now operates from 5:00 a.m. to 11:00 p.m. on weeknights and 6:00 a.m. to 7:00 p.m. on weekends, hours that were extended earlier this year.

Behind that sits the Mass and Cass Table, a weekly case-conferencing initiative co-chaired by BPHC's Recovery Services Bureau and the Boston Police Department's Citywide Hub program. More than twenty agencies have met weekly for the past year to work on individuals with complex behavioral health and housing needs; the city credits the group with facilitating 90 connections to care.

The Numbers Behind the Announcement

Boston's overdose picture has improved. The city says its investments have contributed to a 29% drop in deadly overdoses in 2025 compared with the previous year, and that 2025 saw the fewest fatal overdoses in Boston in a decade.

That local trend is unfolding against a national argument about how opioid settlement money should be spent. KFF Health News, which tracks the roughly $50 billion in settlement cash flowing to states and localities, has documented repeated disputes over whether those dollars go to treatment and harm reduction or to other budget items — including a Louisiana case in which sheriffs received a 20% share. Boston's round is a concrete example of the treatment-and-prevention side of that debate: money awarded to community organizations, with a stated end date and published results from the prior cycle.

What Is Available Right Now

Families in Boston do not have to wait for the new grants to begin. Existing BPHC services are open and walk-in friendly:

PAATHS — treatment referrals, assessments, and care navigation: 1-855-494-4057 or 3-1-1
PAATHS and AHOPE walk-in services — 774 Albany Street, during business hours; no appointment required
AHOPE — harm reduction, including syringe exchange, drug checking to identify fentanyl and xylazine, naloxone distribution, and screening for HIV, hepatitis, and other bloodborne illnesses
Mattapan Recovery Campus — BPHC's inpatient campus serves 850 people per year, with short-term treatment focused on relapse prevention and behavior modification, plus on-site medical clinics run with Boston Health Care for the Homeless and mental health care through a partnership with The Joseph Nee Collaborative Center
boston.gov/recovery — the city's index of recovery services

What to Watch Next

Three things are worth tracking over the next year.

First, whether the six funded organizations can show the same kind of reach the 2024 cohort reported — connections to treatment, people trained in overdose prevention, and naloxone doses distributed. Second, whether PCC actually improves retention, since staying in care across levels of care is where many patients are lost. Third, whether the grant money keeps flowing: settlement payments arrive on a schedule set by litigation, not by program need, and organizations funded through mid-2028 will need a plan for what happens after that.

For now, the practical takeaway for families is simpler. A person does not need a referral, an appointment, or insurance to walk into 774 Albany Street and ask for help — and naloxone, drug checking, and overdose prevention training are available in Boston today, not after the paperwork clears.

Where to Get Help

Boston PAATHS: 1-855-494-4057 or 3-1-1 — assessments, referrals, care navigation
SAMHSA National Helpline: 1-800-662-HELP (4357) — free, confidential, 24/7, English and Spanish
988 Suicide & Crisis Lifeline: call or text 988
Emergency: 911 — Massachusetts has a Good Samaritan law, so callers seeking help for an overdose are protected from certain drug possession charges