From Staff Reports

ASHEVILLE, N.C. — Buncombe County is projected to receive more than $30 million in opioid settlement funds between 2022 and 2038.

The funds are part of the broader statewide National Opioids Settlement with major pharmaceutical companies and distributors. 

The payout is designed to be a long-term resource, with the majority of the money front-loaded and the remainder distributed over 17 years to combat the local overdose crisis.

Locally, these dollars are being used for the following:

• To expand access to medications for opioid use disorders

• To fund post-overdose response teams and peer support specialists.

• To increase the distribution of Naloxone to prevent deaths.

• To bolster vocational programs, housing stability, and economic aid.

Payouts from national opioid lawsuits reportedly have directly funded community programs that are successfully driving down overdose fatalities and emergency room visits. 

State and local governments have secured more than $50 billion from major pharmaceutical companies and pharmacies to invest incrementally in proven rehabilitation, harm reduction, and treatment services. 

Studies indicate that settlement funding is associated with statistically significant drops in overdose mortality as follows: 

• In Buncombe County, emergency room visits for opioid overdoses fell by nearly half from 2023 to 2025, and overdose deaths dropped from a peak of 152 in 2023 to 103 in 2024. 

• State trends: Michigan saw its annual opioid-related deaths plummet from 3,096 in 2021 to projections below 1,800 in 2025, while states like New York and Wisconsin are reporting their lowest overdose death counts in years. 

While the payout period stretches out over roughly 15 years, early evidence shows that funds distributed in proportion to regional need are making a vital difference. 

Typical investments include: 

• Overdose reversal: Scaling up the distribution of the reversal drug naloxone.

• Clinical support: Expanding addiction treatment facilities, peer support networks, and post-overdose response teams.

Community prevention: Funding long-term recovery housing, rehabilitation services, and localized street outreach programs