Leveraging Opioid Settlements to Support Sustainable Community-Based Substance Use Disorder Treatment and Recovery Infrastructure

Leveraging Opioid Settlements to Support Sustainable Community-Based Substance Use Disorder Treatment and Recovery Infrastructure

Project Overview

The COVID-19 pandemic has accelerated the opioid and substance use disorder crisis, leading to the highest number of drug-related overdoses on record. Today’s substance use disorder (SUD) treatment system is falling short, with services being delivered through fragmented providers often lacking coordination or integrated structures to promote whole-person care. Billions of opioid settlement funding is beginning to flow toward decision-makers, especially at the county and municipal level; however, there are limited resources dedicated toward providing officials with actionable tools to organize and sustain key investments over the long term. There is a unique opportunity to support community leaders to develop, scale, and support local infrastructure that is attuned to the chronic nature of addiction and fill existing gaps in care.

The Duke-Margolis Institute for Health Policy, with Third Horizon Strategies as a partner, has launched a project to support community leaders and to develop and disseminate resources and tools to guide state, county, and municipal investments of opioid settlement resources for their communities. The project will convene experts, conduct stakeholder interviews, and analyze qualitative and quantitative data to develop best practices for investments in sustainable, recovery oriented infrastructure. 


This two-year project (July 2022 - June 2024) is supported by The Elevance Health Foundation.

Opioid Abatement and Investment Tool

The opioid abatement needs and investment tool is an interactive data tool designed to assist local, municipal and state level leaders working to address the opioid epidemic in their communities

Project Activities

Measurement Toolkit

Duke-Margolis’s “Opioid Measurement Toolkit: Leveraging Aligned Data and Measures to Sustain Opioid Settlement Fund Investments” outlines a practical approach that state and local organizations receiving opioid settlement funds can use to make the case to health care payers for integrating settlement-funded interventions into accountable payment and whole-person care model structures. In particular, this toolkit:

  • Describes the health care data that can demonstrate the effectiveness of opioid settlement-funded initiatives and provide examples of strategies states and localities can use to access health care data;
  • Describes common measures used by health care payers for SUD that settlement fund stakeholders should seek to align on; and
  • Provides an approach for selecting health care measures that could be used to demonstrate the impact of opioid settlement fund interventions to health care payers.


Click here to launch the Measurement Toolkit


Two people measuring graph bars with a tape measure

Duke-Margolis Project Team

Frank McStay Photo

Frank McStay, MPA

Assistant Research Director


Sandra E. Yankah, Ph.D.

Postdoctoral Research Associate

Samantha Repka Headshot

Samantha Repka, MS

Research Associate

Robert Saunders

Robert Saunders, PhD

Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Executive Team Member
Margolis Core Faculty

External Collaborators

Third Horizon Strategies Project Team: 

SUD/Opioid Subject Matter Expertise

Greg Williams, President 
Tym Rourke, Senior Director 
Ashley DeGarmo, Vice President of Client Services 
Moses Gur, Manager 

Data Design and Analytics

Alex Hryhorczuk, Director of Data Services and Analytics 
Chris Hart, Chief Data Analytics Officer

For more about Third Horizon Strategies please visit their website