Bexar County approves $100,000 from opioid settlement fund and interlocal with San Antonio to expand harm-reduction services

Bexar County Commissioners Court agreed on March 25 to allocate $100,000 from the county's opioid settlement fund to support harm-reduction services, and approved directing an interlocal agreement with the City of San Antonio under which the city would match that amount, producing a $200,000 fund to be distributed via a forthcoming request for proposals.

Dr. Andrea Guerrero, director of the county Department of Public Health, told the court that the county could legally purchase syringes under its state designation and that the interlocal was a practical way to address limitations the city faced in purchasing sterile supplies. Guerrero described a menu of possible items the RFP can fund: sterile syringes and syringe disposal, alcohol wipes, wound-care supplies, personal-hygiene items, PPE, safer-smoking kits, condoms and safer-sex materials, overdose-response kits and Narcan, and community outreach and education.

Public-health details and local data cited - The county has previously used opioid settlement funds for syringe purchases and other harm-reduction efforts; past purchases were described in 2019 and 2021 funding actions. - Dr. Guerrero said the Bexar County Medical Examiner reported that opioids were involved in more than 40% of deaths that came through her office in 2023. - County staff and partner nonprofits reported wide distribution of supplies; Melissa Lucio, substance-use program manager, said the county has distributed Narcan units countywide and is training staff and first responders. - Lucio stated that Narcan is available over the counter at about $55 per unit. She also reported distribution metrics the county has tracked: "we have given away already 3,000 units" through county efforts, and local partners reported distributing syringes at scale during outreach.

Why it matters County health officials told commissioners that clean-syringe access and overdose reversal kits are intended to reduce immediate risks to individuals and the public (for example, accidental needle-stick exposures). Dr. Guerrero said participation in harm-reduction services increases the likelihood that people will seek treatment: "folks who use harm reduction services ... are 5 times more likely to seek treatment and maintain recovery," she said in the meeting.

Next steps The court approved the county allocation and directed staff to finalize an interlocal agreement with the City of San Antonio; the city is expected to consider its contribution at council. Once the interlocal is approved, public-health staff will issue an RFP to distribute funds to community organizations and services. The county's public-health division will report back to commissioners on contract awards and program metrics as the RFP process and service delivery proceed.

Attribution and sources Quotes and program details in this article are drawn from testimony by Andrea Guerrero, director of public health; Melissa Lucio, substance-use program manager; and other county staff during the March 25, 2025 Commissioners Court meeting.