Rowan County health director outlines $28 million opioid settlement plan over 18 years

Rowan County Public Health Director Alyssa reported to the Board of Commissioners on May 4 that the county's opioid settlement allocation has grown from an earlier estimate of $18 million to about $28 million to be distributed over an 18-year period, with larger payments early in the schedule.

Alyssa said the funding arises from national settlements with pharmaceutical companies and pharmacies and is allocated to local governments under a memorandum of agreement (MOA) administered with the North Carolina Department of Justice. "Originally in 2022, Rowan County was set to receive $18,000,000 that has changed, and now we are set to receive $28,000,000," she told the board. The funds are intended for opioid remediation: treatment, overdose prevention, expansion of behavioral health services, workforce development and technology initiatives. The MOA requires counties to pass a resolution and an ordinance to authorize spending and to select from Option A strategies (and optionally pursue deeper Option B strategies through a collaborative strategic plan).

Alyssa described county outcomes since 2020: declines in several indicators (overdose ED visits, opioid prescriptions, foster care entries tied to parental substance use) while noting a persistent concern about illicit overdose deaths and stronger street drugs. She warned the board about a new substance in the supply, "metatomedine," describing it as a veterinary tranquilizer (sometimes called a "rhino tranq") that has contributed to a recent spike in younger overdose deaths. "There's a new substance called metatomedine that is a rhino tranq... and Narcan does not fully revive that individual," she said.

Rowan County is using transparent reporting: an opioid settlement page on the county website is updated monthly with expenditures and outcomes; the Board of Health receives regular updates and the county reports annually on program results. The county has completed collaborative strategic planning and selected Option A evidence-based interventions; staff said some Option B approaches will be unlocked if the county pursues the collaborative planning pathway. Alyssa indicated that some funds have already been used for early grants (RFAs/RFPs) to schools and partner organizations and noted plans to expand medication-assisted treatment (MAT/MOUD) capacity and other services.

What happens next: staff will continue reporting outcomes to the Board of Health and the Board of Commissioners, publish spending details on the county website, and bring specific ordinance/resolution language forward for any spend authorization required under the MOA.