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Durham advisory committee recommends $2.3M in opioid investments; county annualizes $1.1M in settlement revenue
Summary
Durham’s opioid settlement advisory committee recommended $2.296M in FY27 opioid remediation investments — including naloxone distribution, syringe‑service support, post‑overdose response expansion, recovery housing and a medical director for jail addiction care — while county staff stressed the settlement’s Option A restrictions and a sustainable annualized target of about $1.1M.
Durham County presented its opioid settlement program overview and FY27 funding recommendations to commissioners on May 28, highlighting expanded harm‑reduction and treatment links while noting legal constraints on how settlement dollars may be used.
The funding context: Jason Smith, the county’s opioid settlement manager, said Durham expects roughly $20 million over 18 years from the national opioid settlement (2022–2038), an annualized planning assumption of about $1.1 million (payments are front‑loaded and decline). Under Option A rules governing the county’s allocation, funds must be used for opioid remediation and related evidence‑based services and must be publicly reported annually.
OSAC recommendations: The Opioid Settlement Advisory Committee (OSAC) co‑chairs presented FY27 recommendations that total roughly $2.296 million (a one‑year increase above typical annualized investment). Major recommended investments include: expanded naloxone distribution (public‑health vending machines and partner networks), syringe‑service program support, a post‑overdose response team (PORT) expansion within EMS, recovery support services and recovery housing, funding for addiction treatment in incarceration settings (including a medical director position in the sheriff’s office), and collaborative strategic planning and administration. OSAC recommended a roughly 60/40 split of proposed spending to county‑led vs community‑based programs; public survey respondents favored a balanced approach.
Program highlights and outcomes: Smith reported >5,100 naloxone kits distributed this fiscal year with 75 self‑reported overdose reversals tied to local distribution and vending‑machine access; vending machines expanded from two to four locations (including a heritage center and clinic). The syringe‑service program distributed ~122,000 syringes through Q3 — up sharply from ~7,400 the prior year — and expanded partnerships (including the city’s HART 911 crisis response). The PORT team reported engagement with 458 overdose patients through Q3 and direct follow‑up with 163; about half of treatment referrals resulted in successful connections to care.
Sustainability and governance questions: County staff and OSAC members stressed the tension between doing larger one‑time investments in FY27 and planning for sustainable services at the annualized level (the settlement declines over time). Commissioners asked for clarity about the RFP process, nonprofit partner lists, and the balance between county‑run and community‑based investments; OSAC said it will debrief the RFP experience and provide lessons learned.
What commissioners asked for: A list of the ~40 community partners active in naloxone distribution, a deeper explanation of RFP challenges, and follow‑up on how the county will plan for the end of settlement funding for recurring services. Smith and OSAC co‑chairs committed to written materials and a public forum the following week to discuss details.
Bottom line: OSAC delivered a robust set of evidence‑based recommendations for FY27, but commissioners must weigh one‑time increases against long‑term sustainability and clarity on community vs county allocations.
