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San Antonio health officials outline opioid settlement spending; Narcan kits and outreach contracts headed to council
Summary
Metro Health told the Community Health Committee it plans to use city opioid settlement funds for prevention, harm reduction, treatment and recovery — including Narcan distribution, MAT for people experiencing homelessness, outreach contracts and a new resource portal. Seven related contracts will go before City Council next week.
Jessie Higgins, Metro Health's chief mental health officer, briefed the Community Health Committee on the city's planned use of opioid settlement funds and local overdose trends.
Higgins said national fatal overdoses have decreased through 2024 and into 2025, but warned that polysubstance use remains common. "We see here that polysubstance use is common, opioids both poses pose a threat to our community," Higgins said. She urged the committee to support spending across the full "prevention, harm reduction, treatment and recovery" continuum.
The state has secured more than $1,600,000,000 in opioid settlement funds, Higgins said; the city expects to receive about $6,100,000 from the lawsuits it joined directly, of which $2,900,000 has already been received and the remainder will be paid in installments through 2041. Higgins said the funds carry abatement-style spending restrictions and that the city is mapping projects to the four-part framework.
Higgins outlined several concrete steps the city is taking: systems-change work to shift substance-use outreach practice; contracts from an RFP for outreach, engagement, training and Narcan kits that will be presented to City Council on March 5; an interlocal agreement with Bexar County to provide community supplies; funding to pay for medication-assisted treatment (MAT) for people who are both experiencing homelessness and have opioid use disorder; and development of a searchable substance-use resource portal (sacred.org) currently in user testing.
She also noted changes in the external funding landscape that affect city budgeting: Narcan is now available over the counter and can be accessed free through state resources, and the state's TOPS (Texas opioid prevention for students) program is being implemented through Texas A&M San Antonio. "So this money that we had budgeted for Narcan, we don't need to pay for Narcan," Higgins said, adding the city can redirect those funds to other gaps.
Council members asked about 2025 CDC overdose data; Higgins said 2024 data was recently approved and provisional 2025 figures typically become available later in spring or midyear. Higgins said Metro Health coordinates regularly with Bexar County on treatment capacity and that the city will try to fill gaps left by state and county efforts.
The committee took no formal vote on spending today; Higgins said the seven contracts for outreach and Narcan kits will go to full City Council for consideration next week.
