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Matching Funds Available for North Carolina Communities That Invest Opioid Settlement Funds in Harm Reduction

Matching Funds Available for North Carolina Communities That Invest Opioid Settlement Funds in Harm Reduction  


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Vital Strategies to Match Counties That Fund Syringe Service Programs and Distribution of Life-Saving Naloxone 

October 17, 2022 (North Carolina) Every day in 2021, ten North Carolinians died of a drug overdose. Fentanyl is linked to 75% of overdose deaths, and rural counties are particularly impacted. To address the crisis, opioid settlement litigation provides resources for county and municipal health programming. Over the next 18 years, North Carolina counties and municipalities will continue to receive over $640 million, with several larger counties eligible for upward of $1.5 million per year. Local governments are in the process of deciding how to spend these dollars to stem the tide of overdose deaths.   

To incentivize investment in evidence-based and life-saving interventions such as Syringe Service Programs (SSPs) and naloxone distribution, public health organization Vital Strategies is offering to match local opioid settlement dollars through an open application process. SSPs and community naloxone distribution are key in reducing overdose deaths and engaging people who use drugs in health and social services. In a 2022 survey conducted by Vital Strategies of SSPs providing services across 27 counties, only two out of 14 received any funding from local governments.  Most of these programs save hundreds of lives on less than $100,000 a year.  

“Time-tested lifesaving strategies like syringe service programs and naloxone distribution are underfunded in North Carolina,” said Marina Smelyanskaya, Senior Technical Advisor with Vital Strategies’ Overdose Prevention Program. “This match will allow local governments to double settlement dollars and put resources in the hands of people who need them most. Local governments and nonprofit partners have the skills and the capacity to deliver overdose prevention services—this influx of funds can reverse the deadly tide if invested into community response.” 

Opioid settlement funds provide an opportunity to build local capacity to address the overdose crisis through government and community collaboration. To establish or expand these partnerships, Vital Strategies will match county opioid settlement funding directed to SSPs and community naloxone distribution up to $70,000.00 per year for three years. A recently released request for applications (RFA) details the requirements of the proposal— counties and municipalities are encouraged to work with community partners to assess where naloxone and SSPs can make the most impact and save lives.  Strategies addressed in the RFA align with those described in Option A list (Strategies 7 and 9) and Option B list (Strategy H) that are exhibits to the North Carolina Opioid Settlement Memorandum of Agreement. 

Vital Strategies funding is available to local governments, health departments and 501(c)3 nonprofits. Applicants are asked to provide short submissions describing intended interventions as well as proof of county commitment to earmark a matching portion of opioid settlement funds to this initiative. Such proof may be either a formal recorded county budget discussion or a letter of commitment supplied by county officials. Applicants are encouraged to focus on sustainability and equitable allocation of resources to ensure access for North Carolina’s historically marginalized populations.  

“As a Commissioner from a rural county, developing a plan capable of meeting the challenges we face from opioid use disorder is daunting.  Funding this endeavor will exceed our county’s resources, and the need for additional support is vital,” said Commissioner Shaw from Montgomery County. “For months the dedicated staff from Vital Strategies have listened to our stories, provided guidance based on years of experience, and helped us develop a plan to utilize their gracious offer of matching funds toward a unified effort.  We are not naive to the obstacles in our path.  With the help of many hands we will lift our brothers and sisters out of the darkness.” 

“We are committed to investing the settlement funds into low-threshold syringe service programs and naloxone programming; additional funds from Vital Strategies will allow us to scale up interventions to save lives,” said Dr. Jennifer Green from Cumberland County. On August 17, the county board voted to support the Vital Strategies match.  

“This potential match provides an opportunity for county leaders to double the impact of settlement dollars, and increases their county’s capacity to recover from the opioid overdose crisis,” said Kevin Leonard, Executive Director of North Carolina Association of County Commissioners (NCACC). NCACC has been supporting local governments in managing the state MOA.   

The maximum allowable funding request per applicant is $210,000 over the three-year grant period, or $70,000 per year for three years. The three-year grant period is anticipated to begin on January 1, 2023, and funding is non-renewable beyond the grant period; this is a one-time-only award. Funding must be matched with county opioid settlement dollars. Questions regarding the RFA can be sent to Full applications are due to by 11:59pm EST on Monday October 31, 2022; however, extensions will be considered on an individual basis. Counties and partners are encouraged to reach out and to strategize about possible interventions and timelines.  

About Vital Strategies  

In November 2021, Bloomberg Philanthropies announced a five-year $120 million investment to help combat the overdose crisis in the hard-hit states of Kentucky, New Jersey, New Mexico, North Carolina and Wisconsin and advocate for federal policies to expand treatment access and harm reduction with a goal of accelerating progress in reducing overdose deaths nationally.    

The partnership between Vital Strategies, Pew Charitable Trusts, Johns Hopkins University, CDC Foundation and Global Health Advocacy Incubator is helping to strengthen and scale up evidence-based, data-driven policies and interventions to reduce overdose risks and save lives. The initiative builds on work of the past three years in Michigan and Pennsylvania, launched in 2018 with $50 million, and expands that work to promote improved federal policies.  

Learn more at 

Media Contacts:
Tony Newman; 646-335-5384  
Gloria Malone