Wake County is asking residents to help decide how to use more than $67 million in opioid settlement money, and the message from county leaders is clear: this cash should build something that lasts. At a public meeting Wednesday at NC State's McKimmon Center, officials said they want the funding to support long-term prevention, treatment and recovery services, not one-off projects that disappear when the checks stop. Residents, service providers and people with lived experience turned out to push for investments that reach people beyond traditional clinic walls.
According to the county's FY26–27 Funding Plan, Wake is set to receive about $67.7 million from the national settlement, with payments stretching through 2038 and a suggested $19.47 million to be spent over the next two fiscal years, per the county funding plan. The document lays out top strategies such as evidence-based treatment, recovery support services and recovery housing, and it urges multi-year awards to stabilize programs and track outcomes over time. Staff told the crowd that the FY26–27 package is just an early slice of a much longer funding runway.
Officials said Wake has already pushed settlement dollars out the door through a competitive awards process, using the money to launch the state's first mobile opioid treatment program and to open a recovery café and hub. ABC11 covered the June community meeting, and the North Carolina Department of Health and Human Services has highlighted the Raleigh recovery café this year as a tangible example of local recovery supports. County leaders said those early projects are designed to connect with people who might never set foot in a brick-and-mortar clinic.
What's on the table
The FY26–27 proposal breaks the near-term funding into several buckets. About $7.7 million would go to recovery support services, $4 million to recovery housing and $2.7 million to evidence-based treatment, with smaller portions reserved for naloxone distribution, criminal-justice diversion and treatment in jails, according to the county plan. The document lists potential local partners ranging from clinic operators to housing providers and recommends a competitive grant process to decide who ultimately delivers the services. Officials said the goal is to back programs that can show measurable results over several years.
“Although we're seeing a decline, we're still seeing more overdoses than before COVID,” Alyssa Kitlass, Wake County's opioid settlement program manager, told attendees. County staff added that 169 Wake residents died of opioid overdoses in 2024, according to ABC11. Advocates in the room pressed the county to emphasize peer support, housing and mobile treatment, arguing that those approaches can save lives quickly while also steering people into longer-term care.
How to weigh in
Staff said the county will keep running community surveys, public input sessions and open procurement cycles so residents and providers can influence how the rest of the money is spent. Wake County has already been issuing competitive solicitations tied to the settlement, including recent RFPs for opioid-use education and prevention, as shown in a county procurement posting. Officials encouraged people who could not make the meeting to keep an eye out for notices about upcoming sessions and grant opportunities.
For providers and advocates who are used to scraping together short-term funding, the settlement's predictable stream of payments offers a rare chance to design multi-year programs. County leaders said the next rounds of awards, along with how the Board of Commissioners signs off on the funding plan, will shape whether this moment translates into lasting changes in access to treatment and recovery in Wake County.
