North Carolina’s Opioid Settlements

This Community Guide will describe how North Carolina is spending its opioid settlements and whether North Carolina is working to ensure community access to opioid settlement funds. Last revised September 1, 2024

Total Funds

$1.41 billion[1]

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[1] Total is rounded. See The Official Opioid Settlement Tracker Tally. Accessed September 1, 2024.

Allocation

85% to local governments and 15% to the state

Mechanism

State-Local Agreements (Memorandum of Agreement Between the State of North Carolina and Local Government on Proceeds relating to the Settlement of Opioid Litigation and Supplemental Agreement for Additional Funds from Additional Settlements of Opioid Litigation)

	85% Local Share	15% State Share
Ultimate Decisionmaker	Local officials for counties and municipalities	North Carolina General Assembly
Decision-making Process	Localities decide autonomously but are subject to required reporting, annual audit, and consequences for misspend. Localities must authorize settlement spending by budget and separate resolution. A locality may also be required to engage in a collaborative, strategic planning process, depending on which strategies the locality chooses to fund.	North Carolina General Assembly directs spending through appropriations
Supplantation	Not prohibited	Not prohibited
Grant Funding	Up to each locality (availability and processes will vary)	Yes. For live opportunities, see Opioid Settlement Tracker’s Community Grant Tracker.
Public Input	Up to each locality (generally not required). Only the minority of local governments that have opted into Option B’s collaborative, strategic planning process are required to seek public input on uses of their shares.	No opportunities available (not required)
Advisory Body	Up to each locality (not required). The state’s Coordination Group may provide support to local governments but does not operate in a traditional advisory capacity. The Coordination Group is not required to include member(s) with lived and/or living experience.	No (not required)
Expenditures	Public reporting required. Local governments must annually submit financial and impact reports to the statewide Data Dashboards. See, e.g., Local View Dashboard, Past Spending.	Neither public nor intrastate reporting required, but see State Spending of Opioid Settlement Funds.
Updates	For updates on the local share, visit CORE-NC: Community Opioid Resources Engine for North Carolina — which contains several Data Dashboards, e.g., Local View Dashboard, Local Spending Plans — and be sure to bookmark the Coordination Group’s page to stay informed of its public virtual meetings. See also individual localities’ opioid settlement-related websites, e.g., Durham County.	For updates on the state share, visit CORE-NC: Community Opioid Resources Engine for North Carolina’s several Data Dashboards, e.g., State Spending of Opioid Settlement Funds, NC Payment Schedule.