At its quarterly meeting, Alabama’s Oversight Commission for Opioid Settlement Funds reported significant progress in the state’s battle with opioid addiction, including a nearly 31 percent decrease in overdose deaths over the past year and new developments in treatment and prevention programs funded through the state’s share of national opioid settlements.
As of late September, Alabama has received roughly $113.4 million in settlement payments, with an additional $240.5 million expected by 2036. The state has appropriated $81 million so far, leaving about $32 million unobligated. Annual payments are projected to average around $33 million per year, tapering off as the settlement period ends.
In 2023, $8.5 million was directed toward provider grants through the Alabama Department of Mental Health. In 2024, $30 million was appropriated, followed by $41 million in 2025, which included $5 million for new commitment beds and $5 million for a standalone opioid treatment center.
In 2016, Alabama recorded 121.1 opioid prescriptions per 100 residents, more than one per person, including infants and children. That number has since dropped by nearly 41 percent through tighter monitoring and enforcement. The Prescription Drug Monitoring Program, administered by the Alabama Department of Public Health, now allows prescribers to cross-check opioid prescriptions and flag potential overuse or duplication.
Since March 2024, Alabama has distributed more than 88,000 naloxone kits to law enforcement, first responders, community organizations, and individuals. Officials noted that many overdose reversals go unreported when naloxone is used privately, suggesting that the real number of lives saved is likely much higher than official data indicates.
A $5 million appropriation approved this year will fund Alabama’s first dedicated therapeutic community treatment center, designed for individuals requiring long-term, structured recovery support. The model integrates housing, employment preparation, and identity development with clinical treatment. The program will operate as a one-time grant, with recipients expected to build self-sustaining operations over time.
“That’s the first time that we were talking about long-term care. I applauded you for that. That is a major, major need. We need to find another way to reach and to delve into that model,” said Sen. Greg Albritton, R-Atmore.
The Alabama Department of Corrections also reported progress in its Medication-Assisted Treatment program, which launched in 2024 to provide evidence-based addiction treatment to incarcerated individuals. More than 500 people in state custody have received MAT so far, and 256 remain in active treatment.
Under the program, every person entering the prison system is screened for substance use history, and those already receiving MAT continue their medication after incarceration. The department plans to expand treatment to work-release centers, followed by the broader prison population.
ADOC leaders emphasized that expanding treatment access inside prisons also requires education and stigma reduction among correctional staff and inmates.
“People stigmatized individuals that had addiction issues. And so what we had to do was train. We had to train all of our correctional officers, we had to train our support staff, and we had to train our own substance use treatment staff,” said Deborah Crook, Deputy Commissioner Health Services.
The Alabama Bureau of Pardons and Paroles presented data showing a drop in recidivism from 34 percent to 28 percent, ranking the state 12th lowest nationally. Director Cam Ward credited the improvement to data-driven investments and the expansion of day reporting centers that provide treatment, counseling and employment services for individuals on probation and parole.
Approximately 67 percent of Alabama’s 44,500 probation and parole clients have a history of substance use, Ward said.
“These programs are working because we’re finally treating addiction as a health issue instead of just a criminal one,” said Ward.
New settlement-funded initiatives include reopening the Thomasville facility as an all-women’s recovery and reentry center, offering trauma-informed care and vocational programs for women leaving prison.
Transportation continues to be a major barrier for individuals seeking treatment, specifically in rural areas. To address this, the Bureau has funded more than 1,200 rides for clients attending treatment programs in high-need counties.
Public health officials say that while the decline in overdose deaths is encouraging, maintaining that trend will require long-term planning and continued coordination among state and local agencies. Commission members noted that settlement payments will begin to decrease after 2030, meaning sustainable funding models must be in place well before then.
Several members called for better data integration across agencies to measure long-term outcomes, such as reduced relapse rates. Others emphasized the importance of focusing funds on rural and underserved regions that continue to struggle with access to mental health and addiction services.
As the state looks ahead, priorities for the next year include sustaining successful grant programs and expanding access to recovery housing.
