Published: 10/22/2026 | Author: Nikki Wisher

Baltimore has one of the largest opioid addiction settlements in the entire USA. The city was awarded $427.5 million in opioid restitution funds and has already allocated $124,460,291 for treatment. There’s now a second round of community grants in the works.

To be clear, Maryland already has many programs that battle opioids. Services range from large inpatient facilities to local Narcotics Anonymous chapters. However, too many people still die from drugs. Thus, the need for more programs.

The Opioid Settlement in Maryland

The awarded total consists of two halves. The city’s share comes to $259,054,695, while $168,445,305 goes to litigation fees and expenses. Over $87 million already went to programs, $29,293,671 to city agencies, $6,166,620 to administration and $2 million to communities to promote and spread awareness on the local level.

The gap between awarded and allocated money is the heart of the debate. Recovery advocates note that Baltimore is hit harder by opioid abuse than almost any American city and holding money back means more people aren’t being helped.

Some Controversy

However, the main point for many people isn’t just the money. A debate has arisen about whether the cash is best used for simply responding to opioid addiction or actually making infrastructure like housing, peer support and treatment access so people don’t go back to drugs.

Opioid Addiction & Treatment

Opioids include heroin, fentanyl or prescription painkillers. Fentanyl is a deadly synthetic opioid and is the culprit for most fatal overdoses. Withdrawal might not be life-threatening by itself but the real danger comes from relapse because tolerance drops quickly after you’ve been sober for a while.

Baltimore residents have several options. Naloxone, the overdose reversal medication, is available through pharmacies and directly from the city. 

Medication-assisted treatment can be accessed through clinics across the city. Peer support via NA meetings offer free and ongoing recovery communities for people at any stage.

NA Still a Top Option

Speaking of NA, groups dot the landscape and most neighborhoods have chapters made up of peers and locals. The fellowship there lasts for decades, even long after recovery.

You can find NA meetings anywhere in the USA via our browsable directory. Feel free to also dial 800-934-1582(Sponsored) to speak with an expert about opioid addiction treatment options.