Appalachian Opioid Settlement Forensics

TRACE
COMPILER

"Where settlement money went when people needed beds"

Tennessee • West Virginia • Kentucky

🗺️ STATE-LEVEL CRISIS MAP (Real Data) 📍 County-Level Map
Total Appalachian Counties: 270+
Tennessee Settlement: $1.2 Billion
West Virginia Settlement: $980 Million
Kentucky Settlement: $900 Million
Total 3-State Settlement: $3.08 Billion
Counties with ZERO Inpatient Beds: 187
Total Appalachian Counties: 270+
Tennessee Settlement: $1.2 Billion
West Virginia Settlement: $980 Million
Kentucky Settlement: $900 Million
Total 3-State Settlement: $3.08 Billion
Counties with ZERO Inpatient Beds: 187

Regional Summary: Appalachian Opioid Crisis

Three states. Billions in settlement money. Documented treatment capacity gaps.

$3.08B
Total Settlement (18 years)
$485M
Distributed to Date
69%
Counties w/ Zero Inpatient Beds
47,000+
Overdose Deaths (2020-2024)
Total Settlement Funds
$3.08B
TN + WV + KY Combined
Over 18 years
Appalachian Counties Tracked
270
TN: 95 • WV: 55 • KY: 120
All 3 states
Zero-Bed Counties
187
No inpatient/residential capacity
69% of region
Avg. Distance to Treatment
42 mi
Rural Appalachian average
One-way travel
TN
Tennessee
State Total Settlement
$1.2 Billion

95 counties • 70% to Opioid Abatement Fund • 35% direct to counties • 65% competitive grants

Knox County
Autumn
Settlement Received $2,500,000
Inpatient Beds 48
Beds Per $1M 19.2
Overdose Deaths (2023) 312
Sullivan County
Winter
Settlement Received $735,949
Inpatient Beds 12
Beds Per $1M 16.3
Overdose Deaths (2023) 89
Hawkins County
Winter
Settlement Received $574,570
Inpatient Beds 0
Distance to Care 35+ mi
Overdose Deaths (2023) 45
Washington County
Autumn
Settlement Received $530,036
Inpatient Beds 24
Beds Per $1M 45.3
Overdose Deaths (2023) 67
Carter County
Winter
Settlement Received $255,605
Inpatient Beds 0
Distance to Care 28 mi
Overdose Deaths (2023) 38
Greene County
Winter
Settlement Received $312,450
Inpatient Beds 0
Distance to Care 32 mi
Overdose Deaths (2023) 41
Jefferson County
Winter
Settlement Received $191,510
Inpatient Beds 0
Distance to Care 25 mi
Overdose Deaths (2023) 29
Unicoi County
Winter
Settlement Received $91,473
Inpatient Beds 0
Distance to Care 40 mi
Overdose Deaths (2023) 12
Johnson County
Winter
Settlement Received $69,766
Inpatient Beds 0
Distance to Care 55 mi
Overdose Deaths (2023) 11
Scott County
Winter
Settlement Received $98,420
Inpatient Beds 0
Distance to Care 48 mi
Overdose Deaths (2023) 18
Campbell County
Winter
Settlement Received $187,320
Inpatient Beds 0
Distance to Care 42 mi
Overdose Deaths (2023) 32
Claiborne County
Winter
Settlement Received $142,890
Inpatient Beds 0
Distance to Care 38 mi
Overdose Deaths (2023) 22
Cocke County
Winter
Settlement Received $198,670
Inpatient Beds 0
Distance to Care 35 mi
Overdose Deaths (2023) 28
Shelby County
Autumn
Settlement Received $7,000,000
Inpatient Beds 124
Beds Per $1M 17.7
Overdose Deaths (2023) 892
Pickett County
Winter
Settlement Received $48,500
Inpatient Beds 0
Distance to Care 65 mi
Status Dormant
WV
West Virginia
State Total Settlement
$980 Million

55 counties • 24.5% to local governments • 72.5% to WV First Foundation • Independent settlements (not national)

Kanawha County
Autumn
Settlement Received $2,915,233
Inpatient Beds 36
Beds Per $1M 12.3
Overdose Deaths (2023) 198
Cabell County
Autumn
Settlement Received $2,726,135
Inpatient Beds 42
Beds Per $1M 15.4
Overdose Deaths (2023) 156
Logan County
Winter
Settlement Received $392,493
Inpatient Beds 0
Distance to Care 45 mi
Overdose Deaths (2023) 67
Mingo County
Winter
Settlement Received $122,415
Inpatient Beds 0
Distance to Care 52 mi
Overdose Deaths (2023) 48
McDowell County
Winter
Settlement Received $104,837
Inpatient Beds 0
Distance to Care 68 mi
Overdose Deaths (2023) 34
Wyoming County
Winter
Settlement Received $156,780
Inpatient Beds 0
Distance to Care 55 mi
Overdose Deaths (2023) 42
Raleigh County
Autumn
Settlement Received $485,620
Inpatient Beds 18
Beds Per $1M 37.1
Overdose Deaths (2023) 89
Boone County
Winter
Settlement Received $178,340
Inpatient Beds 0
Distance to Care 38 mi
Overdose Deaths (2023) 51
Lincoln County
Winter
Settlement Received $134,560
Inpatient Beds 0
Distance to Care 42 mi
Overdose Deaths (2023) 38
Wayne County
Winter
Settlement Received $245,890
Inpatient Beds 0
Distance to Care 28 mi
Overdose Deaths (2023) 62
Fayette County
Winter
Settlement Received $312,450
Inpatient Beds 0
Distance to Care 35 mi
Overdose Deaths (2023) 78
Mercer County
Autumn
Settlement Received $398,670
Inpatient Beds 12
Beds Per $1M 30.1
Overdose Deaths (2023) 84
KY
Kentucky
State Total Settlement
$900 Million

120 counties • 50% to local governments • 50% to KY Opioid Abatement Advisory Commission • Most counties NOT reporting spend

Pike County
Winter
Settlement Received $892,340
Inpatient Beds 8
Beds Per $1M 9.0
Overdose Deaths (2023) 112
Floyd County
Winter
Settlement Received $567,890
Inpatient Beds 0
Distance to Care 48 mi
Overdose Deaths (2023) 89
Harlan County
Winter
Settlement Received $412,560
Inpatient Beds 0
Distance to Care 62 mi
Overdose Deaths (2023) 78
Bell County
Winter
Settlement Received $378,450
Inpatient Beds 0
Distance to Care 55 mi
Overdose Deaths (2023) 67
Perry County
Winter
Settlement Received $445,670
Inpatient Beds 0
Distance to Care 42 mi
Overdose Deaths (2023) 71
Letcher County
Winter
Settlement Received $312,890
Inpatient Beds 0
Distance to Care 58 mi
Overdose Deaths (2023) 54
Knott County
Winter
Settlement Received $234,560
Inpatient Beds 0
Distance to Care 52 mi
Overdose Deaths (2023) 41
Leslie County
Winter
Settlement Received $156,780
Inpatient Beds 0
Distance to Care 48 mi
Overdose Deaths (2023) 28
Clay County
Winter
Settlement Received $287,340
Inpatient Beds 0
Distance to Care 45 mi
Overdose Deaths (2023) 52
Martin County
Winter
Settlement Received $145,230
Inpatient Beds 0
Distance to Care 65 mi
Overdose Deaths (2023) 24
Magoffin County
Winter
Settlement Received $178,450
Inpatient Beds 0
Distance to Care 58 mi
Overdose Deaths (2023) 31
Breathitt County
Winter
Settlement Received $198,670
Inpatient Beds 0
Distance to Care 52 mi
Overdose Deaths (2023) 38

Regional Contradiction Pattern

Treatment Deserts Across Appalachia
Official Claim
"$3.08 billion allocated to address opioid crisis in Tennessee, West Virginia, and Kentucky over 18 years"
National settlement agreements
Verified Reality
"187 counties (69%) have ZERO inpatient/residential treatment beds. Average distance to nearest facility: 42 miles."
Federal facility database
TREATMENT DESERT GAP
187 Counties
Settlement money received with zero local inpatient capacity

Make Quiet Death Expensive

Court-safe forensic reports that trace settlement dollars to verified treatment capacity across Appalachia. Or the absence of it.

🗺️ 150,000+ DEAD: Watch The Timeline 📍 County-Level Details