Sandhills opioid funding misses the mark for residential treatment

In North Carolina’s Sandhills, where opioid settlement funds are shaping the future of addiction recovery, one critical group, women, remains underserved by housing and support systems designed to help them reclaim their lives. There is a solution, however, to serving both men and women.

North Carolina received its first funds from the $26 billion national opioid agreement with the major drug distributors Cardinal, McKesson, AmerisourceBergen and Johnson & Johnson in June 2022, over three years ago.

Moore, Lee, and Harnett have a combined estimated $21.8 million remaining in funds to be allocated.

Limited Residential Treatment

In Moore, Lee and Harnett counties, residential opioid addiction treatment is limited.

Moore County

Pilgrim’s Progress Safe House provides supportive housing and transitional care for men.

Samaritan Colony, in Rockingham, North Carolina, supports Moore County men in its residential treatment facility, with a 28-day program tailored for adult men struggling with substance use disorders, with 40% of its clients originating from Moore County.

Lee County

Solo Behavioral Health Services PLLC accepts Medicaid and offers residential treatment for opioid addiction for both men and women.

Harnett County

Harvest House, a Medicaid-friendly company, operated by CommWell Health in Dunn, offers residential rehabilitation treatment for men.

Oxford House in Dunn offers housing for people of both genders after an initial detox, and it is self-governed but without clinical treatment.

Also in Dunn, Journey’s Door Women’s Home on Merry Street in the Westhaven subdivision houses six women who are not in active drug withdrawal, who contribute to society by employment, and who pay rent. There is no drug treatment at the Recovery Alive Inc. group home, Journey’s Door.

Budget Priorities

According to the commissioner board meeting minutes, Harnett County has allocated almost $11.9 million over 18 years for opioid response programs such as Medication-Assisted Treatment (MAT), in jails, community paramedicine, drug courts, peer support, and reentry services. In a May 2025 meeting, they announced they had received about $3.8 million.

In 2024, the Moore County Opioid Task Force announced it will receive over $11.7 million by 2038. In February 2025, the county planned to use $690,000 each year between 2022 and 2038 to support recovery housing and provide naloxone.

Lee County has about $1.8 million allocated through 2028 to fund treatment, peer support, naloxone distribution, jail MAT, and reentry services, as outlined in county opioid plans.

Programs

Harnett County reports that its detention center actively uses MAT, widely distributes Narcan and community paramedics regularly respond to overdoses. Although the county’s use of the state’s Option A funding shows a commitment to long-term recovery, the county lacks dedicated housing for women in recovery.

Moore County shows progress with funded organizations meeting reimbursement targets and extending contracts. However, some community partners have struggled with reporting and funding requests, underscoring uneven program implementation.

Lee County’s smaller funding pool limits expansion but supports peer recovery, jail-based MAT, and prevention. Limited local recovery housing for women forces residents to rely on programs outside the county, impacting accessibility and continuity of care.

Disparities in Women’s Recovery Housing

Women seeking recovery housing face distinct challenges in all three counties.

Harnett County offers no dedicated housing for women in active recovery. Women often must access out-of-county programs, such as Robeson Health Care Corporation’s Grace Court and Our House, and both focus on pregnant women or mothers with newborns, limiting acceptance into the programs and raising transportation concerns.

Moore County provides a housing option for women, a faith-based and trauma-informed program, Bethany House, which houses eight women. It encourages drug rehabilitation programs but does not offer clinical recovery treatment.

Lee County’s options for women are the most limited, with temporary shelters not tailored to recovery and no local sober living homes for women. Men have access to peer-run sober living, but women must navigate scarce, distant services.

Why Women Need RAPID Treatment and Housing

According to a 2022 article in the National Library of Medicine, “The co-occurrence of sex trafficking victimization and victim SUDs creates challenges for the identification of victims, the provision of treatment and services for victims, and the criminal justice response to sex trafficking.”

Substance use disorders (SUDs) and sex trafficking awareness, training, and help are lacking in rural areas like North Carolina’s Sandhills.

Looking Forward

All three counties’ track records show dedication to combating opioid addiction through comprehensive funding and programming, but residential treatment is missing.

The 2024 study “Opioid Use Disorder among Hospitalized Adults in North Carolina: Analysis from the 2000–2020 NC State Inpatient Database” shows women aged 25 to 54 were more likely to be diagnosed with opioid use disorder (OUD) during hospital discharge than other groups. The study, analyzing nearly 19.4 million hospital admissions from 2000 to 2020, reported that OUD diagnoses were significantly associated with being in the 25–54 age range and being female.

Moore, Lee, Harnett: Call for Committees for Women in Recovery

To better address the needs of women in recovery:

Conduct a thorough needs assessment focused specifically on housing and support services for women overcoming opioid addiction.

Increase funding allocations toward responsive recovery housing for women.

Comprehensive, ongoing support systems, including peer mentoring and services guided by survivors, should integrate harm reduction approaches and recognize that setbacks are a common part of recovery from substance use and leaving trafficking situations.

Establish partnerships with local shelters and healthcare providers to develop specialized transitional housing programs tailored for women.

Collecting and publicly reporting women-specific recovery outcome data will help guide future funding and program decisions.

To ensure these efforts are effective and community-driven, counties may form dedicated committees with healthcare professionals, recovery advocates, housing experts, and women with lived experience in recovery.

This committee would oversee the planning, implementation, and ongoing evaluation of women-centered recovery housing initiatives, ensuring programs meet the unique needs of women in recovery.

A Tri-County Opioid Recovery Center

Moore, Lee and Harnett counties currently hold a combined $21.8 million in remaining opioid settlement funds. A shared investment in a centralized rehabilitation facility would offer a long-term, life-saving solution.

This idea does not account for purchasing land.

A Tri-County Opioid Recovery Center could be a 40-bed residential treatment facility of about 20,000 square feet with medical detox rooms, group and individual therapy spaces, a dining area, recreational space, and staff offices may save more going into the future than immediate naloxone injections alone.

The program could offer evidence-based therapies, 12-step support, family counseling, peer recovery coaching, and workforce reintegration support.

With tri-county investment, more oversight and community support emerge.

Financial

Construction and Start-Up: $14 million

This includes land, building construction, furnishings, medical equipment, and licensing.

Remaining Funds for Operations: $7.8 million

Estimated annual operating costs are $3.65 million, covering staffing, therapy, food, utilities, and medical services.

These funds would fully support the first two years of operation.

Sustainability

Long-term operations could be sustained through Medicaid and private insurance reimbursements, grants, and local partnerships.

Impact

The Tri-County facility would fill a critical regional gap in services by offering accessible, residential treatment to hundreds of individuals annually. It would reduce overdose deaths, support long-term recovery, and strengthen families and communities impacted by addiction.

Next Steps

Form a regional planning committee with representatives from each county to begin feasibility assessments, site selection, and operational planning. A unified investment today can save lives and build a sustainable future for addiction recovery in the Sandhills.

July 13, 2025

Stephanie M. Sellers

Sellers covered opioid settlement fund use since its release in June 2022.

Alemu, Brook & Beydoun, Hind & Olayinka, Olaniyi & Harmer, Beth & Brown, Aaron. (2024). Opioid Use Disorder among Hospitalized Adults in North Carolina: Analysis from the 2000-2020 NC State Inpatient Database. Southern medical journal. 117. 226-234. 10.14423/SMJ.0000000000001686.

Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Rockville, Md.: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2020, HHS Publication No. PEP20-07-01-001.