How New York is Using Settlement Dollars to Increase Access to Low-Threshold Buprenorphine Services

Program Overview: The New York State Office of Addiction Services and Supports (OASAS) has invested over $20 million of its share of opioid settlement funds to expand access to low-threshold buprenorphine services across fifteen providers statewide. Buprenorphine is an evidence-based medication for opioid use disorder (MOUD). Low threshold approaches aim to eliminate barriers associated with accessing conventional opioid use disorder treatment, such as requiring long assessments or treatment planning sessions prior to initiating MOUD. A specific goal of OASAS’ investment is to increase access to same day, immediate enrollment in buprenorphine treatment.

How OASAS Came to Invest in Low-Threshold Buprenorphine: OASAS’ decision to invest settlement dollars in low-threshold buprenorphine services stems from recommendations from the New York State Opioid Settlement Advisory Board (OSFAB), as well as OASAS’ strategic plan and guiding principles, which emphasize immediate connections to care, evidence-based solutions, and racial equity (given there are notable racial disparities in MOUD access). Additionally, working with the state’s settlement advisory board, OASAS identified several barriers programs had with implementing low-threshold buprenorphine services that could be addressed with settlement funds, such as recruiting staff and reconfiguring workflow and systems to allow for quicker medication access.

How Funds are Supporting Same-Day MOUD Access: The fifteen providers participating in this project are using funds in a variety of ways to expand same day buprenorphine access. This includes:

Expanding drop-in clinic night and weekend hours.
Adding an emergency department-based social worker to engage patients interested in initiating buprenorphine, as well as training emergency department staff on providing referrals for these services and how to meet this need when the social worker is not on call.
Using a mobile van to offer in-community access to buprenorphine.
Partnering with a maternal health program to engage patients who may benefit from buprenorphine during regularly scheduled maternal health visits.

Implementing these workflows of low barrier, in-community care is also helping two providers pursue Certified Community Behavioral Health Clinic (CCBHC) status, which will support long-term sustainability when the program ends. CCBHCs are a federally designated model of care that provide enhanced funding to organizations meeting standards for integrated behavioral health and primary care services.

Initial Impact: Since receiving funding, the 15 providers participating in the initiative have engaged 4,000 unique individuals across 25 New York counties. As of February 2026, this includes 1,400 unique individuals reporting active opioid use, 20% of whom initiated buprenorphine. While the majority (89%) of total visits have involved MOUD services, providers are also delivering several other supportive services such as counseling, harm reduction services, care management, and opioid use disorder screening and diagnosis.

Alignment with the Principles

Principle 1—Spend the Money to Save Lives: Settlement dollars were used to expand access to life saving treatment and MOUD services.
Principle 2—Use Evidence to Guide Spending: Medications for opioid use disorder, like buprenorphine, are associated with more than a 50% reduction in overdose mortality.
Principle 4—Focus on Racial Equity: Racial equity is a key component of OASAS’ strategic plan and guiding principles, and this investment in low-threshold buprenorphine services seeks to reduce racial disparities in MOUD access.