Over the last three years or so, it’s a good bet that between 300 and 400 people have died from opioid-involved incidents across Carbon, Schuylkill and Monroe counties, a small part of more than 10,500 similar deaths reported across Pennsylvania, trends show.

It’s a crisis that’s moving faster than fentanyl’s pace, while the response can move at the speed of piled-up paperwork.

But as the new year unfolds, the three counties are refocusing their efforts — shifting from scattered advertising and small projects toward a more permanent treatment featuring services that are connected to courts.

There’s also a move toward grants that help change how local systems are responding to addiction.

In effect, officials are moving away from spreading the message about the crisis and moving toward shoring up the ways people are guided through jail time, hoping to get victims out of it alive.

All of the work is funded by the Opioid Settlement Fund, a massive piggy bank that started in 2022 and is expected to last for 18 years.

Across the state, until 2038, 70% of that money will flow to the state’s 67 counties to fund safety, treatment, prevention and recovery.

In Carbon, for example, they’ve been spending a significant part of their allocation on advertising to warn residents and connect them with services.

But lately, the focus has shifted, moving more toward a more court-based rehabilitation program at the county lockup in Nesquehoning.

This month, they updated two contracts with neighboring Monroe and Pike counties — one to provide treatment at the jail and another to fund a position that strengthens a link between the courts and treatment for residents battling opioid and related mental health issues.

And they’re looking further, exploring a plan in which the county might use opioid money to physically expand the prison with a dedicated treatment wing — a concrete investment in treating people during their incarceration.

Schuylkill County is already investing in bricks-and-mortar solutions. Last year, they opened a renovated Recovery Center in Pottsville that was funded by the county’s share of opioid settlements.

The center features a crisis walk-in and recovery center that tells those in need that help is available close to places where people in crisis show up.

For the county, it’s a move away from using settlement money to fill budget holes and instead anchoring it to long-term efforts to help people recover.

Then there’s Monroe County, where they’re using settlement money to fund grants and trusts in a more foundation-style approach.

Late last year, Monroe leaders set aside $2 million they’re using this year to approve individual grants to organizations working toward solutions. They’re pushing the money out through competitive or direct grants to help communities find answers.

Together, the counties show how the region is growing and maturing in how they use the piggy bank to target opioid issues.

Carbon is moving from billboards to treatment courts and prison-based care, hoping to establish a dedicated rehab space behind the walls.

Schuylkill is using drywall and paint to put their cut of the cash into a site that changes where and how people can access needed services.

And Monroe is building a grant system that can flex over time as overdose trends and needs of their communities change.

The changes in direction bring some level of risk. Without enough money targeting prevention issues — the current, less visible work that keeps people out of court, or a crisis center, or even jail — that direction may not be enough.

But the changes moving forward generate hope that at least at some level, area counties are asking valid questions.

The largest issue they face isn’t just how they’re spending money this year, it’s how they choose to spend the money in ways that will outlast the opioid settlement itself.

And if they get it right, county leaders can turn what was once a windfall of cash into a system that’s strong enough to keep going long after the cash stops flowing.

ED SOCHA | tneditor@tnonline.com

Ed Socha is a retired newspaper editor with more than 45 years’ experience in community journalism.

The foregoing opinions do not necessarily reflect the views of the Editorial Board or Times News LLC.