Shelby County's Drug Court Is the Largest in Tennessee. It Ran Out of Inpatient Treatment Money, and the $500,000 Approved to Refill It Had No Spending Plan Attached.

SHELBY COUNTY COMMISSION

MEMPHIS, August 10, 2026 - The Shelby County Commission approved $500,000 from the county's opioid settlement special revenue fund for the Shelby County Drug Court on August 10, subject to the availability of funds.

At the August 5 Budget and Finance Committee meeting, the judge who presides over the court told commissioners the program had exhausted most of its inpatient treatment funds over the past year.

What the court told the commission

The judge said Shelby County operates the largest drug court in Tennessee. Roughly 40 percent of participants are opioid cases or present as opioid users.

He described why those cases cost more. Most of the opioid users are fentanyl users, and fentanyl is more addictive and more lethal than other drugs in the county, which means it requires more treatment. About 95 percent of opioid participants enter as inpatient clients, staying inpatient for 28 to 45 days. Because of the addiction, most then move to structured living for six months to a year, which he said can be very expensive.

He said Tennessee has an opioid fund for treating opioid users and that he could not think of a better use for it. At one point the program had 168 active participants, a figure that does not include people evaluated, assessed, or who started the program.

The court's administrator gave the commission four years of data covering 2022 through 2025. Since the judge took the bench in September 2022, 825 individuals were referred to the program and 536 were identified as high risk, high needs with a substance use disorder. Of those, 76 percent were male and 24 percent female.

She said the demographics have shifted. In the first two years the population was 46 percent Black, 47 percent white and 7 percent other. Over the past two fiscal years it is 61 percent Black, 32 percent white and 6 percent other, which she said mirrors the demographics of Shelby County.

On drug of choice, 37 percent of participants identify opiates, but 60 percent test positive for an opioid once admitted.

Asked by Commissioner Amber Mills about relapse, the administrator said under 25 percent of graduates are arrested and convicted of a new charge after graduating.

The missing exhibit

The committee chairman stopped on the mechanics before taking questions on the item.

He said the commission was going to need a budget or an exhibit, that he did not see how the funds would be spent, and that this would have to happen at some point for the item to be considered.

The judge said all of the funding is for treatment and would sit in an account for professional fees. The chairman asked whether that was in the resolution. The judge said he did not believe it was, and that a fund number would have to be created before it could be put in the resolution.

The item went forward.

The sustainability question

Commissioner Erika Sugarmon asked how many individuals $500,000 would support and what the projected outcome is, and raised sustainability, noting opioid settlement money arrives in increments.

The administrator said the court actively seeks other funding, has an application in with the state opioid abatement council with a decision expected the following month, and has a federal grant application pending.

She said the state has funded the court since 2006 and that the state grant is the largest, but that it does not meet all needs as the population changes, because the program takes high risk, high needs individuals who stay at least 18 months and many of whom are unhoused and need housing assistance after residential treatment.

Commissioner Sugarmon asked the court to begin assembling figures showing what a federal task force presence is costing the county court system, saying she intends to ask all divisions to do the same so the county can seek reimbursement.

What happens next

The resolution passed on August 10 and appropriates up to $500,000 subject to availability of funds. The court said a state opioid abatement council decision was expected the month following the August 5 meeting and that a federal grant application is pending. The record does not establish whether a spending exhibit or a fund number was created before the appropriation took effect.

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