The airport near here with only 1 ILS allows them, but the ones with ILS to both ends do not. Not sure if that's part of the story or not.
Here's the whole story if you care to read it below. Long story short it's become so cumbersome that most facilities can't do it much anymore due to other traffic/LOA limitations.
2−1−31. OPPOSITE DIRECTION
OPERATIONS
Opposite Direction Operations consists of IFR/VFR
Operations conducted to the same or parallel runway
where an aircraft is operating in a reciprocal direction
of another aircraft arriving, departing, or conducting
an approach.
REFERENCE−
FAA Order JO 7110.65, Para 1-2-2, Course Definitions
a. Each facility must:
1. Determine the operational feasibility of
conducting opposite direction operations.
2. At a minimum, develop the opposite
direction operations procedures necessary to
accommodate aircraft that have an operational need
or receiving operational priority.
REFERENCE−
FAA Order JO 7110.65, Para 2-1-4, Operational Priority
b. For aircraft receiving IFR services that are
conducting opposite direction operations to the same
runway, facility directives must:
1. Define minimum cutoff points identified by
distance or fixes between:
JO 7210.3AA 10/12/17
2−1−14 General
(a) An arrival and a departure.
(b) An arrival and an arrival.
2. Specify that use of Visual Separation is not
authorized, except at those unique locations that are
operationally impacted by terrain and when issued a
Letter of Authorization by the Service Area Director
of Operations.
3. Require traffic advisories to both aircraft.
EXAMPLE−
OPPOSITE DIRECTION TRAFFIC (distance) MILE
FINAL, (type aircraft). OPPOSITE DIRECTION
TRAFFIC DEPARTING RUNWAY (number), (type
aircraft). OPPOSITE DIRECTION TRAFFIC,
(position), (type aircraft).
4. Require the use of a memory aid.
5. Prohibit opposite direction same runway
operations with opposing traffic inside the applicable
cutoff point unless an emergency situation exists.
6. Specify the position/facility responsible for
ensuring compliance with cutoff points between
aircraft conducting opposite direction operations.
7. Contain the following minimum
coordination requirements:
(a) Define the facility/position that is
responsible for initiating coordination.
(b) All coordination must be on a recorded
line and state “Opposite Direction.” Initial
coordination must include call sign, type, and arrival
or departure runway.
c. The cutoff points established under
subparagraph b1 must ensure that required lateral
separation exists:
1. When a departing aircraft becomes airborne
and has been issued a turn to avoid conflict; or
2. When the first aircraft has crossed the runway
threshold for opposite direction arrivals.
3. If the conditions in subparagraphs c1 and c2
are not met, facility directives must require action be
taken to ensure that control instructions are issued to
protect the integrity of the cutoff points.
d. At a minimum, the following must be
considered when developing cutoff points:
1. Aircraft performance.
2. Type of approach.
3. Operational position configuration.
4. Runway configuration.
5. Weather conditions.
6. Existing facility waivers.
e. For aircraft receiving IFR services that are
conducting opposite direction operations to parallel
runways regardless of the distance between
centerlines, facility directives must:
1. Ensure that a turn away from opposing traffic
is issued when opposing traffic is inside the cutoff
points defined in b1 for the other runway.
2. Specify that use of Visual Separation is
authorized once a turn away from opposing traffic is
issued.
REFERENCE−
FAA Order JO 7110.65, Para 7-2-1, Visual Separation
3. Require traffic advisories to both aircraft.
EXAMPLE−
OPPOSITE DIRECTION TRAFFIC (distance) MILE
FINAL, (type aircraft). OPPOSITE DIRECTION
TRAFFIC DEPARTING RUNWAY (number), (type
aircraft). OPPOSITE DIRECTION TRAFFIC,
(position), (type aircraft).
4. Require the use of a memory aid.
5. Contain the following minimum
coordination requirements:
(a) Define the facility/position that is
responsible for initiating coordination.
(b) All coordination must be on a recorded
line and state “Opposite Direction.” Initial
coordination must include call sign, type, and arrival
or departure runway.
(c) At those locations that routinely conduct
Opposite Direction Operations due to noise
abatement at night and when issued a Letter of
Authorization by the Service Area Director of
Operations, the provisions of paragraph e5 above are
not required.
f. For VFR aircraft that are conducting opposite
direction operations to same or parallel runways,
facility directives must contain procedures requiring
the use of the following, including but not limited to:
1. Ensuring departing VFR aircraft are issued a
turn to avoid conflict with opposing IFR/VFR traffic.
2. Traffic advisories to both aircraft.
10/12/17 JO 7210.3AA
General 2−1−15
3. State the phrase “opposite direction” if
coordination is required.
4. Memory Aids.
g. All facility directives and letters of agreement
addressing opposite direction operations must be
approved by the Service Area Director of Operations.
REFERENCE−
FAA Order JO 7110.65, Para 3-8-4, Simultaneous Opposite