Arapahoe County, CO
Arapahoe County Sheriff’s Office
COlorado
Urban | Population: 667,000Arapahoe County, Colorado’s third largest county, stands at the crossroads of a profound public health and criminal justice challenge. With a population now approaching 667,000 and spanning 805 square miles, the county encompasses a diverse blend of urban, suburban, and rural communities across 13 cities and towns. While the county seat is Littleton, Aurora is its most populous city, reflecting the region’s dynamic demographic and economic landscape.
The Crisis
The impact of opioids, stimulants, and other illicit drugs has been devastating. In 2020, drug and alcohol-related deaths accounted for 45% of all accidental fatalities in Arapahoe County, 154 out of 340, making substance use the leading cause of accidental death and the main contributor to the overall rise in accidental fatalities that year. The surge in overdose deaths has been driven primarily by fentanyl, with fatalities escalating from 21 in 2018 to 71 in 2020. Cocaine-related deaths also nearly doubled in 2020 compared to the previous year. Emergency room visits and hospital admissions for opioid overdoses have risen in tandem, mirroring statewide trends and underscoring the urgency of the crisis.
The criminal justice system is deeply affected by these trends. As of June 2021, approximately 53% of the Arapahoe County Detention Facility’s population met the clinical criteria for a substance use disorder or had a mental health diagnosis. Many individuals present with co-occurring disorders, and the majority are men between the ages of 21 and 40. The Jail Based Behavioral Health Services (JBBS) program, operated in collaboration with Aurora Mental Health Center, provides screening, therapy, and reentry case management. However, the sheer volume and complexity of need have outpaced current resources.
Gaps in Treatment and Service Capacity
Upon release, formerly incarcerated individuals face formidable barriers to successful reentry, including unstable housing, limited employment opportunities, and insufficient access to ongoing treatment. Without robust discharge planning, peer support, and transitional housing, these individuals remain at high risk for relapse, recidivism, and overdose. The proposed project directly addresses these urgent needs by expanding discharge planning, peer recovery support, and transitional housing, thereby strengthening the continuum of care for justice-involved individuals and improving public health and safety outcomes across Arapahoe County.
The Response
Medication-Assisted Treatment
1,177
mat program participants in 2024
As of July 2023, Colorado law requires all jails to have plans for medication-assisted treatment (MAT) services. Before this mandate, the Arapahoe County Sheriff’s Office was already providing MAT in the detention center, but sustaining recovery in the community remained a challenge. As Project Director Carl Anderson notes, when it comes to MAT programs, “medication gets all the headlines.” Yet, as the team observed, medication alone is insufficient when individuals lack essential recovery resources such as safe housing and supportive relationships. “Having the ability to provide some psychosocial support is huge,” Anderson explains. With the implementation of the 2023 Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) grant, Arapahoe County aims to provide meaningful answers to these questions through individualized and relationship-driven reentry support.
“When I work with incarcerated participants, a lot of times, their biggest questions are about resources. Their biggest question is, ‘What do I do when I leave here? Because I want to be done with this. I don't want to continue this life.’”
—Aliya robbins, group therapist
Building Partnerships with Service Providers
31
individuals received housing assistance
Selecting the right community partner was foundational, and Hazelbrook, the project’s virtual peer support and housing provider, quickly became a valued resource among participants. This trust developed organically, as Robbins notes: “Usually, it takes a long time to build that trust and get the ball rolling.” The team recognized that effective transitional support is built on trust.
Peer Recovery Support
Peer coaches provide a vital source of stability during the vulnerable transition back to the community. Natasha Hernandez highlights the transformative power of support: for individuals who lack a network, there is immense value in simply “[having] someone to talk to about their desire to quit and being heard.” Hernandez has already observed positive changes in participants’ outlook and “even the way they present themselves.”
581
individuals received virtual peer support between nov 2024 and may 2025
Two peer recovery coaches are preparing to engage jail-based MAT patients in virtual peer recovery support, available 24/7 through a partnership with Hazelbrook-Paradigm. Introducing virtual peer support presented a learning curve. Coordinating between community-based providers and jail-based teams, especially around scheduling and access during lockdown hours, required openness and transparency. The team identified key areas for improvement, such as patient prioritization, technical support, and streamlined communication. As Anderson reflects, there were “growing pains and learning opportunities to be better in the next month.”
Discharge Planners
Two full-time discharge planners coordinate substance use treatment, reentry plans, and connections to essential services post-release. The program connects individuals to recovery or transitional housing upon release, with transportation and housing stipends available to reduce access barriers. Close collaboration with community-based Opioid Treatment Programs and the jail’s medical/mental health provider ensures a seamless transition to care upon reentry. Arapahoe County’s comprehensive approach, grounded in evidence-based practices, robust partnerships, and a commitment to individualized support, positions the county to make a lasting impact on both public health and public safety.
Collaborative Partners
Arapahoe County Sheriff’s Office Detention Facility
Wellpath
Hazelbrook
Addiction Research and Treatment Services
Behavioral Health Group
Community Medical Services
Denver Recovery Group
Thrive Behavioral Health and Recovery
Key Takeaways
Laying the foundation for recovery before release can be lifesaving for people with opioid use disorder. While jail-based services are critical, the reentry period often brings uncertainty. Peer coaches can support effectively during this transitional period, especially with housing and care coordination services. For people incarcerated in Arapahoe County, this support has been invaluable. As jails continue to reckon with the opioid epidemic, virtual peer services are a promising means of improving recovery outcomes.
Project Director
Carl Anderson, Deputy Director, Detentions Medical Care
Arapahoe County Sheriff’s Office
canderson@arapahoegov.com
720-874-3598
This project was supported by Grant No. 15PBJA23GK02258COAP awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice's Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.