Jackson County, NC

Jackson County Sheriff’s Office

north carolina

Rural | Population: 44,574

Jackson County, North Carolina, is grappling with a devastating opioid epidemic that has deeply impacted individuals, families, and the broader community. Overdose deaths have surged by 79% between 2019 and 2024, with unintentional overdoses occurring at rates 61% higher than the state average. The crisis has also led to a 40% higher rate of children entering foster care due to parental substance use compared to statewide figures. Fentanyl-related fatalities have skyrocketed by 756% between 2016 and 2023, underscoring the urgent need for comprehensive solutions to address substance use disorders and their cascading effects on public health, child welfare, and the justice system.  

The Jackson County Detention Center has identified that 86% of incarcerated individuals exhibit behaviors of both SUD and mental health conditions. The detention center has struggled to address these challenges due to limited resources, fragmented care coordination, and barriers such as funding and lack of access to treatment. Project Inside/Out is a strategic initiative designed to mitigate the impact of opioids, stimulants, and other substances on incarcerated individuals and their families. 

Key COSSUP Initiatives

Medication-Assisted Treatment

Expand access to medications to treat individuals with opioid use disorders in the detention center and support continuity of care post-release.

peer recovery support services

Certified Peer Support Specialists will provide remote peer support via tablets during incarceration, transitioning to in-person services post-release.

comprehensive reentry support

Service providers will convene inside the detention center to offer housing assistance, healthcare enrollment, behavioral health treatment, education opportunities, and employment options directly to inmates.

overdose prevention

A multidisciplinary group will strategize ways to reduce post-release overdoses through data-driven approaches and community collaboration.

Anticipated Benefits of Project

• Reduction in overdose fatalities

  This project aims to reduce overdose fatalities through access to timely and effective treatment, including medications for opioid use disorders (MOUD).

• Increased public safety

  This project aims to increase public safety through seamlessly transitioning individuals from treatment in custody to community-based treatment. 

Collaborative Partners

• Jackson County Sheriff’s Office

• Research Partner, Dr. Al Kopak

• Mountain Area Health Education Center, UNC Health Sciences

• Community organizations, including…

  • Meridian Behavioral Health

  • We Rise Up LLC

  • VAYA Health

  • Mountain Projects

  • Southwestern Commission Council of Governments

Project Director

Sheriff Doug Farmer
Jackson County Sheriff’s Office
dafarmer@jacksonnc.org
828-586-4355

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.