Onslow County, NC
Onslow County Government
north carolina
Suburban | Population: 213,676Onslow County, North Carolina, has pioneered an innovative solution to combat the alarming risk of overdose deaths among individuals leaving its county jail. Leveraging Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) grants from 2021 and 2023, the county has implemented a jail-based treatment program that is reshaping the management of substance use disorders within the justice system. At the heart of this initiative is medication-assisted treatment (MAT), a proven method for addressing opioid addiction and supporting recovery.
Addressing a Critical Gap
“This program has changed my life. I know I can count on the staff in this program to help me with anything that will make my life better and help me on my recovery journey.”
—program participant
Prior to this program, the Onslow County Detention Center faced significant barriers in providing MAT and other essential services within its detention facility. Pregnant women and others with urgent treatment needs often had to be transferred to external facilities, a process that was both costly and inefficient. The jail-based treatment program has eliminated these obstacles by offering MAT directly within the jail, ensuring timely and accessible care.
The program goes beyond MAT by integrating peer support services and post-release recovery support such as care coordination and transitional housing. This holistic approach ensures continuity of care for participants during incarceration and after their release, significantly reducing overdose risks while fostering long-term recovery.
Key Program Components
Medication-Assisted Treatment
Staff have implemented access to medications for opioid use disorder in the detention center and improved the integration of clinical and recovery support services. Two clinicians provide group and individual therapy.
Peer Support Services
A peer support specialist embedded in the detention center engages participants in recovery services during incarceration, offering relatable guidance throughout their journey.
Discharge Planning
A dedicated case manager oversees post-release care coordination, including transitional housing support for smoother community reintegration.
Overdose Prevention
By addressing substance use disorders comprehensively within the jail setting and ensuring continuity of care upon release, the program has successfully prevented overdose deaths among participants. All program participants are discharged from custody with naloxone.
0
overdose deaths post-release among participants since july 2024
Overcoming Challenges
Implementing MAT in a correctional setting required overcoming resistance and stigma. Project Director Veronica Ortiz recalls initial skepticism from correctional staff due to differing views on substance use treatment. “[Correctional officers] see things very differently,” Ortiz notes. To bridge this gap, she facilitated open dialogue between clinical staff and correctional officers, fostering mutual respect for each group’s expertise.
Ortiz adopted a collaborative strategy to address stigma around MAT: “We’re here to help [correctional staff] understand... Instead of defending our position on it, let’s let them tell us what they know about it, and then we can offer a different perspective of what evidence says and what statistics tell us.” Building trust with jail leadership was equally crucial for success. Ortiz emphasizes, “I could not have done what I’ve done had I not built that relationship and that rapport with the jail’s leadership.”
The implementation of evidence-based treatment services has changed the culture of the jail. As one participant noted, “This program is a huge game changer. In 5 months, I’ve seen it grow substantially and turn this jail into a safe, therapeutic environment for everyone involved in the program.”
259
individuals received mat in custody
as of july 2024…
283
individuals served by the program
Collaborative Partners
Onslow County
Onslow County Department of Social Services, Child Protective Services
Onslow County Detention Center
Onslow County Probation/Parole
Bear Island Recovery Services
Clearpath Counseling
Focused Addiction Recovery
Hope Recovery Homes
Jacksonville Treatment Center
Oxford House
The Healing Place of New Hanover County
Veterans Treatment Court
Looking Forward
“We’re here to help people understand, and ultimately change perspectives, so we can make a difference together.”
—veronica ortiz, project director
The program is poised for further expansion. Plans include dedicating an entire cell block to program participants, launching a post-release support group for individuals transitioning back into the community, and forming a multidisciplinary team to connect inmates with community-based treatment upon release.
Project Director
Veronica Ortiz, Project Director
Onslow County Human Services
veronica_ortiz@onslowcountync.gov
910-989-3012978-750-1900
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.