Rutherford County, TN
Rutherford County Sheriff’s Office
tennessee
Rural | Population: 367,101Rutherford County, Tennessee, is experiencing a public health and criminal justice crisis driven by the escalating impact of substance use disorders (SUD) and co-occurring mental health conditions. The county’s rapid population growth, rising 34% over the last decade to more than 350,000 residents, has intensified the demand for law enforcement, corrections, and behavioral health services.
The criminal justice system in Rutherford County is under significant strain due to the prevalence of substance use and mental health challenges among those arrested and incarcerated. In 2022 alone, the county’s correctional facilities processed approximately 12,000 individuals, with one in four bookings related to drug offenses. The average monthly jail population exceeds 750, and the recidivism rate stands at 42%, a clear indicator that traditional punitive approaches are not breaking the cycle of substance use and reoffending.
Substance use is a leading driver of justice involvement in the county. In 2021, Rutherford County recorded 141 fatal drug overdoses, with opioids implicated in 121 of these deaths. Fentanyl has emerged as a primary cause of fatality. Fatal overdoses involving stimulants have also surged, increasing by over 200% since 2017.
The intersection of SUD and mental health is especially acute within the correctional population. Nearly half of all individuals incarcerated in Rutherford County have received medical services for mental health conditions, and 47% are prescribed mental health medications. The risk of fatal and non-fatal overdose is particularly high for individuals leaving incarceration, underscoring the urgent need for targeted intervention and continuity of care.
Rutherford County Sheriff’s Harm Reduction Program (SHARP)
In 2023, Rutherford County, Tennessee, launched the Sheriff’s Harm Reduction Program (SHARP), with the support of a Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) grant. SHARP is a collaborative initiative aimed at reducing the negative effects of substance use disorder (SUD) and preventing overdose among individuals who are currently incarcerated, preparing to reenter the community, or under community supervision.
A cornerstone of the SHARP program is integrating a Certified Peer Support Specialist (CPSS) directly within the Rutherford County Adult Detention Center and Correctional Work Center. The CPSS plays a critical role in connecting incarcerated individuals to behavioral healthcare, substance use treatment, and recovery support resources, building a bridge between custody and community reentry. In addition to providing emotional and motivational support, the program facilitates transportation services for individuals with substance use disorders (SUD), helping them access rehabilitation facilities, court appearances, and other critical recovery-related appointments.
The impact of peer support integration has been significant. Individuals in custody are now more effectively supported in navigating the behavioral healthcare system, benefitting from a collaborative model that includes two full-time counselors (funded through a separate grant) alongside the CPSS and enhanced training opportunities for law enforcement staff. As of April 2025, the current CPSS exceeds expectations, meeting with approximately 50 individuals weekly, doubling the original target of 25. Corrections staff have intentionally facilitated connections by introducing the CPSS in housing units ("pods") and promoting services through facility kiosks, where individuals can directly request peer support. Looking ahead, the initiative's success has led to plans for absorbing the peer support position into county funding after the conclusion of the current grant, ensuring the sustainability and continued impact of this vital service.
Building Momentum and Creating Impact
700
incarcerated individuals interviewed
210
successfully entered treatment
195
accepted and are pending treatment
Since its inception, SHARP has gained remarkable traction, partnering with organizations such as the Prevention Coalition for Success, the Rutherford Opioid Board, the Rutherford County Re-entry Program, Insight Alliance, and the 16th Judicial District Recovery Court. These partnerships extend the program’s reach beyond the jail walls, offering a true continuum of care supporting individuals throughout their recovery journey. SHARP also addresses critical barriers by providing transportation assistance through a licensed provider, ensuring that individuals can access treatment and support services immediately upon release.
To date, over 700 incarcerated individuals have been interviewed, with 210 successfully entering treatment. An additional 195 individuals have been accepted but are pending placement as they navigate the judicial process, and 82 were accepted into treatment but did not attend. These early outcomes demonstrate SHARP’s growing impact on reducing recidivism and enhancing access to treatment. These numbers mainly reflect individuals who are incarcerated at RCSO, but SHARP also provides access to non-incarcerated individuals if requested.
Transportation
A critical component of SHARP’s success has been implementing transportation services to ensure individuals can access treatment and recovery support immediately upon release. Through a partnership with Road to Recovery (RTR)—a peer-run organization—SHARP offers transportation assistance that bridges the gap between incarceration and community-based care. RTR staff are highly trained in overdose recognition, naloxone administration, crisis intervention, and mental health first aid, ensuring that individuals are supported with expertise and compassion during this vulnerable transition period. Since August 1, 2024, Road to Recovery has transported 152 individuals to treatment and recovery locations across the community on behalf of SHARP and its partners.
152
individuals transported to treatment by road to recovery since aug 2024
The Rutherford County Sheriff’s Office (RCSO) has strengthened this effort by developing a transportation tracking system to better manage and evaluate services. A newly installed data software program tracks demographic details, transportation destinations, and identifies special needs such as veteran status, ensuring that services are accessible and tailored to those served. Transportation services are available to individuals who are released from custody with conditions requiring participation in community-based programs and those furloughed due to jail overcrowding. Requests for transport are coordinated through community-based Peer Support Specialists, ensuring a seamless connection to care.
“Prevention Coalition for Success greatly appreciates the continued partnership with the Rutherford County Sheriff’s Office. The COSSUP funding removed barriers to transportation, which increased our capacity to connect individuals with substance use disorder to treatment and recovery resources. Our transportation provider, Road to Recovery, is well-versed in working with individuals struggling with addiction and safely transports them to facilities that best fit their needs. The Peer Recovery Specialist embedded in the correctional facility has allowed our Care Coordinator team to expand their work with individuals both inside the jail and in the community. This coordinated effort has significantly increased our reach and impact across Rutherford County.”
—dr. sarah murfree, director
prevention coalition for success
Law Enforcement Collaboration and Response
Building on the success of the SHARP program, the Rutherford County Sheriff’s Office established the Overdose and Crime Response Unit, a specialized 10-member team dedicated to addressing overdose incidents, violent crimes, and crises tied to substance use disorder. The unit plays a critical role in supporting individuals actively experiencing crises, including those involving substance misuse, family instability, and domestic violence. Recognizing the broader impact on families, the team also provides referrals for family members and school-age children of program participants, connecting them with school counselors, School Resource Officers (SROs), and other appropriate community-based services to ensure they receive the support they need. The Overdose and Crime Response Unit functions as a comprehensive, integrated service hub—merging crisis response, violence intervention, and recovery support into a seamless model of care. The team prioritizes public safety while facilitating access to rehabilitation and preventative resources, particularly for high-risk cases involving any violence. Acting as a "one-stop shop," the unit ensures timely referrals and interventions that reduce the risk of reoffending, promote recovery, and stabilize families impacted by addiction and crime. The unit enhances immediate crisis management and long-term community safety outcomes across Rutherford County through this integrated approach.
"Through this program, with our transport and rehabilitation services, our team of 10 has become a one-stop shop for addressing a wide range of needs. Individuals struggling with addiction often face multiple challenges, including issues like child abuse or neglect, and we are positioned to either facilitate referrals to support services or take necessary enforcement action when required."
—rcso captain
Looking Ahead
The SHARP program has exceeded the original goals outlined in its initial proposal, achieving significant progress within a short timeframe and maintaining strong momentum throughout the grant period. The project’s effective use of funding fulfilled its core objectives and enabled an expansion of services beyond initial plans, contributing to enhanced public safety for the entire community. Expanded efforts now assist the Drug Court with rehabilitation transfers, addressing needs that were not originally anticipated and further strengthening outcomes for participants, the justice system, and law enforcement partners. The program’s ability to continuously adapt and enhance services demonstrates its commitment to better meeting the evolving needs of its target population.
Looking ahead, the SHARP team remains focused on building upon this success. Over the next year, goals include hiring and retaining an additional Certified Peer Support Specialist (CPSS), expanding awareness and availability of Road to Recovery transportation services, and refining the newly implemented data collection system to better measure impact and plan for improved long-term outcomes. Through these efforts, SHARP will continue to drive meaningful change and reinforce its role as a model for recovery-focused public safety initiatives.
Community Partners
Rutherford County 16th Judicial District Recovery Courts
Rutherford County Adult Detention Center
Rutherford County Correctional Work Center
Rutherford County Opioid Board
Rutherford County Overdose Fatality Review Board
Rutherford County Re-entry Program
Rutherford County Sheriff's Office
Insight Alliance
Prevention Coalition for Success
Project Director
Captain Will Holton
Rutherford County Sheriff’s Office
wholton@rcsotn.org
615-533-6073
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.