The Repurposing of the American Jail

Like many other correctional professionals, Sheriff Craig Apple of Albany County, New York, was initially suspicious of using drugs to treat drug addiction. He was considering the merits of introducing buprenorphine and methadone—two drugs used to treat opioid-use disorder—into the county’s main jail facility, and wasn’t sure he should, given that those drugs can become valuable and dangerous contraband. But over time, Sheriff Apple’s opinion began to shift. Local advocates kept sending him data-based evidence showing that medication-assisted treatment, commonly called MAT, helped people recover from their addiction and reduced crime.

So, in 2015, Sheriff Apple got Albany County’s health department to sign off on a plan to treat heroin addiction in his jail. By January of this year, Apple the program to include the full range of MAT, including buprenorphine and methadone. It worked. According to Apple, inmates were receiving proper treatment, so they were healthier and less likely to take illicit drugs. People who had participated in the program in jail before being released, Apple told me, had a , compared with 40 percent for inmates not in the program.