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.
Sheriff Apple also made another, more unusual, change: He converted 25 cells into rooms for people who were homeless, including those struggling with substance-use disorder, whether or not they had been accused of a crime. The move represents a growing—and controversial—trend in the United States as communities struggling with issues such as homelessness and substance-use disorder have begun using detention facilities to house people who haven’t been charged with a crime or sentenced to incarceration.
