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Medication-Assisted Treatment (MAT)

Helping detainees in our care start the road to long-term recovery from addiction to opioids.

Beginning in 2019, the Buncombe County Sheriff’s Office expanded our drug treatment program at our Detention Facility. Medication-assisted treatment (MAT) helps detainees in our care start the road to long-term recovery from addiction to opioids. This is an innovative program for a detention facility as only 1 percent of jails or prisons across the country offer MAT programs according to a study by the Pew Charitable Trust.

picture of ribbon cutting

Previously only pregnant detainees at the BCDF were offered medication for a substance use disorder as part of the recovery process. Other individuals who came into the facility on medications, such as methadone, were tapered off their medication through a process called medical detox. Now individuals with prescriptions have the opportunity to continue their medication while detained at the BCDF as part of the MAT program. Additionally, detainees diagnosed with opioid use disorder will be evaluated for referral to the MAT program and will have access to medication for substance use disorder, recovery counseling, and other psycho-education and support classes. “This expansion of services is in response to the needs of those detained - specifically those impacted by opioid use disorder. Supporting detained individuals in their recovery from opioid use has widespread positive impacts throughout our community. The process of recovery takes time and this MAT program offers individuals the opportunity for recovery advancement during their time served,” says Sarah Gayton, Community Integration and MAT Services Director at the Buncombe County Sheriff’s Office.

“I’m proud to have a dedicated and hard-working team working within our Detention Facility to help make a difference with the opioid crisis. We’ve tried to arrest our way out of the drug epidemic for decades and it hasn’t worked. There must be consequences for people’s actions, but part of our solution has to be providing people access to medication and treatment. We must offer people a chance to get themselves to a better place and programs like MAT are proven to reduce recidivism,” says Buncombe County Sheriff Quentin Miller.



According to a study titled “Opioid Overdose Mortality Among Former North Carolina Inmates: 2000–2015”, inmates across North Carolina are 40 times more likely to overdose on opioids after release from jail or prison. Once an opioid user’s drug tolerance has decreased after being incarcerated they are at high risk if they use again. In 2018, there were 88 opioid-related, registered deaths in Buncombe County and 46 of those individuals had been booked into the BCDF at some point. These new findings are a result of a joint research project between The Register of Deeds’ Office, Buncombe County HHS and the Sheriff’s Office.  Providing a MAT program in a detention setting has proven successful in other communities according to a 2018 report on Medically assisted Treatment produced by the National Sheriff’s Association. The report lays out the clear benefits of the program: “Evidence strongly supports that the use of MAT increases the likelihood of successful treatment for individuals with Opioid and reduces morbidity and mortality. Research has begun to show that adding MAT to the treatment of those involved in the criminal justice system confers the same benefits and also reduces recidivism.” The Sheriff’s Office is also distributing Naloxone kits to individuals self-reporting opioid use upon their release from the Detention Facility. These kits are in accordance with North Carolina Health and Human Services recommendations.



The MAT program builds on the foundation of Buncombe County’s strategic response to the opioids epidemic, including harm reduction, peer support and post-overdose response. Buncombe County Health and Human Services has operated a successful Syringe Services Program since August of 2019, with the assistance of Peer Support services through Sunrise Community for Recovery and Wellness. Evidence-based public health strategies such as syringe services and exchange programs offer opportunities for healthier outcomes by providing testing, sterile injection equipment; linkages to care and recovery options; and Naloxone, an overdose-reversal drug that can save the life of a person experiencing an opioid overdose.  The Buncombe County Sheriff’s Office is confident that supporting and expanding our MAT program will reduce the number of our community members addicted to opiods, help save the lives of community members and reduce property crime associated with drug addiction.

Additional research and statistics on MAT programs and opioid use can be found at these links:

National Sheriff’s Association report, Jail-Based Medication-Assisted Treatment

American Journal of Public Health, Opioid Overdose Mortality Among Former North Carolina Inmates: 2000–2015

Pew Charitable Trust, New Momentum for Addiction Treatment Behind Bars