opinion | Steven W. Tompkins

A coordinated response to substance abuse


As sheriff of one of the largest urban jail systems in the country, I see the devastating impact that the lack of substance abuse and mental health resources has on the women and men in our custody. The hallmark of a great society is how we care for our most compromised, and, as our current treatment policies stand, we are grossly negligent.

County sheriff departments serve as the de facto health and addiction service providers for residents who do not seek, or have access to, care in the community. We deliver detoxification, recovery treatment, and long-term case management for addiction. Individuals in our custody who are struggling with mental illness have access to care and treatment that they could not obtain, much less afford, outside of our walls. But our fellow citizens should not have to go to jail in order to receive treatment.

How should the state address widespread substance abuse that is often coupled with mental illness? The answer is not easy. It will take a coordinated response to change the way we deliver social services.


We need to ensure that we have both short-term crisis intervention programs as well as sustainable plans to deliver services in the long term. County jails are uniquely positioned to be part of the solution. We can deliver critical crisis-intervention services to individuals who need them most. The Suffolk County Sheriff’s Department proposes an opioid treatment plan that would consist of:

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1. Opening and operating two detoxification units at the Suffolk County House of Correction for pre-trial detainees in need of immediate treatment post-arrest.

2. Providing medically assisted addiction recovery to all inmates housed at the Suffolk jail.

3. Hiring “wellness navigators’’ to oversee the treatment and recovery process both during and after incarceration.

4. Creating a pilot program that connects the Suffolk County Sheriff’s Department with neighborhood health centers to make the transition from incarceration to reintegration seamless, using a team approach to handle recovery and reentry services within an individual’s own neighborhood.


Society must also find ways to provide communities with the resources they need to care for addicts so that a jail sentence will no longer be a prerequisite for treatment. Improvements must be made in education, civic engagement, housing, and vocational training. The more resources a community has, the more it can prevent crime, opioid deaths, and untreated mental illness.

Steven W. Tompkins is sheriff of Suffolk County and president of the Massachusetts Sheriffs’ Association.