About one in five detainees in Cook County Jail admit to opioid abuse — in response, the Sheriff’s Department has expanded treatment options to people in its custody, and distributed the opioid-blocker Naloxone to community members.

The department has also started a podcast called Breaking Free: Dispatches from the Opioid Crisis, featuring interviews with treatment experts and survivors of addiction.

Cook County Sheriff Tom Dart joins the Morning Shift to discuss the podcast and other efforts to curb opioid addiction.

The crisis surprised everyone

Sheriff Tom Dart: [The opioid crisis] snuck up on us, and I believe everybody else, and then all of a sudden in the last two years, particularly because of fentanyl, [it] has exploded on everyone, because that is so, so dangerous that now we’re seeing deaths at a higher rate than we’d seen in the past. So that, I think, woke everybody up, and I would like to say everybody, but that’s not the truth. It’s changed a lot of people’s conduct and perception now, and certainly for us, and I believe some of the other jails in the country are starting to come around to it. We’re sort of, I don’t want to say at the epicenter, but we’re right about there, because when people are coming into custody, and they are, frequently, for drug-related offenses and things like that, we’re there. We’re at the heart of it, and so we’ve had to adapt, and we’ve put together multi-layers. And I’ll be honest with you, Jenn, we keep altering, because there’s no playbook for this, so we keep altering. New partners, new approaches, and we’re starting new ones everyday.

How treatment has changed in the past few years

Dart: We’ve been just adapting on a daily basis, not necessarily because there’s the latest greatest book on it, but we’re seeing things, because we got very involved in doing the treatment ourselves. And so we have specific treatments that we ourselves run. We don’t farm it out to outside companies; we do it ourselves, with people we’ve hired with specific backgrounds, specifically for women, to deal with their issues with the opioid issues. It’s a program called Thrive. It’s fantastic, but the hook that we just about a year or two put in there, which I…I’m not exactly saying we forgot it, but there’s only so many things we can do on a given day. We now have it so it walks out to the community with people. And so we now have an element of it where we’re treating people, putting them in step-down type programs, then putting them onto an electronic monitoring program that we worked with some judges with, where we’re treating them out in the community. And so we utilize vans that I have to help people get back and forth to appointments, we have vans that we use for other, getting people prescriptions. We’ve tried to think of this almost as if we are the healthcare provider. Forget about the jail side of it, we just are pure healthcare providers, so we have signed up 45,000 people for Medicaid in the last few years, we now have all these treatment programs in the jail, and our challenges now are outside the jail, and keeping people connected to us.

Should opioids be decriminalized?

Dart: You start with the fact that right now, at the jail, I’m one of the leading people signing people up for Medicaid. Now, how wrong is that? I mean, we shouldn’t be in that business because it should be done already, but we’re doing that. We’re the ones putting together discharge plans for people with addiction and mental health issues. What society would suggest that that’s the right place to be doing that? So it starts with that bigger concept: that if you have an addiction issue, [a] substance abuse issue, you have a mental health issue. You do not belong in a criminal justice system, at all. Under any circumstances—you don’t. If there’s a minor criminal hook to it, that you stole something, you’re sleeping on benches, whatever it is, you know, I believe we can, you know, dispense with that and move ahead with other issues.

This interview has been edited for clarity and brevity. Click play to hear the full conversation.

GUEST: Tom Dart, Cook County Sheriff

LEARN MORE: Listen to the Breaking Free podcast on Soundcloud.