Chesterfield County is the fourth-largest populated county in Virginia. In 2014, the county experienced 53 fatal and nonfatal heroin overdoses. That number increased to 296 in 2021. In 2016, the Chesterfield County Jail began tracking opioid intake numbers. That year, there were 406 opioid intakes. In 2019, there were 679. The Chesterfield County Sheriff's Office (CCSO) is responsible for the operation of the county jail. The CCSO worked with the Chesterfield Mental Health Support Services, the Chesterfield County Community Services Board (CSB), and Community Corrections to implement a medication-assisted treatment (MAT) program for justice-involved individuals. The CCSO made extended-release naltrexone available to opioid-dependent individuals nearing release as well as provided buprenorphine/naloxone to those incarcerated that had been prescribed the medication initially in the community prior to incarceration. Upon their release, individuals continued to receive MAT and counseling through the CSB or another pre-arranged community provider. As an example, the CSB initiated 53 cases of criminal justice-involved clients on MAT to community or internal programs pending trial in lieu of incarceration. The CCSO used its Building Bridges implementation funding to assist with MAT services in the jail and created a database to identify high utilizers of multiple systems (e.g., the jail, emergency medical services, probation, behavioral health) who were at risk for overdose and more effectively linked these individuals to treatment or recovery supports upon release from incarceration.