Harnett County, North Carolina is a rural county southwest of Raleigh, NC. The demographics of the county are 70.7% White, 22% Black/African American, 1.7% American Indian/Alaskan Native, 1.4% Asian, and 14.5% Hispanic/Latino.

Harnett County has experienced an increase in fatal opioid overdoses, rising from 4 in 2000 to 71 in 2021. There has also been an increase in emergency room visits linked to opioid incidents, totaling 280 in 2022. Due to its rural nature, Harnett County struggles with a lack of personnel and resources.

In April 2023, the Sheriff’s Department launched a jail-based program to implement medications for opioid use disorder (MOUD). They currently maintain inmates who were previously taking MOUD but do not induct, or begin, inmates on MOUD. Harnett County would like to expand their use of MOUDs in jail as well as offer substance use-related counseling. Harnett County is also a Reaching Rural initiative participant and has previously developed cross-sector teams to address opioid use in their community.