It has been estimated that nearly 2/3 of inmates in US jails and prisons have a substance use disorder. Historically, SUDs have not been addressed by the prison system while a person is incarcerated. This contributes to a cycle of recidivism that’s detrimental, not only to the individual and their loved ones, but also to the community at large. A recent NIH report highlighted a study that compared two rural Massachusetts’ jails, one that provided medications for opioid use disorder (MOUDs) and one that did not. The people who received medication had a 32% lower risk of recidivism. Interestingly, guided by our own Judge Duane Slone, the 4th Judicial District in Tennessee (Jefferson County in East TN) is the first in the state to implement a similar program in their jails. We hope that this bold step will go a long way in stopping the cycle of SUD and incarceration.