As of the 2020 census, Durham County was the sixth most populous county in North Carolina. In North Carolina, overdose death rates doubled from 2010 to 2016. The state experienced an estimated 98.8 percent increase in fentanyl-related overdose deaths from 2015 to 2016. A recent study of incarcerated individuals conducted in North Carolina found that the risk of overdose death post-release was 40 times greater than that of the general population. Approximately 250 to 300 people per month reporting current use of opioids cycle through the Durham County Detention Center. At the time of Building Bridges, the detention center was in the process of implementing an opioid use disorder screening tool and was seeking to become a provider of medication-assisted treatment (MAT) services to incarcerated individuals. The MAT program worked in cooperation with the existing Substance Abuse and Recidivism Reduction (STARR) Program, which provided harm reduction and overdose education to individuals with substance use disorder. The detention center used its Building Bridges implementation funding to hire peer support specialists who linked individuals receiving MAT in the jail to treatment in the community and improved its data collection and tracking around management of MAT.