In one San Diego jail

February 19, 2026

In one San Diego jail, recovery begins behind bars. Medication-assisted treatment (MAT) has existed for decades, but it has only been introduced in jails in recent years, driven by the fentanyl crisis and a sharp rise in overdose deaths behind bars. Suboxone, the medication most commonly used in MAT programs, reduces cravings and withdrawal symptoms without producing a high. Experts caution that medication alone is not enough. Suboxone can provide stability, but therapy and peer support are what help people change long-standing habits. The Vista jail’s MAT module, which opened in 2023, was built around that model. It houses up to 30 men at a time, each spending three to six months in an intensive, structured treatment program anchored by a morning dose of Suboxone. Before 2019, fatal overdoses in San Diego County jails were uncommon. Over the next three years, 14 people died. Hundreds more were revived with the overdose-reversal medication Narcan, often just in time. “I remember doing CPR and thinking to myself, ‘We’re doing something wrong,’” said the Corporal who helped start the MAT module. Since its launch in January 2023, more than 300 people have completed the program and been released from jail. Among people who complete the MAT module, 19% returned to custody compared with a 33% recidivism rate across the county jail system overall. “We know the program works,” the Corporal said. “Our philosophy has been since day one, when we had our first five people, ‘I’m going to treat you with dignity, I’m going to treat you with respect, but you got to put in the work.’” The staff at the jail work on plans for the participants release — including a plan for housing and continued treatment — from the outset of the program. As of mid-November, about 97% of participants chose to continue treatment after release, often through community providers that offer housing and support. Through counseling and group therapy, one of the participants found that he began to understand his addiction as much more than a lack of willpower. He said, “I learned it wasn’t a moral failing,” and “My brain was wired to respond to any kind of discomfort by reaching for something — drugs, alcohol, instant relief.” The MAT module’s results have convinced the Corporal that the model should be expanded into other San Diego jails. Maryland and Pennsylvania both have MAT programs to help incarcerated individuals with Substance Use Disorders (SUD). Here is the link: ‘Like turning on a light in a dark room’: In one San Diego jail, recovery begins behind bars