Looking for an in-depth peek into the long-term effects of the opioid crisis? The latest issue of The New Yorker has a compelling new long read on how the nation’s criminal justice system is exacerbating public health emergencies related to addiction—telling the personal, political and on-the-ground stories that help shed new light on the epidemic.

Written by reporter at large Steve Coll, “The Jail Health-Care Crisis” begins by telling the harrowing tales of prisoners across the country who died or fell seriously ill while imprisoned. Some suffered from complications associated with withdrawal, while others had hepatitis C virus or mental illness or died by suicide. Linking all their cases are lawsuits alleging that jails routinely mismanage the health needs of prisoners in their care.

At the heart of the crisis, Coll reports, are for-profit firms that provide medical services to the incarcerated on behalf of jails. It is estimated that 70 percent of jails inspected by the National Commission on Correctional Health Care (which accredits medical programs in correctional facilities) have a contract with a for-profit company.

Thus far, no large-scale studies have compared the quality of treatment provided by these private companies to services run by the government or universities. However, a review of the evidence from lawsuits filed against the companies “is troubling,” Collier writes, with thousands of cases alleging neglect, malpractice, wrongful injury and death.

Some of these cases have resulted in real policy change. Last December, for example, a federal judge demanded that Maryland improve medical services at a Baltimore city jail after ruling that the jail had dropped the ball in using private contractors to provide services. Still, hundreds of jails have yet to be investigated; in the meantime, more and more people are dying.

“Historically, sweeping changes in civil rights have occurred only after a moral awakening among at least a vocal minority of the public,” Coll writes. “So far, the articulation of a better ethic of prison medicine is mostly consigned to a small body of specialized literature…” This latest article adds to that growing body.

To read or listen to the article in full, click here.