A heroin ring seems to have been a problem in the New York prison where the inmates escaped with supposed support of correctional staff. Heroin use is escalating and its manifestation must be obvious within the correctional facilities. It is interesting to see if there is any attention to drug and alcohol use within as well as the support to have those within the system transition back into society. Recovery programs are very archaic within prison, limited to 12 stem meetings and faith based interventions. Can we implement telemedicine? Tele-counseling? Where can technology, a very low cost investment to outcome ratio, be implemented? As always, change is needed and the way we have been doing things will not take us to the vision we have as a country and community, there must be support for the unattended and uninsured if there is to be progress in general.