Winning the war on opioids: How law enforcement is creating pathways of care
While Narcan is an immediate, lifesaving fix for someone suffering from an overdose, it doesn’t solve the problem of addiction
This feature is part of our PoliceOne Digital Edition, a supplement to PoliceOne.com that brings a sharpened focus to some of the most challenging topics facing police chiefs and police officers everywhere. To read all of the articles included in the Summer 2018 issue, click here.
By Cole Zercoe, P1 Senior Associate Editor
The opioid crisis in America is not going away. As an increasing number of police departments have responded by outfitting officers with Narcan kits, some have started to take the vital next step of creating pathways of care for victims of the epidemic. While Narcan is an immediate, lifesaving fix for someone suffering from an overdose, it doesn’t solve the problem of addiction.
Here’s a look at how law enforcement agencies are working to beat addiction in their communities by providing access to treatment and recovery services to opioid users.
ESTABLISHING RELATIONSHIPS AND BUILDING TRUST
The first step to successfully getting substance users on the road to recovery is building trust. Cops need no reminder that this is a segment of the population traditionally averse to law enforcement, so initial efforts to help are likely to be met with skepticism and resistance. The Arlington (Mass.) Police Department’s approach to working with opioid users, whom they connect to via responses to overdoses or during drug distribution investigations, is a prime example of how to tackle this.
Arlington Chief of Police Fred Ryan, who also serves as the co-chair of the Police Assisted Addiction and Recovery Initiative (PAARI) and co-authored the John Hopkins-backed “Ten Standards of Care” guide to policing in the opioid crisis, told PoliceOne that his agency took lessons from how they approach victims of domestic violence and applied them to their initial contact with victims of the opioid epidemic.
“The response from law enforcement to women in abusive relationships used to be, 'You need to leave him.' Put it all on the victim. As we began to understand the cycle of violence and the many valid reasons why women don't leave their batterer, we shifted to validating the victim and saying, 'We understand there are many complicated reasons why you're not prepared to leave this relationship, so let's plan for your next assault so that you can survive it,” Ryan said.'
“We brought that same mindset to those suffering from substance disorder. ‘Let's plan for your next overdose so that we can ensure you survive it.’ Now that sounds crazy, right? But when we’re meeting people, some are not ready to get help. And that's the mindset we need to bring to it.”
Officers provide Narcan to the user, as well as educational materials for fatal overdose prevention. Like most police outreach models, this approach is about both harm reduction and building trust – making it clear that the agency is not looking to arrest, but to help.
Arlington cops also reach out to someone connected to the patient such as a roommate, partner, parent, or sibling, and provide them with similar education and tools. Once that trust is built, they’re there to get both the user and those connected to them invested in the addict’s wellness by working with them on a long-term plan for recovery and providing education on the various treatment options and resources available.
COLLABORATING WITH PARTNERS
While not all models for creating pathways to treatment are the same, all share the same basic tenet: Close collaboration with public health and other related services is vital to success.
Arlington PD, along with many other agencies, has public health clinicians co-respond with officers to proactive outreach calls and after overdoses, serving as the bridge from the criminal justice system to the public health system.
“There's a lot of co-occurring disorders going on here – mental health issues combined with substance use issues result in somebody in crisis,” Ryan said. “The traditional model would be to arrest the person for whatever minor frivolous criminal offense that they were committing. The clinician gives LEOs another tool for dealing with people in crisis. It offers a creative approach to solving a problem involving a person in crisis other than a jail cell. And that's a good thing.”
Arlington police hold regular public meetings co-facilitated by a clinician and a certified interventionist on a range of subjects – from training on the proper use of Narcan to access to inpatient and outpatient treatment programs. These meetings work to help break the stigma of addiction and get Narcan into the hands of as many community members as possible – ensuring the greatest chance of preventing fatal overdoses.
The Quincy (Mass.) Police Department – which is home to one of the most well-known Narcan programs in the United States – partnered with its DA to create a buyer diversion program. Officers direct drug buyers to the PD’s outreach partners, where they have 72 hours to get in touch for a free evaluation, information about programs and the option to be directly admitted to a program at the time of their visit.
“We're trying to divert them from the criminal justice system into a treatment program,” Quincy Lt. Patrick Glynn told PoliceOne. “And we're trying to prevent them from overdosing when they go seek out another supplier, because we know the potency of what is on the street is inconsistent from trafficker to trafficker – especially with the advent of fentanyl.”
Agencies in Lake County, Illinois, participate in a program called “A Way Out.” This 24/7 assisted diversion program asks addicts seeking help to visit their local police department, where a deputy takes them through the onboarding process and then connects them to a phone screening with a health professional who determines the appropriate course of treatment.
During a panel at IACP 2017, Eric Guenther, chief of the Mundelein PD in Lake County, stressed the importance of having a system of strong relationships to ensure that an addict is never turned away.
“If we had to say no, we knew it would fail immediately,” Guenther said during the panel.
Four Lake County hospitals are available for immediate treatment of those going through acute withdrawal, outpatient treatment is available for same day or next day treatment, and inpatient treatment is available as soon as possible, depending on the availability of beds. If the user has no method of transportation, a deputy is dispatched to take the person to treatment.
Some agencies, like the Essex County Sheriff’s Department in Massachusetts, offer detox and intensive treatment units inside their correctional facilities that target inmates who have committed crimes to support their habits. In Essex County, once inmates complete a 28-day treatment program, they are given alternate options to imprisonment for their crimes, including outpatient and other long-term care plans.
TIME IS OF THE ESSENCE
Whether you’re engaging in proactive or reactive outreach, time is a critical factor in success. The more time that passes, the less receptive opioid users can be to getting help.
In Quincy, officers and outreach workers are dispatched to a home within the first 24 to 48 hours of an overdose.
“We've done about 350-375 home visits and we've gotten into the house 98 percent of the time. We’ve provided information to the person or to their family members who weren't aware that there were programs set up to help family members deal with their loved one who is addicted to opioids,” Quincy Lt. Patrick Glynn said. “People are not really aware of the services that are available to them as a family member or as someone with a substance abuse issue.”
When a user seeks inpatient treatment from the Mundelein PD’s program, Guenther can usually get an addict in a bed within 90 minutes of contact.
CONNECTIONS TO CARE
By providing your community with education, outfitting them with Narcan and acting as the connection to a range of treatment options for those suffering directly from the opioid crisis, your agency will be taking major steps forward in the battle against an epidemic that shows no signs of slowing down, as well as strengthening the relationship with the members of your community.
“We've built a lot of trust in the community,” Arlington Chief of Police Fred Ryan said. “It's sort of a value-added benefit in that people are now seeing that the police really care, because I don't think there's anyone in the community that hasn't in some way shape or form been impacted by this epidemic.”
About the Author
Cole Zercoe is the senior associate editor of PoliceOne. From the latest police technologies and innovations to the emerging threats cops face in the digital age, his features focus on the complexity of policing in the modern world.