Using data to tackle the opioid epidemic
Responding to the opioid crisis requires a multi-agency approach, using data to drive initiatives between partners
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 Chief Joel Shults, P1 Columnist
Since retiring from the Richmond (Virginia) Police Department in 2017, Captain Michael Zohab has been working as a drug treatment specialist. But his efforts to fight the heroin problem in his community began when he was a police commander in charge of narcotics. Zohab realized at the time, he wasn’t seeing the whole picture.
“I knew we were missing a lot of data and that bothered me. The only time we’d get notified [of a heroin overdose] was at the hospital. But there’s a whole population of people that would not get transported. Once revived by Narcan, they’d say, ‘Screw you, I’m out of here,’ and walk away,” he said.
New data needed
The traditional method of counting overdose deaths does not provide an accurate picture of today’s heroin epidemic. Zohab notes that the increased use of naloxone by community members lowers the fatality rate and can skew the perception of the severity of the problem. He realized the answer was in the survivor data.
The challenge was getting data on all accidental overdoses, not just the ones that hit the hospital or the medical examiner’s office, which typically ran six to 12 months behind.
In 2013, under Zohab’s leadership in cooperation with the Richmond Ambulance Authority (RAA), a regional heroin task force was formed with stakeholders from hospitals, fire, ambulance, public health and local government.
“The only way we can effectively respond to these incidents is pulling in the other stakeholders – and I mean all the stakeholders,” Zohab said.
Overcoming HIPAA fears
Concerns about HIPAA being an obstacle to obtaining data from medical providers were unfounded. Zohab said that after some research, he saw that the data was not protected by HIPAA because they weren’t using the information for prosecution. He noted that the perception that HIPAA does not allow information sharing with law enforcement is wrong.
The personal relationship Zohab had with RAA COO Rob Lawrence made information sharing easier.
“RAA implemented policies and procedures to notify the Richmond Police Department when RAA responded to a substance use disorder-related incident. When we started capturing that data, we had our finger on the pulse of what was going on,” Zohab said.
Required police reports on accidental overdoses
Once Richmond PD got the notification from RAA, officers would try to determine where the drug was purchased and any other information that could be used to prevent another overdose.
“Officers complete a miscellaneous report and that way the data is entered into the system,” Zohab said. “I got commanders in surrounding jurisdictions to do the same thing to get regional tracking.”
Working with the local EMS
Zohab described how RAA established a program that monitored overdoses within a geo-footprint, triggering a notification to the Richmond PD. Officers would notify community members about potentially lethal drugs circulating and they would notify the emergency departments about a spike in overdoses.
Officers also pulled demographic data for tracking purposes. And, once the task force had established a baseline for monitoring, they used density mapping to see where the hotspots were, Zohab said.
Police would work their sources to find out about who was selling the drugs, while also following up individuals who had been brought back from an overdose.
“We’d knock on their door and say here are some treatment providers. If you want some help we can get you into treatment. In addition, resources were given to support people at that residence to get Narcan training,” Zohab said.
That kind of community interaction was quickly and positively embraced by citizens and the police officers on the street. Narcotics detectives were used to make the follow-up visits.
“Our narcotics detectives started embracing it. Cops want to help people and for years this was a very frustrating population to deal with. As we walked down this path, we had something to offer, some treatment options” he said.
Prosecution is still an option
In addition to locating possible drug sources for investigation, other criminal cases are made, although arrests are not a primary goal.
“Nobody wanted arrests even though trace amounts could warrant a felony charge,” said Zohab. “We were making a concerted effort not to arrest accidental overdoses. These people need to be put into treatment outside of incarceration rather than inside.”
He added that the prosecutor’s office, law enforcement and other first responders are all on the same page.
Has the approach worked?
Evidence indicates maybe so, but the collaborative approach is helping to be ready for the next wave of drug to hit.
The group did not see an increase in overdoses in 2016 to 2017 and in fact, numbers are trending down in 2017 to 2018.
“We are seeing more stimulant drugs coming back and we’re able to get a handle on that because we have our finger on the pulse. The stakeholders are already starting to change their strategies to include stimulants,” Zohab said.
Leadership through information and partnerships
The necessary ingredient to create the foundation for creative responses like the Richmond community is exploring is data. Discovering facts and trends derived from mining existing sources depends on technology. Relationships depend on visionary leadership.
About the Author
Joel Shults operates Street Smart Training and is the founder of the National Center for Police Advocacy. He retired as chief of police in Colorado. Over his 30-year career in law enforcement and criminal justice education, Joel served in a variety of roles, including academy instructor, police chaplain, deputy coroner, community relations officer and police chief. In addition to service with the U.S. Army military police and CID, Shults has done observational studies with over 50 police agencies across the country.