Law enforcement is at the front lines of the opioid crisis in America with at least 70,000 overdose deaths a year, two-thirds caused by illicit and prescription opioids. It’s now the leading cause of death for Americans under 50 years of age. Even with recent crackdowns and prescribing guideline changes for opioid medications, heroin and fentanyl are still the biggest culprits of overdose deaths as people turn to street drugs now that they cannot easily obtain prescription opioids. Most often, police are the first to overdose scenes; unfortunately, it’s often too late to help revive the victim. They’re witnessing the daily effects of how this drug is ravaging entire communities while also having to enforce the law as these drugs are most often being illegally sold, bought, and manufactured.
Though internationally some countries have decriminalized drugs in an attempt to help ease drug-related crime and overdose deaths, and treat addiction as a disease, this kind of legislation has yet to be genuinely touched on by the DEA and federal US laws. However, law enforcement is beginning to make changes locally to help people in their communities who are struggling with substance use disorder. The alarming number of opioid-related crimes and deaths has started to shine the light on incarcerating people who should really be getting help with their addictions. In fact, most recently, a federal court ruled that jails are required to give inmates addiction treatment. This is just one hopeful step towards getting a handle on the opioid crisis, particularly of incarcerated people, as 12% admited to habitual opioid use in 2014.
Arthur C. Evans, Jr. Ph.D., CEO of the American Psychological Association asserted, “We cannot arrest our way out of America’s opioid crisis.” It’s become clear that the opioid problem isn’t a criminal, but a medical one. In fact, the term opioid “epidemic” isn’t hyperbole; it’s actually a fitting definition considering it is an outbreak of disease (addiction) that spreads rapidly and affects many people. This is forcing lawmakers and the criminal justice system to reassess their handlings of drug-related crimes, especially opioids, and rethinking whether substance use disorder is truly a moral and criminal issue or an illness that must be treated instead of punished.
Law Enforcement Initiatives
Police officers aren’t just upholders of the law; they are active members of the communities they serve and protect. That’s why many districts across the country are making efforts to help people who have substance use disorder seek treatment and avoid lengthy jail time. By taking on these 10 new standards, officials hope to get a grip on the opioid crisis to potentially prevent future overdose deaths and address the dynamic aspects of incarceration of those with addiction.
- Focus on overdose deaths. Before opioid addiction can be tackled as a whole, preventing opioid overdose deaths should be at the forefront of any initiatives to help communities that have been ravaged by drugs. Working with public safety authorities, law enforcement can get a step ahead by collecting data on where overdose deaths occur most and what specific groups are impacted at the highest rate. With the collaboration of other public health groups, police can create a system to help stop overdoses before they happen without their efforts being driven by the incentive to arrest users and put them in jail.
- Naloxone. This drug was created to serve as the antidote for opioid overdose. Considering that police are one of the first responders to a scene where overdose happens, they should all be properly trained to administer Naloxone to potentially help stop an active overdose. Many districts already have officers carrying Naloxone on their persons and receive regular training updates and tips on how to spot and successfully revive someone who is overdosing. This antidote is also a life-saver for law enforcement that is regularly in contact with drug confiscations as only a tiny amount of fentanyl can prove fatal to those who unexpectedly come into contact with it. Similarly, it’s crucial for law enforcement to encourage members of the community to have Naloxone available to help those who continue to use, both loved ones and strangers they may encounter.
- Addiction education. The science behind substance use disorder has advanced significantly over the past 20 years, especially since the rapid increase of opioid misuse and addiction in the early 2000s. Using their authority, law enforcement should be educating their communities about addiction, and the way drugs can impact someone’s brain and central reward system. This kind of information can help dispel myths about addiction and reduce the stigma around it as well. In turn, this could eventually encourage those who are battling addiction to seek help and treatment, as they’re no longer ashamed to admit that they’re sick, not criminals.
- Treatment referrals. The alarming incarceration rates of people with opioid use disorder continue to climb, so an alternative method is needed. Some departments are looking to help those who are struggling with opioid addiction and send them to proper treatment that uses FDA-approved opioid addiction medications. In fact, people can also go to the station to turn themselves in along with their drugs to be taken directly into treatment with the help of an officer. This is an excellent alternative to locking up people with a disease that inhibits them from stopping the use of drugs on their own. Other departments also conduct open street-level outreach programs available to those who are too afraid or unable to get themselves to the station. Police treatment referrals are hoping to reduce rates of recidivism and get people the help they need for their addiction.
- Treatment access “on demand.” Walking into a methadone clinic and asking for help is much easier said than done. For people who have been using opioids for years, their addiction is engrained into their daily lives and the way the drugs affect their brains makes it difficult to take that life-changing step. Even for people who were once in treatment and relapsed, the second or third attempts can be even more difficult than the first. Plagued by guilt and shame, people should have easier access to addiction treatment that doesn’t involve having to only go to an addiction clinic. Expanding the availability of opioid addiction treatment with FDA-approved medicines both directly and indirectly can help communities reduce overdose rates as a whole.
- Treatment during incarceration. Though considerable efforts to give addicted incarcerated individuals access to treatment have been recently made on a federal level, not all departments and factions of the justice system make it easy for inmates to get the help they need because of the high rates of opioid treatment medication being smuggled inside of correctional facilities. Even for people being released from their sentences, the overdose rates are high as they return to their previous dose of opioids after being unable to use for some time, often overestimating their ability to handle it. This causes numerous overdoses. Access to treatment after incarceration can be used as an incentive and as a benefit for all people institutionalized who have substance use disorder.
- Outbreak prevention. Intravenous opioid use like heroin also poses additional health risks to users because of the trend of needle sharing or the reuse of unsanitary needles. Hepatitis and HIV are just two diseases that have been closely related to this type of drug use and can threaten entire communities quickly. Some areas have proposed the idea of needle exchanges to help control the spread of these illnesses and to keep used needles out of children’s parks and other public areas where unsuspecting people may stumble upon them and stick themselves. These needle exchange areas are also part of an ongoing discussion of safe site areas where people can go to use drugs and inject with clean needles with nearby supervision without any legal consequences. This concept is still highly debated across the globe though centers in the Pacific Northwest are continuing to push the option, along with access to treatment for users who attend.
- Fentanyl detection. Fentanyl has found its way into many different illicit street drugs, and at 100 times more potency than morphine, contact with even a tiny amount can cause someone to overdose. Allowing drug users to test their drugs for the substance can significantly reduce cases of overdose while also making illicit drug manufacturers more accountable for the product they are putting on the streets. Some may see this initiative as condoning drug use, but it’s really a form of harm reduction. While law enforcement cannot completely stop people from using drugs, they can help prevent needless overdose deaths of people who unknowingly are ingesting lethal doses of fentanyl. Not to mention, this could help put sellers and drug makers behind bars, since they are the ones actively promoting the opioid epidemic and profiting from it.
- Innovation. The continual research and exploration of overdose harm prevention through the creation of safe injection spaces, or overdose prevention sites, is essential. Not only will these sites prevent overdoses, but they can also help stop the spread of infectious diseases between users and the public who come across used needles in public places. Research has shown that these places can eventually lead to many people receiving effective opioid treatment instead of continuing to use with access to help in the same locations. Much of the pushback on these sites comes from moral standards that are deeply rooted in outdated approaches towards drugs, addiction, and treatment of those with substance use disorder. The change will have to happen somewhere, and law enforcement has significantly more experience with addiction and those who are directly suffering from the opioid epidemic than policymakers who are deciding what to pass into law. With these initiatives, actual change is possible.
- Good Samaritan laws. These laws are necessary to protect people who are acting with good intent to help someone who is experiencing an overdose or in a situation where drugs are involved. Many people are able and want to help, but are scared that they may be arrested and punished for their good deed. Departments that enact protection for these instances and support Good Samaritan laws can encourage people in the community to help those who sincerely need it. Again, this shift in paradigm is to show that police understand that addiction is a disease and the people who are dealing with substance use disorder need medical intervention, not jail time, and least of all, the people who are wanting to help but have found themselves in the wrong place at the wrong time.
With law enforcement teaming up with public health officials and addiction science researchers, something monumental can be achieved. These 10 standards of care are just the beginning of what can be the remedy for the distressing opioid epidemic that has affected communities in every single state of the country. If departments begin to explore these concepts and amend their handling of people with substance use disorder and those who are regularly running into the law due to their drug use, more attention can be focused on the disease and its treatment. It’s time we stop seeing people who are battling chronic illness as criminals and more as people who are in need of treatment and support.
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